…in which the patient reaches hospital early. The benefit of both methods falls steeply with the time since ingestion, and both can harm the patient…

…activity. When the alcohol level suddenly falls, the compensatory excitation remains, producing tremor, sympathetic activation, hallucinations, seizures and delirium [1,6]. Repeated withdrawal episodes can…

…too large for the available cuffs, and in a patient who does not tolerate repeated compression (for example marked thrombocytopenia). Set up and instructions Choose…

…and the incidence is particularly high after hip fracture, major surgery and intensive care [1,2]. The condition is associated with falls, aspiration, pressure sores…

…In heavy smokers, cardiovascular risk falls within five years of stopping but may remain elevated thereafter. The overall health benefit is greater still when reductions…

…needed around the clock. A continuous infusion or repeated doses, according to the local protocol Renal failure The insulin requirement falls . Reduce the dose and…

…hypertension is not made on a single reading. It requires repeated measurements on at least two occasions, and preferably confirmation by home measurement or 24…

…Reassess speech, work of breathing, level of consciousness and air entry repeatedly. 9. Measure PEF or FEV1 if the patient can manage it without delaying…

…is highly likely, antibiotics must be given immediately [3]. This quick reference applies chiefly to adults with neutropenia related to cancer treatment. Children, pregnant women…

…claudication, the ankle pressure is measured immediately after treadmill walking or after repeated heel raises. A fall of ≥ 20 % after exercise confirms peripheral arterial disease…

…block, Mobitz I (Wenckebach): repeated episodes with progressive lengthening of the PR interval until an atrial beat is blocked (the QRS complex fails to appear)…

…and a postictal state. 3. Check a repeat plasma sodium if the result is unexpected or does not fit the clinical picture. 4. Where possible…

…major vascular bleed. Perioperative bleeding that rapidly fills the suction, the swabs or the operative field and requires repeated units of red cells. Gastrointestinal bleeding…

…oliguria a rising lactate or metabolic acidosis repeated fresh haematemesis haematochezia in combination with circulatory compromise a rapidly falling haemoglobin after fluid treatment has been…

…also prevent ischemia from occurring during exercise stress testing, which leads to false negative stress tests. Studies have shown that if the myocardium obtains 30…

…is logarithmically related to T4 — a small change in T4 produces a large change in TSH. During acute illness the TSH can be falsely low…

…with haemodynamic compromise, whatever the current haemoglobin — haemoglobin falls late in acute haemorrhage and a normal value does not exclude significant blood loss. Massive haemorrhage…

…functional capacity, and health related quality of life substantially influence both cardiovascular risk and the balance between treatment benefit and harm. Prevention in the very…

…kidney function declines and as albuminuria increases. When eGFR falls below approximately 60–75 mL/min/1.73 m², the probability of coronary artery disease…

…at initiation or during routine therapy. Potential clinically important complications and treatment related syndromes include: Hypovolaemia Falls and syncope, particularly in older adults Euglycaemic diabetic…

Myocardial ischemia and infarction Definition and pathophysiology Periprocedural myocardial infarction (MI) is myocardial necrosis temporally related to coronary revascularization. It may follow percutaneous coronary intervention…

…and PAU for about 5%; reported proportions vary by population and region. Intramural haematoma IMH is haemorrhage within the aortic media without an identifiable communication…

…and Pathophysiological Basis High sensitivity cardiac troponin (hs cTn) assays detect circulating troponin released from injured cardiomyocytes at substantially lower concentrations than earlier generation assays…

…of ischaemic symptoms. The immediate pathophysiological objective is restoration of blood flow to the infarct related myocardial territory and limitation of infarct size. The extent…

…myocardial injury occurring in the context of a mismatch between myocardial oxygen supply and demand, which is not related to acute coronary atherothrombosis. By definition…

…the same time. 6. Measure the glucose again after 10 to 15 minutes and repeat treatment until the patient has recovered. 7. Follow up with…

…media. Blood then propagates along the wall, creating a true lumen and a false lumen separated by an intimal flap. Propagation may be antegrade or…

…tear commonly develops at the interface between infarcted and viable myocardium. The incidence has fallen substantially with contemporary reperfusion, particularly primary percutaneous coronary intervention (PCI)…

…May be palpable despite ischaemia ABI 0.9 < 0.9 Often falsely high Contraindications to compression The ankle brachial index measured with Doppler determines…

…trauma. Postoperative pain. Cancer related pain and pain in the palliative phase. Severe breathlessness in the palliative phase (at lower doses than for pain). An…

…according to the fourth universal definition of MI. Type 1 MI is generally related to an atherothrombotic event, whereas Types 2–5 MI have other…

…pressure responses to exercise Detection of exercise induced arrhythmias Identification of exercise related ST segment changes Prognostic and risk stratification information Assessment of response to…

…the 99th percentile upper reference limit (URL). The injury is considered acute if there is a documented rise and/or fall of cTn values. However…

…multivessel coronary artery disease, and diffuse disease increase the likelihood of cardiovascular collapse when PCI fails or flow is severely compromised. Clinical Presentation No reflow…

…upper reference limit (URL). It is considered acute when there is a rise and/or fall in cTn values. An elevated cTn alone does not…

…failure to capture should be distinguished: Genuine failure to capture occurs when a stimulus that is expected to result in activation fails to do so…

…cTnI is the most cardiac specific biomarker. Troponin T (cTnT) is cardiac specific but the cTnT assays also detect proteins released from skeletal muscle. Consequently…

…As evident in Figure 1, 15 O water is the only tracer with myocardial uptake linearly related to coronary blood flow. 15 O Water is…

…resting full cycle ratio [RFR], and related resting indices) simplified the procedure by removing the need for pharmacologic hyperemia, and angiography derived indices (quantitative flow…

…the ECG, this is observed as a gradual prolongation of the PR interval with each successive beat until a P wave fails to conduct, resulting…

…clinical presentation of VT, with a deep dive into the underlying etiologies ranging from benign idiopathic variants to complex scar related and genetic substrates. Furthermore…

…creatinine. Limitations of creatinine and urine output Creatinine is a late marker of function and may rise only after a substantial fall in glomerular filtration…

…or a need for a vasopressor After initial stabilisation Repeat the lactate if it was raised and follow the trend together with the clinical perfusion…

…be given as steroid cover during the test Oestrogen and the combined oral contraceptive These raise cortisol binding globulin and can give falsely normal values…

…HIT): False negative results in platelet function tests (including HIPA test) for HIT have been reported in patients taking ticagrelor. This is related to ticagrelor…

…In fact, studies have shown that LBBB is the most common cause of false activations of the catheterization laboratory. LBBB may mask (conceal) ongoing ischemia…

…repeated after 5–10 min as needed Halve the dose in older people and in renal failure Morphine PO 5–10 mg as needed The…

…seizure lasting at least 5 minutes, or repeated generalised tonic clonic seizures without the patient regaining consciousness between them. Five minutes is the practical threshold…

…termination of ventricular tachycardia. ECG 5 . Polymorphic ventricular tachycardia, self terminating. ECG 6 . Repeated runs of ventricular tachycardia. ECG 7 . Continued ventricular ectopy and VT.

…Three short bursts of ventricular tachycardia occur. ECG 3. Repeated bursts of VT. ECG 4. There are now visible ST segment elevations and Q waves…

…troponin. If clinical suspicion persists despite an initially non diagnostic ECG, the ECG must be repeated, particularly with ongoing or recurrent pain [1,3,4]…

…weakness rapidly progressive symptoms from several organ systems severe abdominal pain or repeated vomiting after probable allergen exposure sudden hypotension or severe bronchospasm during anaesthesia…

…intracerebral haemorrhage, after cardiac arrest. Repeated blood gases, for example during mechanical ventilation or severe metabolic derangement. Major surgery with expected blood loss or large…

…catheter). Measurement of central venous pressure and central venous oxygen saturation. Repeated blood sampling during intensive care. Exhausted peripheral venous access during prolonged intravenous therapy…

…to the local protocol. Usually a bolus followed by repeated doses or an infusion Suspected adrenal crisis Give the corticosteroid immediately. Do not wait for…

…DKA and HHS are dynamic conditions. Treatment must be guided by the clinical response and by repeated laboratory measurements, not by the values on admission…

…as a triage test on the same liquid based sample when the HPV test is positive — the sample therefore does not need to be repeated…

…monitoring. Fluid where hypovolaemia is likely, but avoid repeated blind boluses in cardiogenic toxic shock D Plasma glucose immediately. Assess the level of consciousness, the…

…min. Maximum infusion dose: 300 μg/kg/min. Bolus doses of 300 μg/kg can be repeated during infusion. Adverse effects Flushing. Nausea…

…minutes Duration of action 2 to 4 hours Delivery IV Dose Can be given as repeated intravenous bolus injections or as a constant dose infusion…