…of sepsis induced cardiac arrest, consider the following recommendations: Administer 100% oxygen at the maximum flow rate . Hypoxia can precipitate cardiac arrest in septic patients…

…no absolute contraindications. With active cooling to hypothermia , caution applies in: Ongoing uncontrolled bleeding or marked coagulopathy. Severe sepsis and septic shock. Already marked hypothermia…

…below 8 kPa on an arterial blood gas. Acute critical illness during initial stabilisation — cardiac arrest, shock, sepsis, major trauma, unconsciousness — until the saturation can…

…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…

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

…or shock. Conversely, mechanisms that increase myocardial oxygen demand include sustained tachyarrhythmia and severe hypertension, with or without left ventricular hypertrophy. In patients with stable…

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

…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…

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

…International thresholds vary somewhat, but a PEF of 50 percent or less together with marked symptoms indicates a severe attack, while a PEF below 33…

…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…

…hypertensive encephalopathy and should prompt consideration of stroke. Acute ischemic or intracerebral haemorrhage may coexist with severe hypertension. The decision to lower BP in acute…

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 after previous severe episodes, with concurrent physical illness or after prolonged very high intake More than 90 percent of withdrawal seizures occur within 48…

…patients undergoing coronary angiography, with reported prevalence ranging from 18% to 52%. They frequently occur in patients with severe coronary artery disease, defined in the…

…Cardiogenic shock. The shunt may initially be tolerated, but the defect can enlarge and cause rapid haemodynamic deterioration. Inferior infarction is associated with basal septal…

…as severe pre existing valvular disease or excessive beta blocker or calcium channel blocker exposure. The incidence of cardiogenic shock complicating STEMI has fallen with…

…with thrombosis; other cases result from spasm, microvascular dysfunction, embolism, dissection, hypotension or shock, respiratory failure, severe anaemia, sustained bradyarrhythmia, tachyarrhythmia, or severe hypertension with…

…with Dobutamine in the Treatment of Cardiogenic Shock. N Engl J Med 2021; 385:516 525 Indications Severe left ventricular failure, acute or chronic. Severe…

…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…

…STEMI) is the most severe manifestation of coronary artery disease. This chapter deals with the pathophysiology, definitions, criteria and management of patients with acute STEMI…

…triggers it [1,2]. The single most important practical rule is: Continuous acute dizziness with spontaneous nystagmus: consider HINTS plus, but only if the examiner…

…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…

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

…the following: A systolic blood pressure < 90 mmHg caused by the arrhythmia. Ongoing myocardial ischaemia with chest pain and ECG changes. Acute pulmonary oedema…

…suspected granulomatous disease with marrow involvement. Work up of unexplained iron, B12 or folate deficiency when blood tests are insufficient. Contraindications Severe coagulopathy or ongoing…

…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…

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

…Children, pregnant women and patients with advanced renal failure, marked heart failure or circulatory shock require a specific protocol and early specialist involvement. DKA and…

…standing up, tilting the head backwards. A symptom free interval between attacks, with possible residual unsteadiness. No hearing loss, tinnitus or neurological deficits. In horizontal…

…second attempt). Vasoactive infusions Drug Dose range Primary effect Used in : : : : Noradrenaline 0.05–0.5 µg/kg/min α₁ — vasoconstriction Septic and distributive shock

…IV plus gentamicin 5–7 mg/kg IV as a single dose Urosepsis with shock and suspected ESBL meropenem 1 g × 3 IV Do not…

…on a clear indication and with full preparedness Moderate to severe aortic stenosis without symptoms Individual assessment Hypertrophic cardiomyopathy with outflow tract obstruction Caution Tachyarrhythmia…

…a dialysis patient, in severe acute kidney injury, in treatment failure or in ongoing massive potassium release. In cardiac arrest with suspected hyperkalaemia, advanced life…

…coronary syndrome, acute left ventricular failure with pulmonary oedema, acute aortic syndrome, acute kidney injury, microangiopathic haemolysis, and severe pre eclampsia or eclampsia. The blood…

…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…

…Untreated deep vein thrombosis in the acute phase. Septic phlebitis, ongoing soft tissue infection with systemic involvement. Relative: Condition Adaptation : : ABI 0.5–0.79…

…inflammation Splinting with a cotton wisp Ingrown nail with moderate inflammation Splinting with a strip of suture material or a drain Ingrown nail, severe or…

…the tube is safe. A misplaced tube in the airway produces no reliable symptoms in a patient with an impaired cough reflex, and the first…

…Intraosseous access: Cardiac arrest where venous access is not immediately available. Shock, severe trauma, burns or status epilepticus when peripheral access fails or is judged…

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

…close to delivery (embryopathy and fetal bleeding respectively). Marked liver failure with coagulopathy. Severe uncontrolled hypertension. Recent intracranial haemorrhage without a fresh assessment of benefit…

…Turner syndrome 40 mm • Patients with mutations in TGFBR1, TGFBR2 or Loes Dietz syndrome, who have low BSA or severe extra aortic features 45 mm …

…heparin). Patients with gastrointestinal disorders. Patients with severe kidney disease (glomerular filtration rate < 30 mL/min). Patients with mild to moderate heart failure, kidney…

…<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…

…failure. Caution • Used cautiously in patients with acute heart failure. • Clevidipine can cause reflex tachycardia. • Contraindicated in severe aortic stenosis due to risk of hypotension…

…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…

…less Myocardial infarction severe CAPASTAT SULFATE CAPREOMYCIN capreomycin sulfate NA no no INFED IRON DEXTRAN IRON DEXTRAN Mixed ar less patients with pre existing cardiovascular…

…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…

…and additionally severe hypertension (caution if patient on nonselective beta blockers). Dobutamine Cardiogenic shock Bradycardia (second line therapy) Stress testing (due to induced increase in…

…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…

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

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

…early hours following infarction may be associated with hemodynamic compromise. More broadly, bradyarrhythmic arrest and asystole represent severe manifestations of impulse generation or conduction failure…