…breathing and circulation Perform an ABCDE assessment and document the time of seizure onset, or the time the patient was last known to be well…

…the exact clock time of symptom onset or the time last known to be well NIHSS A complete score by a physician or nurse experienced…

…Invitations are sent up to and including the age of 70, and the last sample is in practice taken some time between the ages of…

…in millimetres, the time to diplopia on upward gaze, or the number of seconds the patient can hold the head lifted off the couch. Filming…

…hernia or visible abdominal wall collaterals (caput medusae) Puncture at least a few centimetres away from them Full bladder Have the patient void, or catheterise…

…and a known gastrointestinal source are investigated before starting. A referral or notification to the anticoagulation clinic, and a decision on who will dose during…

…manoeuvre ends when the volume increases by less than 0.025 L during the last second , or when the expiratory time has reached 15 seconds…

…to a known or probable allergen , even if skin symptoms are absent [1,4]. Typical warning symptoms are: hoarseness, stridor, swelling of the tongue or…

…down for at least 10 minutes in a room at a comfortable temperature — a cold foot gives falsely low pressures. No smoking or coffee in…

…and it is the time to haemorrhage control that determines the outcome. Indications Symptomatic anaemia, or a haemoglobin below the applicable transfusion threshold (see below…

…blood cultures. For questions other than acute meningitis — an insidious onset, known malignancy, immunosuppression, papilloedema or new focal neurological signs — CT is performed first. Preparation…

…least 1.5 times baseline, known or presumed to have occurred within 7 days. Urine output below 0.5 mL/kg/h for at least…

…and urticaria are usually due to histamine release, not allergy. Concurrent MAO inhibitor, particularly with pethidine. Caution: untreated sleep apnoea, a concurrent benzodiazepine or gabapentinoid…

…treatment is given, and the test is performed later. Contraindications Known hypersensitivity to tetracosactide or ACTH. Marked atopic disease, particularly severe asthma and a history…

…syndrome (ACS) or a prior heart attack and a high risk of developing an atherothrombotic event. Contraindications Hypersensitivity to the active substance or any excipient…

…and lasts longer. The pain usually involves the central portion of the chest or the epigastrium and occasionally radiates to the arms. Less common sites…

…of hospital cardiac arrest (OHCA), the delay from collapse to defibrillation is substantially longer. The median time to arrival of the EMS is 10 to…

…and several syndromes can overlap [1,4]. Time after a clear reduction or the last intake Common clinical picture : : 4 to 12 hours Tremor, sweating…

…at least 6 hours after insulin. 7. Contact nephrology early in anuria, in a dialysis patient, in severe acute kidney injury, in treatment failure or…

…a non PCI hospital to wire crossing As quickly as possible, primary PCI if the total expected time is 120 minutes or less If PCI…

…is therefore not sufficient to exclude stroke [3]. Step 1: classify by time course and triggers Syndrome Typical course Common or important causes Targeted examination…

…same lead, in at least two contiguous leads). R wave progression is checked in V1–V6. The electrical axis should be −30° to 90°. Normal…

…For many poisonings, well delivered supportive treatment matters more than the antidote [1,2]. Telephone your national or regional poison control centre , which in most…

…is in addition the only one that will go in. The rule that saves time is simple: two attempts or 90 seconds — then go intraosseous…

…Romhilt Estes point score system for diagnosing LVH assigns 2 points for left axis deviation that is greater than or equal to 30 degrees [11]…

…roughly 100,000 times daily, each time overcoming the aortic resistance, which is typically 110 mmHg or more. It is straightforward to understand why systolic…

…does not have to meet every criterion in a column. Clinical deterioration or a poor response to treatment carries more weight than a single apparently…

…thawing, that a blister (sometimes a blood blister) is to be expected, that the area will be red and weeping for a week or so…

…occur even when the glucose has already begun to rise by the time it is measured, for example after relatives have given carbohydrate or glucagon…

…capacity, but it cannot compensate for an uncontrolled source of bleeding. Minimise the time to surgery, endoscopy, an obstetric procedure or angiographic intervention. Summon anaesthesia…

…hypovolaemia, requires a vasopressor to maintain a MAP of at least 65 mmHg and at the same time has a lactate above 2 mmol/L…

…higher long term and in hospital mortality rates, as well as lower ejection fractions and higher peak biomarker levels, compared to those without such conduction…

…using the components of: Frequency Intensity Time or duration Type Progression The prescription should be individualized rather than based solely on an age based target…

…QT duration represents the total time for depolarization and repolarization. It is measured from the beginning of the QRS complex to the end of the…

…less than 10 minutes from STEMI diagnosis to the fibrinolytic bolus. In suitable systems, pre hospital fibrinolysis is reasonable when it provides a substantial time…

…new loss of viable myocardium or a new regional wall motion abnormality in an ischaemic pattern. Identification of a coronary thrombus by angiography or autopsy…

…explained in this article). An isolated QS complex is allowed in lead V1 (due to missing r wave or misplaced electrode). Lead III occasionally displays…

…risk (according to TIMI score or similar) may undergo stress testing when their clinical condition is stabilized. This usually takes 2 to 3 days and…

…0–1 48 hours or unknown duration An anticoagulant for at least 3 weeks before cardioversion, or alternatively transoesophageal echocardiography to exclude thrombus After cardioversion…

…is suspected (normal 10–21 mmHg). Tonometry is contraindicated with suspected perforation or infection. Removal Proceed from the least to the most invasive technique. 1…

…Moderate 125 to 129 mmol/L Severe Below 125 mmol/L Duration Definition : : Acute Documented development within less than 48 hours Chronic At least 48…

…10⁹/L An expected high risk course Neutropenia expected to last longer than 7 days, or shorter neutropenia with clinical risk factors International guidelines generally…

…to particle size and composition. As a result, apoB and cholesterol measures may be discordant. A patient may have: Relatively high apoB despite normal or…

…The longer the distance, the more time required for sound waves to travel back and forth, which results in lower pulse repetition frequency (fewer ultrasound…

…with at least 20 daytime and 7 night time values, and with a measurement interval of no more than 30 minutes throughout the 24 hours…

…only in shock, by experienced staff) 0.05–0.1 mg at a time, diluted to 0.1 mg/mL 1 µg/kg, titrated Fluid…

…least one of the following criteria present: haemodynamic instability or cardiogenic shock recurrent or ongoing chest pain refractory to medical treatment life threatening arrhythmias or…

…that favour ACS rather than chronic stable angina include sudden symptom onset at rest or with minimal exertion, symptoms lasting at least 10 minutes unless…

…and lasts longer. The usual location is the central chest or epigastrium. Radiation may occur to one or both arms and less commonly to the…

…of a previously atherosclerotic coronary artery. Slowly progressive severe stenoses are less likely to cause STEMI because collateral vessels may develop over time. By contrast…

…the flaps and appear as moving masses. Mural vegetations are attached to the endocardium and, accordingly, less mobile. Echocardiography is the first place method for…

…in hospital protocols, etc) is necessary to improve outcomes in out of hospital cardiac arrest (OHCA) and in hospital cardiac arrest (IHCA). Initiating or withholding…

…located below the renal arteries and are related to atherosclerotic disease. At least 90% of AAAs larger than 4 cm are associated with atherosclerotic pathology…

…in mL/min , not eGFR relative to 1.73 m². Recalculate in patients who are markedly larger or smaller than average. Higher doses may be…

…breakthrough ventricular tachycardia (VT) or ventricular fibrillation (VF). IV infusions can be safely continued for 2 to 3 weeks. IV amiodarone is generally well tolerated…

…should be distinguished from severe muscle injury. Myopathy is characterized by muscle symptoms accompanied by CK greater than 10 times the upper limit of no

…4a MI is defined by: cTn greater than 5 times the 99th percentile upper reference limit; and At least one of the following: New ischemic…

…in LVOT to improve the accuracy of the measurement. Flow velocity in LVOT : Velocity is measured in apical four chamber view (4C) or five chamber…

…More than 12 hours after onset: primary PCI remains indicated when there are ongoing ischaemic symptoms, haemodynamic instability or life threatening arrhythmias. Twelve to 48…

…medical system (EMS), as well as the hospital cardiac arrest team (CAT) and intensive care units and other units caring for resuscitated patients. Figure 1…