…with hemodynamic effects is a potentially life threatening condition and should be managed urgently. The risk of cardiogenic shock and cardiac arrest is high and…

…ceiling of care. Signs of a serious condition Finding Significance : : Inability to speak in full sentences Marked work of breathing Use of accessory respiratory muscles…

…Alcohol withdrawal occurs after an abrupt reduction or cessation of prolonged and heavy alcohol intake. The condition can develop despite a measurable or high blood…

…condition may be transient. Pericardiotomy can be curative, which is why it is important to detect the disease early in the course. Hemodynamic effects of…

…Relative — avoid forced manoeuvres An ongoing respiratory infection with a risk of transmission Until symptom free Haemoptysis of unclear cause Until investigated Relative obstacles also…

…with the principles of hemodynamics and conditions prevailing on the right side. Echocardiography is the first choice for assessing the right side of the heart…

…respiratory or circulatory compromise despite two adequate intramuscular doses of adrenaline and initial fluid treatment Adrenaline infusion and advanced resuscitation in a monitored setting The…

…failure where high flow nasal oxygen is insufficient and the carbon dioxide is normal. Bilevel NIV: Acute exacerbation of COPD with respiratory acidosis , that is…

… this non atherosclerotic condition may occur especially in young women. Non coronary mechanisms that reduce oxygen supply include severe bradyarrhythmia, respiratory failure with severe hypoxaemia…

…sample. Indications Diagnostic paracentesis: Newly detected ascites — always. Every admission of a patient with known ascites. Clinical deterioration in a cirrhotic patient with ascites: fever…

…disorientation, agitation, drowsiness or a reduced GCS Respiration A respiratory rate of at least 22/min, increased work of breathing, a new oxygen requirement, a…

…gas is needed mainly when concomitant respiratory failure or an exact assessment of oxygenation requires it [3]. Calculation of osmolality Use the same formula throughout…

…grade alone does not indicate how acute the condition is. A patient with a chronic plasma sodium of 112 mmol/L may be relatively unaffected…

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…

…Respiratory conditions : Tension pneumothorax Drowning Airway obstruction Hanging Pneumonia High altitude sickness Aspiration Chronic obstructive pulmonary disease (COPD) Bronchospasm (asthma) Other : Coma Central hypoventilation syndromes…

…not exclude Diastolic collapse of the right atrium and right ventricle The cardinal echocardiographic finding A dilated inferior vena cava without respiratory variation Strongly suggests…

…crisis. Contraindications There are no absolute contraindications in hypoxaemia. Take particular care in: A risk of hypercapnic respiratory failure — COPD, severe obesity with hypoventilation, neuromuscular…

…with respiratory disorders, notably obstructive sleep apnoea (OSA) and obesity hypoventilation syndrome, which further increase cardiovascular burden. Obesity may be a particularly important cause of…

…Respiratory rate and oxygenation Evidence of systemic congestion or acute RV failure Syncope or altered clinical status Comorbid cardiopulmonary disease, active cancer, and other conditions…

… the risk of bronchospasm is real. Hypotension and haemodynamic instability. Respiratory compromise during an ongoing crisis. Distinguish the conditions instead by temporarily withdrawing the cholinesterase…

…Myocardial injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated…

…NNT) Basic life support (BLS) includes rapid recognition and treatment of life threatening conditions or injuries, including cardiac arrest, drowning, trauma, asphyxia and respiratory arrest…

…increased respiratory rate and depth, increased sweating, and muscle fatigue. Although this is a subjective measure, it provides a fairly good estimate of the actual…

…R waves: R wave ≥0,04 s in V1 V2 and R/S ratio ≥1 with concordant positive T wave in absence of conduction defect…

…Figure 1. Sinus arrhythmia (respiratory sinus arrhythmia). Treatment of sinus arrhythmia Sinus arrhythmia is a normal finding among young and healthy individuals. It is generally…

…refers to the measurement of end tidal carbon dioxide (ETCO 2 ) in the respiratory system. ETCO 2 is the partial pressure of carbon dioxide (CO…

…and dynamic hyperinflation. The consequences are increased work of breathing, exhaustion and, in the most severe cases, hypotension, pneumothorax and respiratory arrest [1]. The first…

…or severe respiratory failure. A peripheral venous blood gas is easier to obtain and can often be used for an initial assessment of pH and…

…a non pregnant adult of normal weight, and individual assessment. See the separate quick reference for dosing in impaired renal function. Respiratory tract Diagnosis Agent…

…non invasive ventilation. Inadequate ventilation with a rising pCO₂ and respiratory acidosis, or a markedly increased work of breathing with impending exhaustion. Threatened airway obstruction…

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

…Sedation precedes respiratory depression and is the early warning sign. Choice of agent Situation Choice Reason : : : An opioid naive adult with normal renal function Morphine…

…failure, heart failure, a history of peptic ulcer, and old age Titrate according to the effect and the respiratory rate, not to a schedule. Always…

…needed. Intubate for a threatened airway, a marked risk of aspiration, or failure that is not rapidly reversed by an antidote B Respiratory rate, saturation…

…a rapid assessment of the airway is paramount to evaluate for impending respiratory compromise. Diagnostics The diagnosis of ACE inhibitor induced cough is primarily clinical…

…other viral respiratory infections. However, in some individuals the infection may be severe and deadly. Importantly, COVID 19 has caused an unprecedented number of severe…

…while the remainder manifest ventricular fibrillation (VF) or asystole ( Ebo et al ). Clinical manifestations of anaphylaxis Nervousness, anxiety. Dermatological: Pruritus Urticaria Respiratory: Dyspnea Bronchospasm, stridor…

…injuries, hemodynamic and respiratory instability, multiorgan failure, infections, seizures and temperature management. The ICU is the preferred level of care for the absolute majority. The…

…to assist in cases of cardiac or respiratory failure by means of an extracorporeal pump and oxygenator. ECMO (Extracorporeal Membrane Oxygenation) , a type of ECLS…

…Choose a point with at least 15 mm depth of fluid throughout the respiratory cycle and where the lung does not come up against the…

…Respiratory complications occur, but untreated convulsive status itself carries a considerable risk of hypoxia and respiratory failure. In placebo controlled trials, respiratory depression was no…

…is reasonable in: a reduced level of consciousness with inadequate protective reflexes active major haematemesis severe agitation respiratory failure an anticipated difficult or prolonged endoscopic…

…permits delineation of the coronary lumen. Coronary imaging is technically demanding because the vessels are small and are subject to both cardiac and respiratory motion…

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

…acute myocardial injury without having an infarction. The degree of troponin elevation does not by itself establish the mechanism. Increased concentrations may result from acute…

…spasm, microvascular dysfunction, embolism, dissection, hypotension or shock, respiratory failure, severe anaemia, sustained bradyarrhythmia, tachyarrhythmia, or severe hypertension with or without left ventricular hypertrophy. Among…

CPR Cardiac arrest is a result of tachyarrhythmia, bradyarrhythmia or asystole. The tachyarrhythmias include ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT). The bradyarrhythmias include…

…mmol/L Seizures, coma, respiratory arrest, brainstem herniation and death. Table 2. Grading of hyponatremia. Hypernatremia Hypernatremia does not cause cardiac arrest. Calcium imbalance Hypercalcemia…

…node. Thus, withdrawal of parasympathetic activity results in increased heart rate and increased impulse transmission across the AV node. Sympathetic fibers innervate the entire heart…

…Treatment of the underlying cause should resolve the sinus tachycardia. Sinus arrhythmia Sinus arrhythmia (respiratory sinus arrhythmia) fulfills all criteria for sinus rhythm except for…