…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…

…investigations. The emergency differential also reflects distinct mechanisms of acute cardiopulmonary disease: Pulmonary embolism and spontaneous pneumothorax may produce abrupt chest pain and respiratory distress…

…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…

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…

…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…

…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…

…without undue delay in persistent hypercapnic respiratory acidosis, if invasive ventilation is not immediately required. 8. Document the ceiling of care and the decision on…

…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…

…readiness for respiratory support. 5. Treatment of the alcohol use disorder and planned follow up , not merely detoxification. Benzodiazepines reduce the severity of withdrawal and…

…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…

…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…

…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…

…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…

…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…

…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…

…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…

…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…

…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…

…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…

…Type 2 myocardial infarction (MI) is defined as an ischaemic myocardial injury occurring in the context of a mismatch between myocardial oxygen supply and demand…

…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…

…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…

…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…

…Management of acute bradycardia in the emergency setting. Parameter Assessment A Airway Voice Breath sounds B Breathing Respiratory rate (12–20 / min) Chest wall movements…

…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…

…obstructive airways disease — relative; the risk of bronchospasm is real. Hypotension and haemodynamic instability. Respiratory compromise during an ongoing crisis. Distinguish the conditions instead by…

…Scale below 8 Vomiting together with clear neurological impairment Respiratory failure or respiratory arrest Clinical signs of raised intracranial pressure or impending herniation Moderately severe…

…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…

…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…

…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…

…focus on: Blood pressure and evidence of hypotension Heart rate and tachycardia Respiratory rate and oxygenation Evidence of systemic congestion or acute RV failure Syncope…

…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…

…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…

…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…

…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…

…the chin up. Does the person breathe? Look for respiratory signs for 10 seconds. Palpation of pulses : carotid, femoral or radial artery. According to current…

…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…

…thickened (about 80% have thickening). The parietal and visceral leaves of the pericardium are most often fused. The process most often affects the entire pericardium…

ECG Myocardial ischemia and infarction Pathological Q waves are evidence of myocardial infarction Myocardial infarction – particularly if extensive in size – typically manifests with pathological Q…

…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…

…estimation of atrial pressure. This is done by assessing the diameter of the vena cava inferior and whether the diameter varies during the respiratory cycle…