…less commonly, retrograde. Distal re entry tears may allow blood to return to the true lumen, whereas disruption of the adventitia can result in rupture…

…Tamponade with swinging heart of the pericardium. Source. Rapid diagnosis of cardiac tamponade is possible via bedside echocardiography. This reveals pericardial fluid, suggesting hemorrhage in…

…a traumatic hemorrhage can deplete intravascular volume to such an extent that chest compressions fail to generate stroke volumes. Consequently, addressing reversible causes of cardiac…

…JE, Gwyther R, Kirkman E. Closed chest compressions reduce survival in an animal model of hemorrhage induced traumatic cardiac arrest. Resuscitation 2019;140: 37 42…

…requirement. Obstetric haemorrhage of around 1,500 mL or more with continuing bleeding, or a smaller measured blood loss if there is physiological compromise. Do…

…most important dangerous differential diagnosis. Clear focal neurological findings are absent in roughly half of patients with a central cause. A normal routine neurological examination…

…JE, Gwyther R, Kirkman E. Closed chest compressions reduce survival in an animal model of haemorrhageinduced traumatic cardiac arrest. Resuscitation 2019; 140:37 42. Endo…

…Coimbra R. Open chest versus closed chest cardiopulmonary resuscitation in trauma patients with signs of life upon hospital arrival: a retrospective multicenter study. Crit Care…

…even with a reduced level of consciousness, focal neurological signs or seizures — because the delay costs more than the scan contributes. Only clinical signs of…

…Comment : : : Intracranial pressure (ICP) < 22 mmHg The treatment threshold in traumatic brain injury Cerebral perfusion pressure (CPP) 60–70 mmHg CPP = MAP − ICP…

…the commonest cause of permanent loss of function is a tendon injury that was sutured over without being found. Indications A traumatic wound that gapes…

…be considered anginal equivalents. The emergency evaluation of non traumatic chest discomfort is structured around three principal diagnostic categories: Myocardial ischaemia , particularly acute coronary syndrome…

…cause: Diminished heart sounds Disappearance of the friction rub Loss of the apical impulse Electrical alternans on the ECG Compression of the left lung base

…and traumatic haemopericardium — these require surgery; pericardiocentesis is at best a bridge to it. A small (under 10 mm), loculated or purely posterior effusion with…