Adult Bradycardia Algorithm Download algorithm Features of unstable bradycardia • Hypotension?• Signs of shock?• Acutely altered mental status?• Ischaemic chest discomfort?• Acute heart failure? Causes Common causes:• Myocardial ischaemia / infarction• Hypoxia • Drugs e.g. calcium channel blockers, beta blocker, digoxin• Electrolyte imbalance e.g. hyperkalaemia Other causes:• Endocrine related e.g. hypothyroidism• Typhoid • Cushing reflex […]
Definition Mild hyperkalaemia: >5.5 – 6.0 mmol/L Moderate hyperkalaemia: >6.0 – 7.0 mmol/L Severe hyperkalaemia: >7 mmol/L 💡Tips– Check formal RP result, to look for documentation of ‘haemolysed blood‘ in the formal report. If so, the ‘hyperkalaemia’ might not be reliable and RP should be repeated prior to giving treatment. – Do ECG! If ECG […]
Normal Range Notes: Some blood gas machines can analyse additional parameters such as lactate, Hb, potassium, calcium levels which would be helpful for decision making during emergencies Respiratory acidosis Features in ABGpH <7.35 + pCO2 >45 mmHg + HCO3- >30 mmol/L —–(i) Acute respiratory acidosis – For every 10 mmHg increase in pCO2, HCO3- will […]
COPD Assessment Modified MRC Dyspnoea scale mMRC Grade 0: I only get breathless with strenuous exercise mMRC Grade 1: I get short of breath when / walking up a slight hill mMRC Grade 2: I walk slower than people of the same age on the level because of breathlessness // I have to stop for […]
Diagnostic criteria • S wave depth in V1 + tallest R wave height in V5-V6 > 35 mm Voltage criteria Limb LeadsR wave in lead I + S wave in lead III > 25 mmR wave in aVL > 11 mmR wave in aVF > 20 mmS wave in aVR > 14 mm Precordial LeadsR […]
Introduction Trimodal model of trauma mortality • — death within minutes of injury• — ‘early death’, i.e. death within hours of arrival to hospital• — ‘late death’, i.e. death after 24 hours of trauma (days to weeks post injury) =====Further reading: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3603725/#:~:text=The%20first%20peak%20in%20the,after%20arrival%20to%20the%20hospital. Polytrauma • A clinical syndrome with severe injuries, involving two or more major […]
Risk Factors • History of thromboembolism / Inherited thrombophilia• • • Malignancy• Active inflammation• Pregnancy / COCP / HRT Investigations Blood • D-Dimer : Cardiac USG for massive acute pulmonary embolism : – right ventricle with of right ventricular apex – right ventricular wall– —–• is no longer a reliable sign for pulmonary embolism —–Relevant […]
Preparation Patient’s position: supinePreset: cardiacProbe: Sector probe, B mode Indications / Uses • Cardiac tamponate• Massive acute pulmonary embolism• Estimation of left ventricular ejection fraction 4 Standard Cardiac Views • Parasternal long axis: 2 – 4th left intercostal space just next to sternum • Parasternal short axis (parallel to long axis of left ventricle): rotate […]
Preparation • Patient’s position: supine• Preset: lung• Probe: curvilinear B and M mode• Probe position: anterior chest wall mid clavicular line, sagittal plane; R1 / L1 Signs ⚽️ A-lines– Repetitive horizontal artifacts that recur at recur at regular intervals that are equal to distance between probe-skin interface and pleural-subpleural air interface – Not representing any […]
Introduction Indication: To detect (e.g. haemoperitoneum, free pericardial fluid, free pleural fluid) Preparation Position of patient: supine Preset: AbdominalProbe: Curvilinear, B mode 4 quadrants (i) Subxiphoid / Subcostal – Pericardium • Over epigastrium, almost in coronal plane• Find the ‘heart shape’ during scan, look for • Use liver as acoustic window (ii) Right upper quadrant […]