…approach is preferable: it passes through muscle without major vessels or nerves, and the landmark — the posterior corner of the acromion — is easy to palpate…

…book is not the one making it simple In the thrilling and ever evolving field of medicine, a question echoes in the hallways of hospitals…

…for the majority of cases, and the great majority of objects can be removed in general practice or in the emergency department with simple equipment…

…medium for most adults, long for thick soft tissue and for the head of the humerus. A pressure bag or a 50 mL syringe with…

…equipment for arterial sampling. Urinary catheter with hourly urine output measurement — the treatment cannot be guided without reliable measurement of urine output. Baseline tests: blood…

…Ejection fraction is simple to calculate; if the left ventricle contains 100 ml of blood at the end of diastole and 40 ml is pumped…

…important parameter in the assessment of ventricular hypertrophy and cardiomyopathy. Numerous formulas have been developed to approximate ventricular mass. Most formulas are simple mathematical equations…

…Infarction (STEMI) [1] . Historically viewed as a simple plumbing problem characterized by the gradual accumulation of inert cholesterol debris, modern vascular biology has redefined atherosclerosis…

ECG Introduction to ECG interpretation Standard display of ECG leads in the 12 lead ECG Numerous conditions that can be diagnosed using the 12 lead…

…a low stroke volume Capillary refill < 3 s A simple and validated marker of perfusion Lactate < 1.6 mmol/L Clearance over time…

…lymphoma or granulomatous disease. A treatment resistant rash without a definite diagnosis. Choice of technique Diagnostic question Method Comment : : : Pigmented lesion, suspected melanoma Excision with…

…cardiac output, pressure conditions, severity of stenoses and regurgitations, etc . These calculations are based on simple mathematical equations, which are based on hemodynamic principles. It…

…with blood. Although diastole may appear as a simple and passive process, it is actually a complicated and fundamental aspect of ventricular function. Impaired diastolic…

…From a clinical point of view, clinicians must be able to separate pericarditis from ST elevation myocardial infarction (STEMI). This may not always be simple…

…speed , and direction . The underlying mathematical principles are simple and important to understand. Figure 2 illustrates the wavelength and amplitude of sine curves. Figure 2…

ECG Myocardial ischemia and infarction ST elevation myocardial infarction (STEMI) without ST segment elevations on 12 lead ECG This chapter covers situations in which the…

…Without this layer, the impedance difference becomes large, which causes too much of the sound waves to be reflected (leaving fewer sound waves to penetrate…

…and whether the other variable lies within the expected range of compensation. Sample type and baseline values An arterial blood gas is the reference method…

…several factors Inattention is central. A simple check is to ask the patient to recite the months of the year backwards. A normal result does…

…Flows above 6 L/min dry the mucosa without delivering more oxygen Simple face mask 5–10 L/min 35–60 % Never below 5 L…

…the rest of the intensive care. 2. Insert the core temperature probe and connect it to the feedback loop of the cooling device. Without continuous…

…greater ventricular wall stress, probably because of suppression of natriuretic peptide production or post translational modification rather than a simple clearance effect. Treatment also affects…

…ECG (recall that ST segment depression is the hallmark of NSTE ACS/NSTEMI). The answer is rather simple: the probability that the patient has NSTE…

…120 seconds of cardiac arrest and light reactivity is lost when cerebral blood flow ceases. In other words, during prolonged cardiac arrest without effective perfusion…

…Brugada syndrome. This disorder is easy to diagnose with a simple blood test and the ST segment elevations resolve after normalization of potassium levels. Brugada…

…and Mobitz type 2. A very simple rule of thumb can be applied to do this: whenever there are varying PR intervals, the diagnosis is…

Echocardiography Color Doppler Velocities recorded in a sample volume of the pulsed wave Doppler can be presented with a color. A color scale from blue…

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

…presented in the parenthesis). Values without confidence interval are simply the 98 th percentile (i.e the upper reference limit). Age <1 day 1–3…

…medicine). This is high quality medical education simply. Life in the Fast Lane Australian site with one of the most impressive ECG libraries available. A…

…etc . The purpose of such changes is simply to enable the cardiopulmonary system to increase its delivery of oxygen to skeletal muscle and myocardium. The…

…presented in the parenthesis). Values without confidence interval are simply the 98 th percentile (i.e the upper reference limit). Age <1 day 1–3…

…many of the causes require prompt treatment. Inappropriate sinus tachycardia: When all the abovementioned causes have been ruled out and the sinus tachycardia persists without…

…alteplase and is simpler to administer, since the whole dose is given as a bolus [1,2]. In a meta analysis of three phase 3…

…offered an HPV tested sample without waiting for the next routine invitation. Self sampling for HPV is now a permanent part of the programme and…

…and record an ECG. 2. Confirm the potassium with a repeat sample, but do not delay treatment when there are ECG changes, circulatory compromise or…

…vasoconstriction, adhesion of circulating cells, inflammatory cell entry into the intima, and thrombus formation. Atherosclerosis is therefore not simply a disorder of lipid storage. Its…

…and other symptoms may occur without chest pain and should be considered anginal equivalents. The emergency evaluation of non traumatic chest discomfort is structured around…

…complementary mechanisms of drugs from different classes. By acting on more than one pathophysiological pathway, combinations generally lower blood pressure more effectively than simply increasing…

…regardless of the appearance of the QRS complex. All positive waves are referred to as R waves. The first positive wave is simply an "R…

…periods. Aberrant conduction occurs when the length of the cardiac cycle is changed without a compensatory change in the length of the refractory period. This…

…The sample volume (SV) should be placed between the leaflet tips (1–3 mm axial length of SV) and sweep speed is set to 50…

…end of the T wave. The QT interval should be measured in 3 to 5 consecutive beats in leads II, V5 and V6. Leads without…

…without excluding regions of interest. Reducing the depth results in an increased frame rate and thus enhanced image resolution. If a particular region is of…

…since the speed of ultrasound is constant in the body. The investigator specifies where the measurement should be performed by moving the sample volume (SV…

…sound waves reflected from myocardium have high amplitude. This is due to the high density of myocardium. It follows that myocardium generates reflections with high…

…seconds). The QRS complex is wide simply because the ectopic impulses that cause these rhythms spread partially or entirely outside of the ventricular conduction system…

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

…the clinical picture, repeat the sample and send a venous plasma glucose, but do not delay treatment of a neurologically compromised patient. Continuous glucose monitoring…

…the threshold, but the threshold varies between regions. Infection of the skin over the puncture site. Marked haemodynamic instability — stabilise the patient first. CT before…

…vena cava without respiratory variation Strongly suggests a raised filling pressure Marked respiratory variation in mitral and tricuspid inflow The echocardiographic counterpart of pulsus paradoxus…

Procedurer Almost all the complications of pleural aspiration arise from two errors: the needle is placed in the wrong site, and too much is drained…

…the very question at issue A patient who needs steroid cover simply to get through the day of the test can therefore be given dexamethasone…

…pancreatitis. Evaluation and physical examination Evaluation should establish: The triglyceride concentration and whether the sample was fasting or non fasting. The presence of ASCVD, peripheral…

…However, the cardiovascular effects of SGLT2 inhibitors are not explained simply by their effects on haemoglobin A1c. Clinical benefits have been demonstrated in several overlapping…

…with advancing age. Presentations without pain may include: Sudden breathlessness Syncope or sudden loss of consciousness Confusion Profound weakness An arrhythmia Peripheral embolism An ot

…in the myocardium. The electrical potential difference exists between ischemic and normal myocardium and it results in displacement of the ST segment. The ST segment…

…also capable of transmitting the action potential, albeit at a much lower speed than the conduction cells. The terms contractile myocardium , myocardium, or simply myocardial…

Arrhythmias and arrhythmology ECG Diagnosis and management of narrow and wide complex tachycardia All clinically significant supraventricular and ventricular tachyarrhythmias have been reviewed in previous…

…risk of an event (such as sudden cardiac arrest) is simply the number of individuals that experience the event divided by the number of individuals…