…and upper airway. Due to the risk of airway compromise, it represents a medical emergency. Evaluation and Physical Examination The evaluation of chronic cough in…

…peripheral cannulae. Consider an arterial line if the patient is unstable or frequent blood gases are needed 3 Blood grouping and cross matching. Order red…

…to left heart disease Group 3: PH due to chronic lung disease, hypoxia, or sleep disordered breathing Group 4: Chronic thromboembolic pulmonary hypertension (CTEPH) and…

…then 100 mg × 1 5–7 days Epiglottitis and other severe upper airway infection cefotaxime 1–2 g × 3 IV Depends on the diagnosis Always…

…oxygenation despite maximal oxygen or non invasive ventilation. Inadequate ventilation with a rising pCO₂ and respiratory acidosis, or a markedly increased work of breathing with…

…former smokers over 40 with respiratory symptoms, and occupational exposure to dust, gas or fumes. Preoperative assessment before thoracic or upper abdominal surgery in a…

…pain and respiratory distress. Aortic dissection may cause sudden severe pain, often radiating to the back. Pericarditis may produce pleuritic or positional pain. Myocarditis and…

…troponin value above the assay specific 99th percentile upper reference limit. It is classified as acute when serial measurements demonstrate a rise and/or fall…

…1 2 mg of glucagon intravenously. Currently, there is insufficient evidence to support the use of steroids and antihistamines during cardiac arrest due to anaphylaxis.

…and the facility to give nebulised drugs within the circuit. Monitoring: continuous pulse oximetry, ECG, blood pressure, respiratory rate. A blood gas before starting and…

…needle is inserted close to the upper border of the rib, never at the lower border where the neurovascular bundle lies, and the drainage is…

…These age variations in heart rate are due to variations in the activity of the autonomic nervous system and changes in the automaticity of the…

…inversely with heart rate; it shortens at higher heart rates and lengthens at lower heart rates. To account for this variability, the QT interval is…

…and pathophysiology Acute limb ischaemia (ALI) is an abrupt reduction in arterial perfusion of an upper or lower limb that causes tissue metabolic requirements to…

…and are currently the most reliable for patients aged 1 month to 16 years. Reference values for patients aged <1 month are less reliable due…

…This pain is thought to result from right ventricular ischemia that develops during physical exertion [5]. Associated Findings: Exertional dyspnea, dizziness, and syncope may also…

…and infarction Use of ECG in acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical attention due to…

…and are currently the most reliable for patients aged 1 month to 16 years. Reference values for patients aged <1 month are less reliable due…

…evident, ventricular tachycardia may appear more polymorphic in one lead (the upper lead). ECG 2 . Although the signal in the upper lead appears very disorganized…

…a field block in healthy skin around the abscess instead of injecting into it, and expect the procedure to hurt even so. Offer nitrous oxide…

…free mass index 15–19 kg/m² 17–22 kg/m² Ideal and dosing weight Drug dosing often requires a weight other than the actual…

…is used thereafter Two to three measurements one minute apart, taking the mean of the last two Orthostatic testing after 1 and 3 minutes of…

…added: transfusion saves no one whose bleeding is not stopped, and it is the time to haemorrhage control that determines the outcome. Indications Symptomatic anaemia…

…50 × the upper limit of normal: paracetamol poisoning, ischaemic hepatitis ("shock liver") or acute viral hepatitis. The three are distinguished by the history and the…

…because inconsistent or incorrect measurement may lead to misclassification. Blood pressure should be measured with a validated and calibrated device using a consistent method for…

…form of typical atrial flutter, the reentrant circuit is confined to the right atrium and travels in a counterclockwise direction. The activation wavefront propagates in…

…atherosclerotic plaque disruption (rupture or erosion). The dynamic thrombotic component can vary in burden and may lead to distal coronary embolization, resulting in myocyte necrosis…

…by a rising and/or falling troponin pattern with at least one value above the assay specific 99th percentile upper reference limit; and Evidence that…

…above the assay specific 99th percentile upper reference limit (URL). It is considered acute when there is a rise and/or fall in cTn values…

…wave contour on ECG The normal P wave (Figure 1, upper panel) is typically smooth, symmetric and positive. The P wave in lead II may…

…and electrical vectors have been discussed in the chapter The ECG Leads. Acquisition of ECGs in pediatric patients is slightly different from adults, due to…

…pathway). This is associated with a delta wave. For further details on the PR interval and the PR segment, refer to The normal electrocardiogram (ECG).

…can also be sought anterior to the lateral malleolus. Calculation: for each leg, the highest of the dorsalis pedis and posterior tibial pressures is divided…

…clearance from day to day. Reassess the dose daily and follow creatinine. Underdosing in sepsis is more dangerous than exceeding the upper dose limit during…

…at retrieval Maintained up to retrieval Ceased; warm ischaemic time is the limiting factor The time critical element The diagnosis and the donor care The…

…the patient to look down. Grasp the eyelashes, press gently downwards on the upper border of the tarsal plate with a cotton bud, and at…

…lies supine or sits. The upper arm is held adducted against the trunk and the elbow is flexed to 90 degrees. The forearm is moved…

…upper normal range, around 4.0–4.5 mmol/L, and continue replacement throughout the treatment. This is the prerequisite for the urine pH to…

…predisposes the myocardium to a specific form of polymorphic ventricular tachycardia (VT) known as torsades de pointes (TdP). Drug induced LQTS and TdP represent a…

…other platelet pathways. The distinction between primary and secondary prevention is fundamental: Primary prevention refers to individuals without established atherosclerotic cardiovascular disease (ASCVD), coronary artery…

…characterized systematically, including: Onset and duration. Location and radiation. Quality and intensity. Precipitating factors, including exertion, emotional stress, meals, or exposure to cold. Relieving factors…

…and Cardiovascular Outcomes The global burden of obesity is increasingly defined by its cardiovascular consequences. In 2015, high body mass index (BMI) was linked to…

…vena cava continues to the right atrium. Meanwhile, deoxygenated blood in the superior vena cava (which returns blood from the head and upper limbs) also…

…This is rather easy to understand because lead II is angled alongside the P wave vector, and the exploring electrode is located in front of…

…much more common than upper extremity symptoms. The severity of symptoms should be described by their effect on walking distance, daily activities, work and independence…

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

…symptoms (SAMS). These range from diffuse myalgia with a normal CK and no functional impairment to myositis with muscle inflammation and elevated CK. Rhabdomyolysis is…

…sensation across the precordium and may radiate to the neck, shoulder, jaw, back, upper abdomen, and left or right arm. Onset and evolution How do…

…skeletal muscle damage or inflammation may result in elevated cTnT levels. Although both troponin T and I may be chronically elevated in patients with renal…

…artery disease (CAD), frequently referred to as stable angina pectoris , has traditionally been defined and managed as a distinct clinical entity. The hallmark of stable…

…AHA) and European (ESC) guidelines. Reference limit for troponins Regardless of how sensitive troponin assays are, it is always possible to define an upper reference…

…vena cava continues to the right atrium. Meanwhile, deoxygenated blood in the superior vena cava (which returns blood from the head and upper limbs) also…

Arrhythmias and arrhythmology ECG The QT interval, long QT syndrome (LQTS) & ventricular arrhythmias (torsade de pointes) due to prolonged QT interval The QT interval is…

Introduction to Coronary Atherosclerosis, Plaques, Atherothrombosis Coronary atherosclerosis is a chronic, progressive, and highly dynamic inflammatory disease of the arterial wall. It is characterized by…

…not conducted to the atria or are so with a delay. This manifests with loss of P waves (loss of atrial activation) and consequently loss…

…artery disease (CAD), frequently referred to as stable angina pectoris , has traditionally been defined and managed as a distinct clinical entity. The hallmark of stable…

…interval and ride straight through the strip, without any relation to QRS complexes. P waves may occur on the ST T segment ( Figure 1 , upper…

…of an upper limit for ventricular compliance. The greater the left ventricular compliance, the less steep the slope of the EDPVR curve, and vice versa…