…amputation. The decisive step is therefore not the choice of dressing but the ankle brachial index before the first bandage is applied . Indications Venous leg…

…rest pain in the foot or leg, or a non healing distal ulcer. Before compression treatment of a leg ulcer — compression in arterial insufficiency can…

…Indications Decompression in ileus, subacute obstruction or gastric retention — the commonest indication on a surgical ward. Decompression in severe vomiting where the stomach does not…

…that is disproportionately severe, a rapid course, skin discolouration, systemic upset — is an acute surgical emergency, not an abscess. Preparation and equipment No. 11 scalpel…

…nitrate. Electrocautery or a heated paper clip for trephination. Antibiotic ointment, a non adherent dressing, gauze. The digital block Anaesthetise from the dorsal aspect, one…

…high income countries, idiopathic pericarditis, radiation to the pericardium and surgical interventions are the most common causes of constrictive pericarditis. Of these three, idiopathic pericarditis…

…reflexes, vomiting with a risk of aspiration. Inadequate oxygenation despite maximal oxygen or non invasive ventilation. Inadequate ventilation with a rising pCO₂ and respiratory acidosis…

…dose are according to the local protocol. Alternatives when there is a contraindication: catheter directed treatment or surgical embolectomy where available. A vasopressor (noradrenaline) and…

…rehabilitation, ablative or surgical interventions The test does not define the structure or composition of coronary atherosclerotic plaque, identify plaques at high risk of rupture…

…and treatment goals Diabetes, left ventricular function and other comorbidities Surgical risk and contraindications to prolonged dual antiplatelet therapy Patient preferences, local expertise and operator…

…systole. Transesophageal echocardiography and surgical pathology demonstrate that over 90% of thrombi in non valvular AF originate within this specific anatomical cul de sac [19] …

…injuries to the mediastinum can cause tamponade. Post operative Complications : Post surgical complications following thoracic procedures can cause tamponade. Tamponade with swinging heart of the…

…Diuretics may be used for symptom relief. Surgical repair or valve replacement is considered when medical therapy is insufficient, or when concomitant valvular disease (e…

…The laryngeal mask is a compromise and does not protect the airway completely. Relative contraindications: A high risk of aspiration: a non fasted patient, ileus…

…it. A small (under 10 mm), loculated or purely posterior effusion with no safe route for puncture — surgical drainage or pericardiotomy instead. Relative: uncorrected coagulopathy…

…Artery forceps, toothed surgical forceps, scissors, a needle holder. Sutures: 5 0 or 6 0 non absorbable for the face, 4 0 for the trunk…

…ventricular septal defects (VSD), and patent ductus arteriosus (PDA). Echocardiography provides a non invasive, accessible method to calculate this ratio, guiding clinical decisions about intervention…

…with acute coronary syndrome, randomized evidence has demonstrated lower rates of access site bleeding, surgical repair, and blood transfusion with radial access. Radial access has…

…provide better haemodynamic stability. Define the operative electrical environment The surgical team should establish: Whether electrosurgery or diathermy will be used. Whether monopolar or bipolar…

…or sudden loss of effective cardiac output. Their recognition is essential because treatment often requires urgent surgical or transcatheter intervention, with temporary mechanical circulatory support …

…troponin elevation, ACS are classified into unstable angina (UA), non ST segment elevation myocardial infarction (NSTEMI), and ST segment elevation myocardial infarction (STEMI). While the…

…precipitants include vigorous physical activity, emotional stress, and an intercurrent medical or surgical illness. Events may occur at any time, although clustering in the morning…

…surges [4]. Surgical Interventions : Stellate ganglion block (SGB) or cardiac surgical sympathetic denervation can be performed to mechanically reduce sympathetic output [4]. Evaluation of Treatment…

…Congenital Heart Disease (CHD) and Grown Up Congenital Heart (GUCH) disease Survival in congenital heart disease (CHD) has increased dramatically over the past few decades…

…survival in out of hospital cardiac arrest. Although the required skills, complexity and costs of interventions increase with each step in the chain of survival…

CPR Extracorporeal Life Support (ECLS) and ECMO (Extracorporeal Membrane Oxygenation) Survival after cardiac arrest depends on the restoration of spontaneous cardiac rhythm. The likelihood of…

…glucose : : Most inpatients 6–10 mmol/L Frail older people, a short expected survival, a high risk of hypoglycaemia 8–12 mmol/L The critically…

…Lowering the body temperature to 33 °C has not been shown to improve survival or the neurological outcome compared with keeping the patient normothermic — but…

…Biological death usually occurs within minutes thereafter; survival is highly unlikely after 8–10 minutes of no flow (i.e. cardiac arrest without any circulation)…

…and cardiac tamponade, each implicated in roughly 10% of cases. Potentially reversible causes of traumatic cardiac arrest ( Salomone et al ): Hypovolemia : Hypovolemic shock is common…

…by echocardiography. Reduced LVEF reliably identifies a high risk group that derives a large, trial proven survival benefit from primary prevention ICDs. Its dominance, though…

…heart failure with reduced ejection fraction (HFrEF) in developed countries. New ischemic events are major determinants of subsequent LV deterioration and long term survival. Viable…

…lesion proximal to the first septal perforator of the left anterior descending artery was associated with lower five year survival than a more distal lesion…

…attempted recanalization of a chronic total coronary occlusion. Angina or ischaemia with non obstructive coronary arteries (ANOCA/INOCA), after appropriate investigation has identified the relevant…

…patients with established peripheral artery disease, those who stop smoking have approximately twice the five year survival of those who continue. After acute coronary syndrome…

…making rapid recognition, defibrillation capability and expedited reperfusion central to survival. Clinical Presentation and Symptoms The characteristic symptom prompting activation of the STEMI pathway is…

…Indeed, the greatest opportunities for survival exist during the first few minutes from collapse. Table 1 shows the number needed to treat (NNT) for various…

…term outcomes. Patients with low flow low gradient aortic stenosis (discussed below) have a 3 year survival rate of 50% ( Eleid et al ). The cause…

…instantaneous identification of the initial rhythm ( Thorén et al ). The initial rhythm has immense significance for survival in cardiac arrest, regardless of all other circumstances…

…rescue, and security guards) in BLS is key to improving outcomes in OHCA and may be the single strongest factor driving improvement in survival rates…

…When hypothermia precedes cardiac arrest, the body has undergone cooling before circulatory cessation, enhancing the likelihood of survival. In such instances, favorable neurological outcomes are…

…patients who experienced a brief cardiac arrest. Post resuscitation care is an integral component of the chain of survival. It includes diagnosis of post cardiac…

…evaluate exercise performance, evaluate the effect of interventions and medications, and prognosticate survival. However, exercise stress testing must not be performed within 4 to 6…

…1980s. Beta blockers, ACE (angiotensin converting enzyme) inhibitors, and angiotensin receptor blockers (ARB) were introduced and improved survival dramatically. When the pioneers Waagstein, Hjalmarsson, and…

…1980s. Beta blockers, ACE (angiotensin converting enzyme) inhibitors, and angiotensin receptor blockers (ARB) were introduced and improved survival dramatically. When the pioneers Waagstein, Hjalmarsson, and…

…blockers in heart failure; these drugs antagonize neurohormonal mechanisms and improve cardiac function and survival dramatically in heart failure ( Yancy et al ). Acquiring a basic…

…A recent meta analysis showed that survival to hospital discharge is 8.8% and survival to 30 days is 10.7% in out of hospital…

…they described these phases, which require different treatment strategies to maximize survival (Table 1). Phase Period Optimal treatment Electrical phase 0 to 4 minutes Defibrillation…

…increasing coronary blood flow. In circumstances with non shockable rhythm or with prolonged periods of VF (fine VF resistant to defibrillations), the purpose of CPR…

…bulging ). Bedside echocardiography allows for immediate recognition of tamponade. Typically, acute tamponade arises from aortic dissection, and survival among such patients is, unfortunately, very rare.

…symptoms (pericarditis, encephalopathy) and certain poisonings. Early initiation without an absolute indication has not been shown to improve survival. Parameter Guide value : : Effluent dose, continuous…

…troponin I levels). Hence, troponin I was a strong predictor of survival in patients hospitalized with COVID 19 (Figure 2). Figure 2. Shi et al…

…resting heart rate 75 beats/min, based on a retrospective subgroup analysis in which a survival benefit was observed. Inappropriate sinus tachycardia Treatment of inappropriate…

…Prognosis and Survival The presence of LBBB has several implications for patient outcomes: Mortality in STEMI : Patients presenting with ST elevation myocardial infarction (STEMI) and…

…be considered. Effective lipid lowering improves survival and reduces cardiovascular mortality in patients with coronary artery disease irrespective of the baseline cholesterol concentration. Intensive statin…

…cardiac arrest due to asphyxia, the probability of return of spontaneous circulation (ROSC) is high but survival is very low, as is the proportion surviving…

…et al. Epidemiology and outcome of adult out of hospital cardiac arrest of non cardiac origin in Osaka: a population based study. BMJ Open 2014…

…et al. Epidemiology and outcome of adult out of hospital cardiac arrest of non cardiac origin in Osaka: a population based study. BMJ Open 2014…

…et al. Epidemiology and outcome of adult out of hospital cardiac arrest of non cardiac origin in Osaka: a population based study. BMJ Open 2014…

…review of 141 studies on the survival in treated OHCA. Pooling all the eligible studies resulted in the following survival estimates: Likelihood of return of…