…of hospital cardiac arrest due to external causes ( Kitamura et al). References DeBehnke DJ, Hilander SJ, Dobler DW, Wickman LL, Swart GL. The hemodynamic and…

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…

…relatively difficult to examine, which is due to the location of the ventricle in the thorax. It is localized immediately behind the sternum and thus…

…is characterised by myocyte necrosis and troponin elevation due to mechanisms other than myocardial ischaemia. Acute myocardial injury may arise from conditions such as sepsis…

…the condition is. A patient with a chronic plasma sodium of 112 mmol/L may be relatively unaffected, while a rapid fall from 140 to…

…nitrogen out of the pleural air and speeds resorption. Other conditions in which high flow oxygen is given irrespective of the saturation according to international…

…liver, lung or vessel lies in the path of the needle. Access Puncture site Direction Comment : : : : Subxiphoid 1–2 cm below and to the left

…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…

…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…

…response and by repeated laboratory measurements, not by the values on admission alone. Diagnosis Current diagnostic criteria According to the international consensus report of 2024…

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

… 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…

…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…

…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…

…This leads to increased and equivalent diastolic pressure in all rooms. Because pressure is high in the atria, filling of the ventricles occurs fast at…

Cardiology Diagnosis and treatment of bradycardia (bradyarrhythmia) Acute bradycardia with hemodynamic instability Acute bradycardia with hemodynamic effects is a potentially life threatening condition and should…

…compromise of the airway, breathing or circulation. Skin symptoms may be absent, and circulatory shock does not have to be present for the condition to…

…lateral to the rectus sheath, and a cell count plus albumin on the sample. Indications Diagnostic paracentesis: Newly detected ascites — always. Every admission of a…

…chest findings, MAP and the response to every intervention Within 60 min Contact intensive care in shock, rapidly progressive organ dysfunction, respiratory failure, impaired consciousness…

…or COPD — diagnosis and follow up. Risk groups: current or former smokers over 40 with respiratory symptoms, and occupational exposure to dust, gas or fumes…

…cancer and previous venous thromboembolism. A documented decision on the ceiling of care. Signs of a serious condition Finding Significance : : Inability to speak in full…

…method and settings Condition Method Starting pressure Escalation Oxygen target : : : : : Cardiogenic pulmonary oedema CPAP 5–7.5 cmH₂O Increase in steps of 2.5 to…

Arrhythmias and arrhythmology ECG Definition of sinus arrhythmia (respiratory sinus arrhythmia) Sinus arrhythmia and respiratory sinus arrhythmia both refer to the same phenomenon. Sinus arrhythmia…

…an integrated view of ventilation , metabolism , and perfusion . Carbon dioxide, a byproduct of aerobic metabolism, is transported from the tissues back to the lungs where…

…or unable to speak Position and behaviour Can lie down or sit Often sits leaning forward, anxious Confusion, reduced consciousness or marked stillness Respiratory rate…

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

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

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

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

…to taper off, not to increase the dose. Contraindications Ongoing respiratory depression, or untreated severe respiratory failure without the possibility of monitoring. Paralytic ileus and…

…to total body weight Concomitant benzodiazepine A markedly increased risk of respiratory depression. Avoid the combination, or reduce both Red flags and pitfalls A respiratory…

…the expected course and the possibility of rapid reversal with an antidote. Intubation is recommended for neurological, respiratory or haemodynamic failure that cannot be corrected…

…transient swelling of the subcutaneous or submucosal tissues, most frequently involving the face, lips, tongue, and upper airway. Due to the risk of airway compromise…

…outcomes. The vast majority of infections with COVID 19 result in mild disease, with symptoms similar to seasonal flu (influenza) and other viral respiratory infections…

…1 2 mg of glucagon intravenously. Currently, there is insufficient evidence to support the use of steroids and antihistamines during cardiac arrest due to anaphylaxis.

…of patients should be managed in the ICU. Post resuscitation care requires expertise and resources to diagnose, monitor and manage neurological injuries, hemodynamic and respiratory…

…however, be distinguished from dyspnea which is shortness of breath. Dyspnea may be due to poor exercise capacity (with normal ventilatory capacity and cardiac output)…

…and is generally reserved for meticulously selected cases. Extracorporeal Life Support (ECLS) encompasses several extracorporeal systems designed to assist in cases of cardiac or respiratory…

…depth of fluid throughout the respiratory cycle and where the lung does not come up against the probe on inspiration. 3. Measure the skin to…

…to 20 minutes at the latest Give a full loading dose of an intravenous antiseizure drug If the seizure continues after adequate step 1 and…

…perfusion and the signs of shock 2 Two large bore peripheral cannulae. Consider an arterial line if the patient is unstable or frequent blood gases…

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

…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…

…rise and/or fall. A stable elevation indicates chronic myocardial injury . Myocardial injury is not synonymous with myocardial infarction. Cardiac troponin identifies injury to myocardial…

…bearing microparticles contribute to activation of coagulation. Plaque rupture is typically associated with a fibrin rich, red thrombus. The size and persistence of the thrombus…

…and therefore the worse the prognosis. This does not always hold true. For example, in cardiac arrest due to pulmonary embolism the initial rhythm is…

…acute pancreatitis, alkalosis due to hyperventilation, rhabdomyolysis (particularly the initial phase), sepsis, malignancies with osteoblastic metastases, diminished calcium absorption and/or enhanced calcium excretion, chronic…

…suggested that pathological Q waves may also arise due to extensive subendocardial infarction (NSTEMI). If pathological Q waves occur as a result of myocardial infarction…

…increases due to the fact that systolic blood pressure increases during exercise. The increase in cardiac output during moderate exercise is the result of increased…

…tone) and decreases during expiration (due to increased vagal tone). This results in a slightly irregular rhythm. Sinus arrhythmia occurs in the majority of healthy…