…compression. Infection in the skin overlying the puncture site. Previous pelvic irradiation on the intended side (yields fibrotic, unrepresentative marrow — choose the other side). A…

…electrolytes can be interpreted, but some laboratories do not accept marrow blood in their analysers — check locally. Contraindications Peripheral venous cannula: Infection, burns or trauma…

…haematological malignancy, stem cell transplantation, immunosuppressive drugs, radiotherapy, bone marrow failure and certain targeted cancer treatments. Fever is not obligatory Hypothermia, new confusion, tachypnoea, hypotension…

…compression. The reason compression nevertheless so often fails is that it is done wrongly: the patient pinches the nasal bone instead of the soft part…

…steatohepatitis or viral hepatitis. An isolated raised ALP — check the GGT. A normal GGT shifts the suspicion to bone, pregnancy or malignancy. A markedly raised…

…does not distinguish between fat, muscle, and bone mass. It does not indicate the types or distribution of body fat. It may not be accurate…

…ECG, selective vascular imaging Traumatic or toxic syndrome Onset after trauma, a change in medication or an exposure Concussion, temporal bone injury, dissection, aminoglycoside toxicity…

…at multiple angles. Tissue attenuation is expressed relative to water in Hounsfield units. Bone is highly attenuating, air has very low attenuation, and blood and…

…comes after the injury, not before — and that an edge or a fold presses on a bony prominence until the skin breaks down. An acute…

…make sure that never happens, and to make sure the catheter does not become the patient's next focus of infection. Indications Infusion of vesicant…

…incoming products and contact with the blood bank. 3. Secure large bore access, or rapid central access, but do not delay transfusion or control of…

…wait for complete diagnostic certainty. Sepsis is defined as life threatening organ dysfunction caused by a dysregulated host response to infection. Clinically this usually corresponds…

…the work of breathing, the peripheral perfusion and the signs of shock 2 Two large bore peripheral cannulae. Consider an arterial line if the patient…

…prevention of cardiac arrest. Unfortunately, these efforts have not borne fruit. Our current ability to predict cardiac arrest remains poor at best. A key explanation…

…age) while awaiting the result. Equipment A large bore peripheral cannula — at least 1.3 mm (green) for rapid transfusion, preferably two lines in a…

…and equipment for confirming the position. For gastric lavage: a wide bore orogastric tube (Ch 28–32 in an adult), a funnel or a lavage…

…Preparation and equipment A tube of a suitable size. A wide bore tube (Ch 14–18) of polyvinyl chloride for decompression and evacuation; a fine…

…will heal badly however neatly the suture is placed. The commonest cause of wound infection is retained contamination, not poor suture technique — and the commonest…