…al. The effects of calcium and sodium bicarbonate on severe hyperkalaemia during cardiopulmonary resuscitation: a retrospective cohort study of adult in hospital cardiac arrest. Resuscitation…

…hypoxia, hypoglycaemia, circulatory failure, sepsis, stroke, intracranial haemorrhage, seizure, poisoning and severe withdrawal. 4. Establish whether the condition is new or clearly worse than baseline…

…necrosis. It is characterized by prolonged angina at rest, usually lasting more than 20 minutes; new severe angina; an accelerating pattern with increasing frequency, duration…

…arterial blood gas. Acute critical illness during initial stabilisation — cardiac arrest, shock, sepsis, major trauma, unconsciousness — until the saturation can be measured reliably. Conditions in…

…from conditions such as sepsis, myocarditis, or takotsubo syndrome, while chronic myocardial injury may be seen in heart failure, cardiomyopathies, and severe valvular heart disease…

…Acute pancreatitis, pancreas surgery, alkalosis (hyperventilation), rhabdomyolysis, septicemia (sepsis), osteolytic cancer metastases, abnormal calcium absorption (gastrointestinal) and resorption (from primary urine), renal failure, small bowel…

…hypothermia , caution applies in: Ongoing uncontrolled bleeding or marked coagulopathy. Severe sepsis and septic shock. Already marked hypothermia from another cause — warm the patient instead…

…over the counter preparations, herbal remedies, contrast media and recently stopped drugs. 8. Treat sepsis, bleeding, shock, hypoxia and any other underlying cause immediately. 9…

…nausea, vomiting, muscle cramps, apathy, confusion, impaired reflexes. Severe <115 mmol/L Seizures, coma, respiratory arrest, brainstem herniation and death. Table 2. Grading of hyponatremia…

…of breathing, level of consciousness and PEF improve at the same time. Acute severe asthma is characterised by bronchospasm, mucosal oedema and mucus plugging. Expiratory…

…is made without reduction for incomplete cross tolerance. Indications Acute severe nociceptive pain where paracetamol and a COX inhibitor are not enough: fracture, renal colic…

Pulmonary valve regurgitation Mild regurgiation Moderate regurgitation Severe regurgitation Pulmonary valve morphology normal normal/abnormal abnormal Density CW Doppler weak, slow deceleration variable dense, steep…

Mitral valve regurgitation Primary parameters Mild regurgiation Moderate regurgitation Severe regurgitation Vena contracta (cm) < 0,3 0,3 0,69 0,69 EROA (cm²…

Tricuspid valve regurgitation Primary parameters Mild regurgiation Moderate regurgitation Severe regurgitation PISA radius < 0,6 0,6 0,9 0,9 Vena contracta (cm…

Cardiology Emergency medicine Definition and Pathophysiology A hypertensive emergency is severe blood pressure elevation accompanied by acute hypertension mediated target organ damage (HMOD). The European…

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Ischemic cardiomyopathy is severe myocardial dysfunction caused by coronary artery disease (CAD). The clinical syndrome may resemble…

…before treatment. 5. With severe symptoms: give hypertonic saline immediately. Do not wait for a complete work up of the cause or for imaging. 6…

ECG Myocardial ischemia and infarction Acute Myocardial Infarction: Definition & Criteria Acute myocardial infarction is the most severe complication of coronary artery disease. The most common…

…particularly in patients with marked tolerance. The most important measures in severe or complicated withdrawal are: 1. A benzodiazepine in a sufficient and repeated dose…

…reported prevalence ranging from 18% to 52%. They frequently occur in patients with severe coronary artery disease, defined in the source material as stenosis greater…

…and cardiac tamponade. Papillary muscle rupture, producing acute severe mitral regurgitation (MR). These complications result from transmural myocardial necrosis and subsequent tissue disruption. Infarct expansion…

… approximately 90% deteriorate during hospitalization. Patients who develop shock often have severe multivessel coronary disease and progressive, “piece meal” necrosis extending beyond the original infarct…

…Acute coronary occlusion is the abrupt or progressive reduction of coronary blood flow sufficient to produce myocardial ischaemia and, when prolonged or severe, myocardial necrosis…

…and valvular function. Levosimendan drug is generally well tolerated. Severe adverse effects are less common. Levosimendan may be administered simultaneously with milrinone. The drugs can…

…exercise due to physical limitations. Contraindications to exercise, such as unstable angina, severe aortic stenosis, decompensated heart failure, or aortic aneurysm. Baseline ECG abnormalities rendering…

…Diagnosis (ECG), Criteria & Management Acute ST Elevation Myocardial Infarction (STEMI) is the most severe manifestation of coronary artery disease. This chapter deals with the pathophysiology…

…arrhythmia, among others. Acute severe balance disturbance without nystagmus: HINTS does not apply. Assess gait and truncal stability and investigate for a central cause. Acute…

…adrenaline never replace intramuscular adrenaline [1,2]. Delayed administration of adrenaline is associated with more severe and more protracted reactions, biphasic courses and fatal outcome…

…cardiac arrest. Repeated blood gases, for example during mechanical ventilation or severe metabolic derangement. Major surgery with expected blood loss or large volume shifts. Patients…

…Dose reduction in renal failure and in old age Amiodarone In severe haemodynamic compromise where the above cannot be used It also has a rhythm…

…up of unexplained iron, B12 or folate deficiency when blood tests are insufficient. Contraindications Severe coagulopathy or ongoing anticoagulation — correct this first . Thrombocytopenia, by contrast…

…departments — follow local protocol. Severe lung disease or a contralateral pneumothorax: avoid the subclavian and jugular routes on the healthy side, since a pneumothorax there…

…withdrawal of treatment to circulatory arrest Indications An intensive care patient with severe brain injury in whom total brain infarction is judged possible during ongoing…

…a longer symptomatic course Consciousness Usually preserved, but may be impaired in severe DKA Cognitive impairment is more common, particularly at very high osmolality Blood…

…injury, recent cervical spine surgery, atlantoaxial instability, severe rheumatoid arthritis of the neck. Symptomatic carotid stenosis, recent stroke or TIA in the vertebrobasilar territory. Retinal…

…a fuller account of two of the commonest acute drug problems, see Warfarin therapy and Opioid therapy in severe pain. Cardiac arrest Drug Adult Child : : …

…Duration : : : : Pneumonia, non severe (DS CRB65 0–1) phenoxymethylpenicillin 1 g × 3 PO 5–7 days or benzylpenicillin 3 g × 3 IV Pneumonia, in chronic…

…48 hours, or ongoing unstable angina. Uncontrolled symptomatic arrhythmia. Symptomatic severe aortic stenosis. Decompensated heart failure. Acute pulmonary embolism or deep vein thrombosis. Acute myocarditis…

…nephrology early in anuria, in a dialysis patient, in severe acute kidney injury, in treatment failure or in ongoing massive potassium release. In cardiac arrest…

…acute kidney injury, microangiopathic haemolysis, and severe pre eclampsia or eclampsia. The blood pressure is often at least 180/120 mmHg, but no absolute threshold…

…marked reflux. A need for high airway pressures, for example severe ARDS, marked obesity or a stiff chest wall. Glottic or subglottic obstruction — the mask…

…Dry, necrotic, pale Variable, often deep Pain Moderate, relieved by elevation Severe, worse on elevation, better when dependent Often painless (neuropathy) Surrounding skin Hyperpigmentation, oedema…

…a strip of suture material or a drain Ingrown nail, severe or recurrent Partial nail avulsion, often with chemical matrix ablation A nail spicule that…

…retention — the commonest indication on a surgical ward. Decompression in severe vomiting where the stomach does not empty. Intraoperatively and postoperatively after major abdominal surgery…

…venous access is not immediately available. Shock, severe trauma, burns or status epilepticus when peripheral access fails or is judged futile. Children in an emergency…

…ACTH. Marked atopic disease, particularly severe asthma and a history of anaphylaxis — a relative contraindication; the test is then performed with preparedness for anaphylaxis. An…

…fetal bleeding respectively). Marked liver failure with coagulopathy. Severe uncontrolled hypertension. Recent intracranial haemorrhage without a fresh assessment of benefit and risk. An inability to…

…who have low BSA or severe extra aortic features 45 mm • Patients who are undergoing aortic valve surgery • Patients with Marfan syndrome who have additional…

…Active gastric or duodenal ulcers. Liver cirrhosis. Severe heart failure. Doses 100 mg/day during the third trimester of pregnancy. Dosage Acute myocardial infarction: Initial…

…<13 g/dL in men or <12 g/dL in women (3 points) Severe Renal Disease: Estimated glomerular filtration rate (eGFR) <30 mL/min or…

…with acute heart failure. • Clevidipine can cause reflex tachycardia. • Contraindicated in severe aortic stenosis due to risk of hypotension. Clevidipine doses and administration in hypertension.

…Caution • Clonidine may induce severe hypotension. • Clonidine is not recommended in most patients with severe cardiovascular disease or in those who are otherwise haemodynamically unstable…

…A PENICILLIN G BENZATHINE PENICILLIN G BENZATHINE Arrhythmia ar less Cardiac arrest severe INVEGA HAFYERA PALIPERIDONE PALMITATE paliperidone palmitate Arrhythmia wp most QT Prolongation moderate…

…depletion and high plasma renin activity increase the effect of enalaprilat, and may cause severe hypotension. Time to onset of action 15 to 30 minutes…

…As medium dose, and additionally severe hypertension (caution if patient on nonselective beta blockers). Dobutamine Cardiogenic shock Bradycardia (second line therapy) Stress testing (due to…

…Effective in pulmonary edema. Can produce severe hypotension. Time to onset of action 30 seconds to 1 minute Duration of action 1 to 10 minutes…

…<17 Tricuspid valve Tricuspid valve regurgitation Primary parameters Mild regurgiation Moderate regurgitation Severe regurgitation PISA radius < 0,6 0,6 0,9 0,9…

…active substance or any excipient. Active bleeding. Previous intracranial hemorrhage. Severe liver impairment. Concurrent administration of ticagrelor with strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin…

…muscle rigidity and ultimately major tissue loss. Reperfusion after severe or prolonged ischaemia may be accompanied by rhabdomyolysis, with potential renal failure and increased mortality…

…More broadly, bradyarrhythmic arrest and asystole represent severe manifestations of impulse generation or conduction failure. The pathophysiology of these events may stem from reversible causes…