…mean that alveolar ventilation is already failing. A raised pCO₂, respiratory acidosis, a falling pH or a rising trend indicate exhaustion and impending respiratory arrest…

…of hypoxia and respiratory failure. In placebo controlled trials, respiratory depression was no more common — and sometimes less common — after a benzodiazepine than with continued…

…VF) and pulseless ventricular tachycardia (VT). The bradyarrhythmias include all bradyarrhythmias, pulse less electrical activity (PEA), and asystole. Bradyarrhythmias are discussed in the chapter Management…

…two mechanisms that kill patients during airway management , and both are predictable. Indications Inability to protect the airway: reduced level of consciousness, loss of pharyngeal…

…respiratory distress. In patients with HFpEF, acute hypertension is a frequent trigger of decompensation and may produce abrupt pulmonary oedema, sometimes requiring non invasive ventilation…

…insufficient and the carbon dioxide is normal. Bilevel NIV: Acute exacerbation of COPD with respiratory acidosis , that is, a pH below 7.35 and a…

…respiratory system. ETCO 2 is the partial pressure of carbon dioxide (CO 2 ) at the end of expiration. It provides an integrated view of ventilation…

CPR Hypoxia and asphyxiation Hypoxia refers to a reduced partial pressure of oxygen in the blood. Asphyxia is characterized by insufficient ventilation, leading to hypoxia…

…respiratory acidosis, if invasive ventilation is not immediately required. 8. Document the ceiling of care and the decision on intubation early. Initial assessment Confirm that…

…last intake Common clinical picture : : 4 to 12 hours Tremor, sweating, anxiety, insomnia, tachycardia, hypertension, headache, nausea and vomiting 8 to 24 hours Alcoholic hallucinosis…

…a primary metabolic disturbance within minutes by changing ventilation. Renal compensation for a primary respiratory disturbance, by contrast, develops over hours to days [1,2]…

…asthma. Severity in COPD Arterial blood gas Type 1 respiratory failure: PaO₂ < 8 kPa with a normal or low PaCO₂ — a problem of oxygenation…

…which demonstrates that the majority of patients will not survive post resuscitation care. Among those who survive to hospitalization, 50 65% die within 24 hours …

…Contracting muscles function as a pump that propels blood back to the heart. The respiratory depth (volume) increases and this reduces the intrathoracic pressure by…

…The nasal cannula, the simple mask and the reservoir mask deliver an FiO2 that varies with the patient's minute ventilation: a markedly hyperventilating pati

…degrees — the fluid then collects anteriorly and inferiorly, which makes it easier to reach subxiphoid. Avoid sedation and positive pressure ventilation before decompression where possible…

…ventilation, airway protection, the expected course and the possibility of rapid reversal with an antidote. Intubation is recommended for neurological, respiratory or haemodynamic failure that…

…in chest trauma and postoperatively. Emergency needle decompression: a clinical suspicion of tension pneumothorax in a haemodynamically or respiratorily unstable patient. Contraindications In tension pneumothorax…

…If an intervention has an NNT of 10, then 10 people must be treated to save 1. Number Needed to Treat (NNT) Basic life support…

…arrhythmia and respiratory sinus arrhythmia both refer to the same phenomenon. Sinus arrhythmia fulfill all criteria for sinus rhythm except from the fact that the…

Cardiology Respiratory medicine Definition and Pathophysiology Pulmonary hypertension (PH) is a heterogeneous pathophysiological disorder characterized primarily by elevation of pulmonary arterial pressure. It may arise…

Akutsjukvård Lathundar Basic principle Anaphylaxis is a rapidly developing systemic hypersensitivity reaction that can cause life threatening compromise of the airway, breathing or circulation. Skin…

…the separate quick reference for dosing in impaired renal function. Respiratory tract Diagnosis Agent Dose Duration : : : : Pneumonia, non severe (DS CRB65 0–1) phenoxymethylpenicillin 1…

… avoid morphine Morphine has an active renally excreted metabolite that causes late sedation and respiratory depression Marked liver failure A reduced dose of all of…

…have no place in acute, unstable pain: the onset takes 12 to 24 hours and the offset just as long. Breakthrough dose During ongoing opioid…

…peritonitis or pancreatic ascites. Therapeutic paracentesis: Tense ascites with abdominal discomfort, early satiety or respiratory compromise. Diuretic refractory or diuretic intolerant ascites, as recurrent treatment…

…ongoing respiratory infection with a risk of transmission Until symptom free Haemoptysis of unclear cause Until investigated Relative obstacles also include dementia, marked hearing loss…

…the respiratory tract. This process is not dose dependent. Similarly, angioedema occurring in the setting of ACE inhibitor therapy is bradykinin mediated rather than mast…

…Data on the natural history of COVID 19 relies on small samples of hospitalized patients. Most reports have suggested that comorbidities – e.g. cardiovascular disease…

…coronary mechanisms that reduce oxygen supply include severe bradyarrhythmia, respiratory failure with severe hypoxaemia, severe anaemia, and hypotension or shock. Conversely, mechanisms that increase myocardial…

…Ebo et al ). Clinical manifestations of anaphylaxis Nervousness, anxiety. Dermatological: Pruritus Urticaria Respiratory: Dyspnea Bronchospasm, stridor, wheezing Hypoxia Life threatening edema involving the lips, tongue…

…with a worse prognosis than termination due to chest pain. Leg fatigue Leg fatigue is particularly pronounced on bicycle, and less pronounced on the treadmill…

…Life Support (ECLS) encompasses several extracorporeal systems designed to assist in cases of cardiac or respiratory failure by means of an extracorporeal pump and oxygenator…

…in bradycardia (Figure 1). Cardiac output and blood pressure, rather than ECG, are the strongest predictors of adverse outcomes. Non acute or asymptomatic bradycardia Non…

…quick reference is intended primarily for adults and summarises the order in which measures are taken and the principles that are common to all protocols…

…cholinesterase inhibitor: the effect appears within less than a minute and has gone after 5–10 minutes. That makes the test useful only if you…

…Duration Definition : : Acute Documented development within less than 48 hours Chronic At least 48 hours Unknown Treated as chronic with respect to the correction limits…

…must be given within three hours. The evidence for an absolute one hour requirement is clearest in septic shock and less certain in sepsis without…

…intestinal transit. Coffee ground vomiting is less specific than fresh haematemesis and can also be seen when the bleeding is slow or has stopped. The…

…the extent of circulatory compromise. Features associated with an unfavourable short term prognosis include: Tachycardia Low systolic blood pressure Respiratory insufficiency, manifested by tachypnoea and…

Emergency medicine Myocardial ischemia and infarction Definition and Clinical Framework Chest pain is a broad clinical syndrome rather than a narrowly defined symptom. It includes…

…coronary, pulmonary, and aortic angiography can achieve less than 5 mSv in appropriate settings. Clinical Presentation and Indications CCTA is relevant to several clinical presentations…

…myocardial infarction. Cardiac troponin identifies injury to myocardial cells, but infarction requires additional clinical evidence that the injury resulted from acute myocardial ischaemia. Thus, a…

…respiratory, metabolic, musculoskeletal and psychological complications. Symptoms and conditions that should prompt assessment include: Hypertension Dyspnoea Exercise intolerance Congestive HF CAD Palpitations or suspected atrial…

…are less likely to cause STEMI because collateral vessels may develop over time. By contrast, an acute thrombus may form at a site that was…

…syndrome (ODS). It is therefore recommended to raise serum sodium by a maximum 8 mEq/L in the first 24 hours. Hyponatremia of unknown duration…

…is explained by the fact that high pressure in the right atrium leads to a decrease in atrial filling. Respiratory variations in E wave velocity…

…and deeper than normally occurring Q waves, and they are referred to as pathological Q waves. They typically emerge between 6 and 16 hours after…

…tachycardia. Sinus arrhythmia Sinus arrhythmia (respiratory sinus arrhythmia) fulfills all criteria for sinus rhythm except for the fact that the rhythm is slightly irregular. The…

…the presence of right ventricular load. This condition implies that the right ventricle is pressure and/or volume loaded. The load itself leads to impaired…