…that the the ventricle must overcome to pump blood out into the pulmonary artery. Resistance may increase in, for example, pulmonary hypertension or pulmonic stenosis…

…antidote. Intubation is recommended for neurological, respiratory or haemodynamic failure that cannot be corrected quickly. Rapid sequence induction is used when intubation is required [1]…

…where intubation has been judged not to be appropriate. Contraindications Respiratory arrest, agonal breathing or cardiac arrest — intubate. Inability to protect the airway: a reduced…

…team, not in your head. Functioning suction within reach under the pillow or by the right shoulder. A reservoir mask with a tight fitting seal…

…if you have selected an objectively measurable finding in advance — usually ptosis or fatigable gaze palsy — that can be assessed before and during the window…

…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…

…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…

…by myocardial ischemia (affecting the sinoatrial node), sinus node dysfunction or side effects of digoxin treatment. If the rhythm becomes completely regular when holding 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…

…end tidal carbon dioxide, ETCO2) Capnography refers to the measurement of end tidal carbon dioxide (ETCO 2 ) in the respiratory system. ETCO 2 is the…

…Central nervous system (CNS) injuries might cause apnea or hypoventilation. Respiratory conditions : Tension pneumothorax Drowning Airway obstruction Hanging Pneumonia High altitude sickness Aspiration Chronic obstructive…

…rigors and respiratory tract symptoms. Chest pain, haemoptysis, syncope and palpitations. Orthopnoea, weight gain and peripheral oedema. Previous hypercapnia, NIV or invasive ventilation. Home oxygen…

…respiratory arrest. A venous blood gas can give useful information about pH and the trend in carbon dioxide, but in critical illness, marked hypoxaemia, or…

…disturbance. 4. Monitoring at the appropriate level of care , with readiness for respiratory support. 5. Treatment of the alcohol use disorder and planned follow up …

…reactions in the lower grades and marked airway, respiratory or circulatory compromise in the higher ones [5]. For acute clinical use the following simplification can…

…gas is the reference method when the question concerns oxygenation, precise ventilation or severe respiratory failure. A peripheral venous blood gas is easier to obtain…

…Respiratory tract Diagnosis Agent Dose Duration : : : : Pneumonia, non severe (DS CRB65 0–1) phenoxymethylpenicillin 1 g × 3 PO 5–7 days or benzylpenicillin 3 g…

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

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

…both Red flags and pitfalls A respiratory rate < 8/min, or an increasing level of sedation , are signs of overdose. Sedation precedes respiratory depression…

…why, or the patient at risk of carbon dioxide retention is given 15 litres on a reservoir mask and drifts off into a respiratory acidosis…

…leucocytosis or acidosis. Suspected malignancy, tuberculous peritonitis or pancreatic ascites. Therapeutic paracentesis: Tense ascites with abdominal discomfort, early satiety or respiratory compromise. Diuretic refractory or…

…despite medical treatment. Diagnostic drainage in suspected purulent pericarditis, tuberculosis or malignancy. Tamponade is a clinical diagnosis supported by echocardiography: Finding Comment : : Hypotension, distended neck…

…1 month Neurosurgery or an intracranial aneurysm Contact the responsible specialist An aortic aneurysm 6 cm Relative — avoid forced manoeuvres An ongoing respiratory infection with…

…P. When ACE is inhibited, the resulting accumulation of these peptides irritates afferent neural pathways in the respiratory tract. This process is not dose dependent…

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

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

…anaphylactic cardiac arrests present with pulseless electrical activity (PEA) as the initial rhythm, while the remainder manifest ventricular fibrillation (VF) or asystole ( Ebo et al…

…coronary care unit (CCU), or catheterization laboratory. A 12 lead ECG must be obtained immediately after ROSC in order to identify cases with ST segment…

…It is based on the subjective physical sensations experienced during exercise, including increased heart rate, increased respiratory rate and depth, increased sweating, and muscle fatigue…

…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…

…young individuals. The severity of symptoms and presence of high risk arrhythmias on ECG guides the management of non acute or asymptomatic bradyarrhythmia. In patients…

…pH and bicarbonate. An arterial blood gas is needed mainly when concomitant respiratory failure or an exact assessment of oxygenation requires it [3]. Calculation of…

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

…respiratory failure, impaired consciousness, or a need for a vasopressor After initial stabilisation Repeat the lactate if it was raised and follow the trend together…

…consciousness with inadequate protective reflexes active major haematemesis severe agitation respiratory failure an anticipated difficult or prolonged endoscopic intervention a need for general anaesthesia for…

…of hypotension Heart rate and tachycardia Respiratory rate and oxygenation Evidence of systemic congestion or acute RV failure Syncope or altered clinical status Comorbid cardiopulmonary…

…abrupt chest pain and respiratory distress. Aortic dissection may cause sudden severe pain, often radiating to the back. Pericarditis may produce pleuritic or positional pain…

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

…may precipitate myocardial ischemia or infarction, acute heart failure, or pulmonary oedema. Patients may present with chest pain, severe breathlessness, hypoxaemia, rales, or respiratory distress…

…Examples Acute coronary atherothrombosis Plaque disruption or erosion with thrombosis Reduced myocardial perfusion Coronary spasm, microvascular dysfunction, coronary embolism, coronary dissection, hypotension, shock, respiratory failure…

…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…

…dissection, hypotension or shock, respiratory failure, severe anaemia, sustained bradyarrhythmia, tachyarrhythmia, or severe hypertension with or without left ventricular hypertrophy. Among patients with NSTE ACS…

…tachyarrhythmia, bradyarrhythmia or asystole. The tachyarrhythmias include ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT). The bradyarrhythmias include all bradyarrhythmias, pulse less electrical activity (PEA)…

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

…confusion, impaired reflexes. Severe <115 mmol/L Seizures, coma, respiratory arrest, brainstem herniation and death. Table 2. Grading of hyponatremia. Hypernatremia Hypernatremia does not cause…

…in the right atrium leads to a decrease in atrial filling. Respiratory variations in E wave velocity Under normal circumstances, intrathoracic pressure decreases during inhalation…

…respiratory Q wave, because its amplitude varies with respiration. Lead III may also display small Q waves (not related to respiration) in individuals with electrical…

…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…

…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…