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Featured
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Featured
pain- do not miss:
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Featured
A. S.H.O.C.K.E.D. patient
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Featured
S.H.I.T. happens
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Featured
ICU
A ABC of Intensive Care https://vigilant.school.blog/2025/05/01/abc-of-the-intensive-care-bmj-1999/ Analgesia and sedation https://vigilant.school.blog/2024/08/13/analgesia-and-sedation-in-the-icu/ Anticoagulation Argatroban https://vigilant.school.blog/2025/01/04/argatroban/ Heparin https://vigilant.school.blog/2025/01/04/uhf-heparin-heparin-pseudoresistancy/ HIT https://vigilant.school.blog/2025/01/04/hit-hit-2-hitt-hitts/ ARDS https://vigilant.school.blog/2024/09/10/ards/ Arterial line https://vigilant.school.blog/2025/09/02/arterial-line/ Aspergillosis https://vigilant.school.blog/2024/09/10/invasive-pulmonary-aspergillosis-in-the-icu/ B Bronchoscopy https://vigilant.school.blog/2025/09/08/bronchoscopy/ C CDI C.diff infection https://vigilant.school.blog/2025/12/22/c-diff-infection/ Central venous lines https://vigilant.school.blog/2024/03/15/mental-roadmap-to-cvc/ D E vvECMO Alarm: low flow https://vigilant.school.blog/2025/05/01/ecmo-alarms-low-flow/ Pressures https://vigilant.school.blog/2025/09/10/vvecmo-pressures/ Priming https://vigilant.school.blog/2020/07/29/novolung-priming-ecmo/ Anschluss https://vigilant.school.blog/2021/08/15/vvecmo-anschluss/ Hypoxemia on vvECMO https://vigilant.school.blog/2025/04/01/hypoxemia-on-vvecmo/ Hypercapnia on… Read more
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Methylene Blue
Causes for methemoglobinemia
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C.diff infection
European Guidelines ESCMID https://www.clinicalmicrobiologyandinfection.org/article/S1198-743X(21)00568-1/fulltext PEARLS CDI ________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________
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Perfusoren Barmherzige Brüder
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PDK Markierungen
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approach to oliguria Joannides 2018
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arboviruses
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GEO
A arboviruses https://vigilant.school.blog/2025/09/12/arboviruses/ B C D dengue https://vigilant.school.blog/2010/07/05/dengue/ E F G H geographic causes of headache with normal CSF https://vigilant.school.blog/2023/10/01/headache-fever-normal-csf/ I J K L M N O P Q R S T U V VL visceral leishmaniasis https://vigilant.school.blog/2024/11/25/visceral-leishmaniasis-vl/ W X Y Z
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vvECMO pressures
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bronchoscopy
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arterial line
Leveling and zeroing of the arterial line
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Perkutane dilatative Tracheotomie PT
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Impella
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Liver injury: “driver” or “bystander”
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Levosimedan
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TOF
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pacemaker settings
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pancreatitis
_____________________________________________________________________________________________________________ NUTRITION IN PANCREATITIS NECROSIS: INFECTED?
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DM medications
FOAMed resources
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toxic alcohols: ethylene glycol and methanol
FOAMed resources PEARLS toxic alcohols _____________________________________________________________________________________________________________
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high ferritin
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mental roadmap to brucellosis
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ECMO alarms: low flow
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ABC of the Intensive Care, BMJ 1999
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hypoxemia on vvECMO
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mental roadmap to Sweet syndrome
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hypercapnia on vvECMO
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H.I.E.T HIET HyperInsulinemic Euglycemia Therapy
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neurologische ICUs in München
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septic pulmonary emboli SPE
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HIT HIT-2 HITT HITTS
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UHF heparin heparin pseudoresistancy
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Argatroban
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light chain monoclonal gammopathy of undetermined significance, sFLC, LC-MGUS
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Schrittmacher-Notfälle
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mental roadmap to intubation
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video laryngoscopy VL
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mental roadmap to cryoglobulinemias
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vasopressors as drips (Perfusor)
FOAMed resources
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Methylene Blue in shock
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hypoxia
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visceral leishmaniasis VL
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mental roadmap to PiCCO
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rhabdomyolysis CK-elevation hyperCKemia
https://www.mdcalc.com/calc/4017/mcmahon-score-rhabdomyolysis PEARL Rhabdomyolysis
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Invasive pulmonary aspergillosis in the ICU
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ARDS
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PESO
NutriVent Placement:
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analgesia and sedation in the ICU
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PVT portal vein thrombosis
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post-cardiac arrest care / postROSC / post-resuscitation care
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Paracetamol / Acetaminophen toxicity including NAC ACC acetylcystein Fluimucil protocols
Fluimucil Antidot 20% Fachinfo
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mental roadmap to aortic stenosis AS
VIDEOs PEARLS AS
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mental roadmap to neuromuscular blocking agents NMB NMBA
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iron deficiency
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peripheral line PVL PVC
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treatment of hypersensitivity/ anaphylaxis with IV Adrenalin
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mental roadmap to AOSD
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mental roadmap to CVC
Visualizing the tip of the needle The tip of the needle is visualized best when the bevel and the probe are perpendicular (90°): https://www.youtube.com/watch?v=nJCcJu4e-yM to-and-fro method for U/S-guided dynamic needle tip positioning: to-and-fro method FOAMed resources General information https://derangedphysiology.com/main/required-reading/equipment-and-procedures/Chapter%20211/central-venous-access-device-insertion https://www.pocus101.com/ultrasound-guided-central-line-placement-made-easy-step-by-step-guide/ Visualization of the needle https://pie.med.utoronto.ca/OBAnesthesia/OBAnesthesia_content/OBA_needling_module.html https://icuscenarios.com/tirbo-20-understanding-the-needle/ https://youtu.be/nJCcJu4e-yM?si=6vfcVjyqEcI4qEdv Tipps and tricks by Scott Weingart https://emcrit.org/squirt/central-lines/ https://youtu.be/ukEv7NgH3iQ?si=1QYuiwxm5fNWiWTw… Read more
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S-Ketamin KetaminS Esketamin KetanestS
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mental roadmap to enteric fever (typhoid/paratyphoid fever, Typhus abdominalis)
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pulmonary cavities/ cavitary lesions
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pulmonary nodules
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mental roadmap to AMR antimicrobial resistance: Gram negative rods
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HCID
https://www.gov.uk/guidance/high-consequence-infectious-diseases-hcid#definition-of-hcid https://multimedia.gsb.bund.de/RKI/Flowcharts/HCID-FS/# https://ndc.services.cdc.gov/case-definitions/viral-hemorrhagic-fever-2022/#:~:text=Clinical%20Criteria&text=severe%20headache,vomiting http://www.who.int/csr/don/en/ Home – ProMED http://www.fevertravel.ch/
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mental roadmap to LDH
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mental roadmap to AECOPD
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mental roadmap to infective endocarditis IE
Skin manifestations IMAGING https://www.emugs.org/post/bedside-echo-to-diagnose-native-valve-infective-endocarditis-a-case-series PROLAPSE AGAINST THE BLOOD FLOW PEARLS infective endocarditis _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _____________________________________________________________________________________________________________
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mental roadmap to leptospirosis
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mental roadmap to postoperative care
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mental roadmap to PHS parkinsonism hyperpyrexia syndrome / akinetische Krise
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FIVE to remember
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thunderclap headache
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secondary headaches
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GEO geographic causes of headache + fever + NORMAL CSF
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mental roadmap to adrenal insufficiency
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metabolic acidosis: presentation of data
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mental roadmap to TLS tumor lysis syndrome
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proteinuria
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chylothorax
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hemothorax
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autoimmune encephalitis incl paraneoplastic encephalitis
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Pleural effusion
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VAP
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aspiration
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GGO ground-glass opacities
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sore throat badnesses
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mental roadmap to hypovolemia
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renal manifestations of a systemic disease
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NO gastroenteritis
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mental roadmap to toxic shock syndrome TSS
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OACs after stroke
Dr. Katie Lin, the latest guidance with regards to initiation of oral anticoagulants in stroke patients follows the AHA/Canadian Stroke Best Practice Guidelines is the “1-3-6-12 rule”, which states that OAC may be initiated based on size of infarct as follows: TIA with no visible infarct on imaging – 24hrs post eventMinor stroke (NIHSS<8) with… Read more
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AMPLE: do not miss allergies, anticoagulants etc
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documentation
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mental roadmap to pituitary apoplexy
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hemostatic resuscitation
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IMH PAU
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Polycythemia Vera PV and relative polycythemias incl stress hemoconcentration
Relative polycythemias incl stress hemoconcentration (stress-hemoconcentration) Second, and more commonly, hemoconcentration occurs when the number of red blood cells remains constant while plasma volume decreases. This condition has been variously referred to as ‘stress’ polycythemia, relative polycythemia, pseudopolycythemia, spurious polycythemia, or stress-hemoconcentration.
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refractory hypoxemia
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Sudden death in adults
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monomorphic VT on the ICU
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ventricular tachycardia VT on the ECG: WCT
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1122646/ Ventricular Tachycardia – Monomorphic VT
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CS cardiogenic shock
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myocarditis
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mental roadmap to epiglottitis
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hypertensive crisis
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predisposing factors for ventricular arrhythmias
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diuresis
https://onlinelibrary.wiley.com/doi/10.1002/ejhf.1369 PEARLS diuresis
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CO poisoning
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mental roadmap to PRES
medications associated with PRES https://www.medsafe.govt.nz/profs/PUArticles/March2017/PERSLinkedtoMedicines.htm tacrolimus (rarely sirolimus) ciclosporin bevacizumab sunitinib sorafenib interferon alpha intravenous immunoglobulins cisplatin cytarabine fludarabine rituximab infliximab alemtuzumab corticosteroids bortezomib
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toxidromes
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acute RV dysfunction/ failure
References Links To EMCrit 272 – Right Heart Failure With Dr. Sara Crager https://www.cfrjournal.com/articles/right-ventricular-failure-pathophysiology-diagnosis-and-treatment#ArticleInfoTab https://erj.ersjournals.com/content/42/6/1696#T1https://www.atsjournals.org/doi/10.1513/AnnalsATS.201312-446FR?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed https://www.hindawi.com/journals/bmri/2017/8217105/
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cardiac pericardial tamponade
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pericardial disease: pericardial effusion, pericarditis
for pericardial tamponade = cardiac tamponade, please refer to “tamponade” EKG https://emergencymedicinecases.com/tag/pericarditis/ POCUS: vanPOCUS: Pericardial Effusion and Tamponade Pleural Effusions, Part 1 Pleural Effusions, Part 2 http://5minsono.com/quantifying-pleural-effusions/
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cirrhosis in the ED
CHECKLIST for ED GUIDELINES German Sk2 Guideline 2019
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variceal bleeding
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liver in sepsis and systemic infection
sepsis-induced cholestasis https://aasldpubs.onlinelibrary.wiley.com/doi/10.1002/hep.21480
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liver enzymes
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jaundice: hyperbilirubinemia
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hypoglycemia
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mental roadmap to TTP
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spontaneous retroperitoneal hemorrhage SRH, RPH
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mental roadmap to Budd-Chiari syndrome BCS
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treatment for Stenotrophomonas maltophilia
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diabetes mellitus (DM): in-patient management
https://clinical.diabetesjournals.org/content/29/1/3 https://care.diabetesjournals.org/content/40/4/509 https://care.diabetesjournals.org/content/42/Supplement_1/S173 https://www.ncbi.nlm.nih.gov/books/NBK279093/ https://diabetesjournals.org/care/article/45/Supplement_1/S244/138924/16-Diabetes-Care-in-the-Hospital-Standards-of https://www.diabetes.org.uk/professionals/resources/shared-practice/inpatient-and-hospital-care/joint-british-diabetes-society-for-inpatient-care
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id reaction
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Livedo reticularis, livedo racemosa and retiform purpura
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DM diabetes mellitus: diagnosis and classification
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(first-time) seizure in the ED
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atrial fibrillation with rapid ventricular rate in critically ill
_____________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ approach to anticoagulation in NOMED, rechts der Isar FOAMEd resources PEARLS atrial fibrillation ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ _______________________________________________________________________________________________________________
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vvECMO Anschluss
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leukocytosis and leukemoid reaction
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polycythemia
Polycythemia Vera PV and relative polycythemias incl stress hemoconcentration
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von Willebrand Jürgens disease vWD and acquired von Willebrand Jürgens syndrome avWS
https://www.haematologica.org/article/view/6652 acquired vWS in aortic stenosis incl. Heyde’s syndrome https://www.nejm.org/doi/full/10.1056/nejmoa022831
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agitation in a geriatric patient
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agitation in a non-geriatric patient
_______________________________________________________________________________________________________________ _________________________________________________________________________________________________________________ https://www.acep.org/patient-care/clinical-policies/severe-agitation
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elevated lactate
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urine electrolytes
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mental roadmap to cholesterol crystal embolization syndrome (CES) = atheroembolism
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mental roadmap to Penicillin allergy
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roadmap to Legionella
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dyspnea
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psoas abscess
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SCA/ SCD
Hypertrophic Cardiomyopathy (HCM) Arrhythmogenic Right Ventricular Dysplasia (ARVD) Brugada Syndrome EKG Case – Der hat doch nur „Kreislauf“…oder? Pre-excitation syndromes
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SIADH
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glomerulonephropathies
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PEARLS ventricular tachycardia
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RAF rash arthralgia fever
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electrocardiographic pause= ECG pause
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5642031/ https://reference.medscape.com/features/slideshow/cause-ekg-pause Symptomatic sinus bradycardia and syncope of the vasovagal type in young healthy people may be associated with very long pauses (>30 seconds). The duration of the pause should not necessarily be a cause for concern. This is transient and the treatment is reassurance. In some circumstances, symptomatic sinus bradycardia may need to be… Read more
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sarcoidosis
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antihistamines H1 blockers
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steroids
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VIGILANTIA et HUMILITAS 