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Fetal Tachycardia

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101. Ectopic pregnancy and miscarriage: diagnosis and initial management

by a healthcare professional. Signs of ectopic pregnancy include: more common signs: pelvic tenderness adnexal tenderness abdominal tenderness other reported signs: cervical motion tenderness rebound tenderness or peritoneal signs pallor abdominal distension enlarged uterus tachycardia (more than 100 beats per minute) or hypotension (less than 100/ 60 mmHg) shock or collapse orthostatic hypotension. [2012] [2012] 1.3.5 During clinical assessment of women of reproductive age, be aware that: they may (...) and of tubal ectopic pregnancy 1.4.1 Offer women who attend an early pregnancy assessment service (or out-of- hours gynaecology service if the early pregnancy assessment service is not available) a transvaginal ultrasound scan to identify the location of the pregnancy and whether there is a fetal pole and heartbeat. [2012] [2012] 1.4.2 Consider a transabdominal ultrasound scan for women with an enlarged uterus or other pelvic pathology, such as fibroids or an ovarian cyst. [2012] [2012] 1.4.3

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

103. Clinical management of severe acute respiratory infection when COVID-19 is suspected

respiratory distress; or SpO2 = 93% on room air (adapted from 14). Child with cough or difficulty in breathing, plus at least one of the following: central cyanosis or SpO2 2 mmol/L. Children: any hypotension (SBP 2 SD below normal for age) or two or three of the following: altered mental state; tachycardia or bradycardia (HR 160 bpm in infants and HR 150 bpm in children); prolonged capillary refill (> 2 sec) or feeble pulse; tachypnea; mottled or cool skin or petechial or purpuric rash; increased lactate (...) of therapy for patients that develop severe manifestations of COVID-19. Remarks 3: After resuscitation and stabilization of the pregnant patient, then fetal well-being should be monitored. Understand the patient’s co-morbid condition(s) to tailor the management of critical illness. Remark 1: Determine which chronic therapies should be continued and which therapies should be stopped temporarily. Monitor for drug-drug interactions. Use conservative fluid management in patients with SARI when

2020 WHO Coronavirus disease (COVID-19) Pandemic

104. Clinical care of severe acute respiratory infections – Tool kit

. ? May need escharotomy Signs of ail chest (section of chest wall moving in opposite direction with breathing) Give oxygen. ? May need advanced airway management and assisted ventilation Signs of haemothorax (decreased breath sounds on one side, dull sounds with percussion) Give oxygen, IV uids. ? Will need chest tube Circulation C Signs of shock (capillary re ll >3 sec, hypotension, tachycardia) Give oxygen, IV uids, control external bleeding, splint femur/pelvis as indicated. Uncontrolled (...) and crackles on both sides Pulmonary oedema, heart failure Wheezing Asthma, allergic reaction, COPD Fast or deep breathing DKA Low blood pressure, tachycardia, mu ed heart sounds Pericardial tamponade Altered mental status with small pupils and slow breathing Opioid overdose Key Findings from the SAMPLE History and Secondary Exam IF YOU FIND... REMEMBER... DIB worse with exertion or activity Heart failure, heart attack DIB that began with choking or during eating Foreign body, allergic reaction History

2020 WHO Coronavirus disease (COVID-19) Pandemic

105. Early Cerebral Hemodynamic, Metabolic, and Histological Changes in Hypoxic-Ischemic Fetal Lambs during Postnatal Life. Full Text available with Trip Pro

hours of postnatal life following severe fetal asphyxia. Eighteen chronically instrumented newborn lambs were randomly assigned to either a control group or the hypoxic-ischemic (HI) group, in which case fetal asphyxia was induced just before delivery. All the animals were maintained on intermittent positive pressure ventilation for 3 h after delivery. During the HI insult, the injured group developed acidosis, hypoxia, hypercapnia, lactic acidosis, and tachycardia (relative to the control group (...) Early Cerebral Hemodynamic, Metabolic, and Histological Changes in Hypoxic-Ischemic Fetal Lambs during Postnatal Life. The hemodynamic, metabolic, and biochemical changes produced during the transition from fetal to neonatal life may be aggravated if an episode of asphyxia occurs during fetal life. The aim of the study was to examine regional cerebral blood flow (RCBF), histological changes, and cerebral brain metabolism in preterm lambs, and to analyze the role of oxidative stress in the first

2011 Frontiers in neuroscience Controlled trial quality: uncertain

106. Developmentally Regulated SCN5A Splice Variant Potentiates Dysfunction of a Novel Mutation Associated with Severe Fetal Arrhythmia Full Text available with Trip Pro

magnetocardiography was used to demonstrated torsades de pointes and a prolonged rate-corrected QT interval. In vitro electrophysiological studies were performed to determine functional consequences of a novel SCN5A mutation found in the fetus.The fetus presented with episodes of ventricular ectopy progressing to incessant ventricular tachycardia and hydrops fetalis. Genetic analysis disclosed a novel, de novo heterozygous mutation (L409P) and a homozygous common variant (R558 in SCN5A). In vitro (...) Developmentally Regulated SCN5A Splice Variant Potentiates Dysfunction of a Novel Mutation Associated with Severe Fetal Arrhythmia Congenital long-QT syndrome (LQTS) may present during fetal development and can be life-threatening. The molecular mechanism for the unusual early onset of LQTS during fetal development is unknown.We sought to elucidate the molecular basis for severe fetal LQTS presenting at 19 weeks' gestation, the earliest known presentation of this disease.Fetal

2011 Heart Rhythm

107. Diagnosis and management of common fetal arrhythmias Full Text available with Trip Pro

Diagnosis and management of common fetal arrhythmias Fetal arrhythmias are detected in at least 2% of unselected pregnancies during routine obstetrical scans. Most common are transient, brief episodes of a slow or fast heart rate or of an irregular heart rhythm. Less common are prolonged or persistent abnormalities such as supraventricular tachycardia and complete heart block which may lead to low cardiac output, fetal hydrops and demise. The objectives of this review are to update the reader

2011 Journal of the Saudi Heart Association

108. Fetal heart ventricle mass obtained by STIC acquisition combined with inversion mode and VOCAL. (Abstract)

Fetal heart ventricle mass obtained by STIC acquisition combined with inversion mode and VOCAL. Estimation of fetal heart ventricular mass is important for fetal cardiac evaluation in cases of structural or functional cardiac disorders or extracardiac factors. It may be used with other cardiac parameters to ascertain the severity and prognosis of such disorders, or the nature and timing of intervention. We applied a novel technique combining spatiotemporal image correlation (STIC) with three (...) -dimensional inversion mode and Virtual Organ Computer-aided AnaLysis (VOCAL™) for fetal cardiac mass assessment in healthy fetuses in the second and third trimesters.STIC acquisition was performed during fetal quiescence with the abdomen uppermost, at an angle of 30-50°, without color Doppler mapping. Myocardial volume measurements were performed in postprocessing using VOCAL mode, set to 15°. Beginning with the heart in four-chamber view at end diastole, a trace was drawn manually including

2011 Ultrasound in Obstetrics and Gynecology

109. [Comparison of effects in puerpera and fetus with ephedrine and phenylephrine during a cesarean delivery]. (Abstract)

changes [5 min: (143 ± 9) times/min vs(143 ± 6) times/min, P > 0.05]. The incidence of fetal tachycardia in groups E and E + Ph was greater than that in group Ph. In group E, umbilical arterial and umbilical venous pH and base excess were lower than those in groups E + Ph and Ph [umbilical arterial: 7.20 ± 0.10 vs 7.27 ± 0.05, 7.28 ± 0.03, (-3.1 ± 3.1) mmol/L vs (-0.9 ± 1.7) mmol/L, (-0.3 ± 1.7) mmol/L, umbilical venous:7.29 ± 0.09 vs 7.34 ± 0.03, 7.34 ± 0.03, (-3.3 ± 2.9) mmol/L vs (-2.0 ± 1.7) mmol (...) following spinal anesthesia, improves fetal oxygen supply and demand balance but induces no metabolic excitation in fetus as compared with ephedrine.

2011 Zhonghua yi xue za zhi Controlled trial quality: uncertain

111. Placenta praevia

with an abnormally adherent placenta, where the placenta attaches to the myometrial layer of the uterus. Vasa praevia, where the fetal vessels lie over the internal cervical os, is an associated condition. In this topic we refer to all varieties of invasive placentation as abnormally adherent placenta. There are three commonly defined variants: placenta accreta (where chorionic villi attach to the myometrium, rather than being restricted within the decidua basalis), placenta increta (where the chorionic villi (...) invade into the myometrium), and placenta percreta (where the chorionic villi invade through the myometrium and sometimes into adjoining tissue). Publications Committee, Society for Maternal-Fetal Medicine, Belfort MA. Placenta accreta. Am J Obstet Gynecol. 2010 Nov;203(5):430-9. https://www.ajog.org/article/S0002-9378(10)01159-2/fulltext http://www.ncbi.nlm.nih.gov/pubmed/21055510?tool=bestpractice.com Although these distinctions are important to consultants, they do not change management decisions

2019 BMJ Best Practice

112. Polyvalent immunoglobulins – Part 1: A rapid review

, tachycardia, which may in some cases, be avoided by lowering the infusion speed, or switching to SCIg 33 . Infusion- related risks of AEs have been reduced considerably in recent years, due to improved manufacturing processes. 34 Next to the systemic AEs, there are also local side effects. Mild local reactions appear to be more frequent with SCIg use. 34 Other, more serious side effects mentioned in the literature include anaphylactic reactions (2–27 % of all infusions) 35 , thromboembolic events, aseptic

2020 Belgian Health Care Knowledge Centre

113. Meconium aspiration syndrome

tachypnoea cyanosis systolic murmur chest wall asymmetry with decreased air entry barrel-shaped chest grunting chest retractions rales rhonchi tachycardia hypotension gestational age >42 weeks maternal history of hypertension, pre-eclampsia, eclampsia, smoking, substance abuse fetal distress oligohydramnios thick meconium Apgar score <7 chorioamnionitis caesarean delivery black or East Asian ancestry male sex Diagnostic investigations CXR FBC CRP blood culture dual pulse oximetry ABG (pH, PaO₂, PaCO (...) in the presence of maternal and fetal risk factors. Soon after birth, infants present with respiratory distress (tachypnoea, chest retractions, and hypoxia). Some may be asymptomatic and apparently vigorous at birth, and develop severe respiratory distress hours later. Signs of post-maturity, a strong risk factor, include green/yellow-coloured skin; long, stained nails; and dry, scaling skin. Diagnosis is confirmed by chest x-ray. Management is largely supportive. Infants should be monitored closely to ensure

2019 BMJ Best Practice

114. Naloxone nasal spray (Nyxoid) for opioid overdose

of one pack (two doses) with no repeats. Acute withdrawal can occur Acute opioid withdrawal is a common adverse effect that can occur when the patient has a physical dependence on opioids. , Symptoms of acute opioid withdrawal include, restlessness, nausea, vomiting, gastrointestinal pain, yawning, muscle spasms, dysphoria, anxiety, agitation, tachycardia, increased blood pressure and confusion. If these symptoms occur, then no further naloxone nasal spray should be given to the patient (...) . , Precautions are required for pregnant women, neonates and paediatric patients. Naloxone crosses the placenta and can cause acute opioid withdrawal in the foetus as well as the mother if they have opioid dependency. A balance of the risks and benefits should be considered before using naloxone nasal spray for pregnant women. If used, the foetus should be monitored for signs of distress. , In neonates, acute opioid withdrawal can be life-threatening if not recognised and properly treated. Signs

2020 National Prescribing Service Limited (Australia)

115. Diagnosis and Management of Acute Pulmonary Embolism Full Text available with Trip Pro

CYP3A4 Cytochrome 3A4 DAMOVES D-dimer, Age, Mutation, Obesity, Varicose veins, Eight [coagulation factor VIII], Sex DASH D-dimer, Age, Sex, Hormonal therapy DVT Deep vein thrombosis ECMO Extracorporeal membrane oxygenation ELISA Enzyme-linked immunosorbent assay EMA European Medicines Agency ERS European Respiratory Society ESC European Society of Cardiology FAST H-FABP, Syncope, Tachycardia (prognostic score) FDA US Food and Drug Administration GUSTO Global Utilization of Streptokinase and Tissue

2019 European Society of Cardiology

116. Management of Poisoning

should be used (pg 57). Grade D, Level 3 B Patients with actual or potential life threatening cardiac arrhythmia, hyperkalaemia or rapidly progressive toxicity from digoxin poisoning should be treated with digoxin-speci? c antibodies (pg 57). Grade B, Level 2++ B Titrated doses of benzodiazepine should be given in hyperadrenergic- induced tachycardia states resulting from poisoning (pg 57). Grade B, Level 1+ D Non-selective beta-blockers, like propranolol, should be avoided in stimulant toxicity (...) as unopposed alpha agonism may worsen accompanying hypertension (pg 57). Grade D, Level 3 D Physostigmine should be considered for treating tachycardia resulting from pure anticholinergic poisoning (pg 58). Grade D, Level 3 Executive summary of key recommendations2 GPP Lidocaine is the drug of choice for most ventricular arrhythmias due to drug toxicity (pg 58). GPP C Sodium bicarbonate should be used in impaired conduction defect caused by sodium channel blocking agents such as tricyclic antidepressants

2020 Ministry of Health, Singapore

120. Pharmacological Agents for Procedural Sedation and Analgesia

and analgesia 2. analgesia Administration: Can be administered in IV boluses, as an IV infusion or intramuscularly. Side effects: tachycardia, hypertension, laryngospasm, unpleasant hallucinations (reduced by pre-medication with a benzodiazepine), nausea and vomiting, hyper- salivation, increased intracranial and intraocular pressure. Contraindications: Absolute contraindications: age less than 3 months, known or suspected schizophrenia. Relative contraindications: age less than 1 year, active pulmonary (...) contraindications to PSA in paediatric patients include difficult airway or significant co-morbidities, sleep apnoea, special needs, and decreased GI motility (5). Given the increasing risk of airway complications in younger ages, extreme caution is advised under the age of 2 years, especially when using benzodiazepines, and many local polices and RCEM sedation guidance 2009 limit this. Pregnant patients: Additional considerations include positioning, oxygenation, foetal monitoring and pre-procedural medication

2019 Royal College of Emergency Medicine

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