Description
The hour that decides the outcome
Infarct size, neurological recovery after arrest, whether a dissection extends — much of what determines a cardiac patient’s eventual outcome is settled within sixty minutes of presentation, usually by whoever happens to be present rather than by a specialist.
For a large part of our directory, that person is them, and the specialist is a phone call and a transfer away.
Written as ordered actions
Sixteen chapters, each a sequence rather than a description: what to establish, in what order, what to give, what to prepare, and the specific point at which the plan changes if there is no response. Pathophysiology is not what a clinician lacks at a trolley at four in the morning.
Stabilise-and-transfer decisions
Because many members work without on-site intervention, transfer is treated as a clinical decision in its own right — who needs a catheter laboratory within ninety minutes, who can be stabilised and moved at a safer pace, what must be done before the ambulance departs, and what to hand over.
Scope
Acute coronary presentation and reperfusion. Arrest and post-resuscitation care. Unstable arrhythmia. Pulmonary oedema. Shock, including the compensated patient. Aortic emergency. Tamponade. Hypertensive crisis. Acute valve failure.
PDF, 419 pages, lifetime access, from CardiologyBooks.com.
The first sixty minutes
Acute cardiac care is decided in the interval before the specialist arrives, and this handbook is written for that interval. Cardiogenic shock, the tachyarrhythmia with a pulse, the bradycardia that will not wait for a wire, tamponade, aortic syndrome and the pulmonary embolism that has already destabilised are each presented as a sequence of actions with the thresholds attached.
Protocols that survive a bad night
Drug doses, infusion rates and escalation triggers are stated in full rather than referenced elsewhere, because a protocol that requires a second lookup is not a protocol. Where the evidence is weak the text says so and gives the pragmatic default. The handbook also covers the handover — what the receiving unit needs in the first thirty seconds of the call, and what delays acceptance.
