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Injection technique — intramuscular, subcutaneous and intradermal

…A paretic limb — poorer absorption. Injection into an arm with a dialysis fistula. Preparation and equipment Hand disinfection; gloves where there is a risk of…

Urinary alkalinisation

…urine stays acidic however much bicarbonate is given. Potassium replacement is not the management of a side effect; it is part of the treatment itself…

Opioid therapy in severe pain

…Flush the cannula before and after every dose, otherwise the dose does not arrive until the next flush. Assess the pain both at rest and…

Ankle-brachial index (ABI)

…of objectively demonstrating peripheral arterial disease, and it is needed more often than it is used — not only in claudication, but before every compression treatment…

Warfarin therapy

…What determines whether the treatment is safe is not the starting dose but the system around the patient : that the weekly dose is adjusted in…

Arterial line

…s phenomenon, thromboangiitis obliterans. An arm with an AV fistula or with planned vascular access for dialysis. Previous vascular surgery in the area. Coagulopathy and…

Central venous catheter

…Haemodialysis, plasmapheresis or other extracorporeal therapy (requires a large bore dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure and central…

Gastric lavage and activated charcoal

…also does not bind every poison. With the following substances charcoal is ineffective and management is instead governed by the antidote, supportive treatment or dialysis:…

Acute kidney injury: quick reference for management

…AKI, is a syndrome of rapidly deteriorating renal function. Management is governed not by the creatinine value alone but by the course, urine output, volume…

Ambulatory blood pressure monitoring and Holter ECG

…the patient to stop, keep the arm still and lowered at each measurement, and not to talk. Otherwise ordinary activities, including work. No showering or…

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