…vomiting is less specific than fresh haematemesis and can also be seen when the bleeding is slow or has stopped. The first steps Step Content …

…pseudoaneurysm Surgeon, ultrasound first Other situations that argue for the operating theatre rather than the emergency room: a very large or deep abscess, a markedly…

…Remove socks and any compression stockings. Avoid measuring the arm pressure on the side with a dialysis fistula, lymphoedema after axillary clearance or a recently…

…oxygen content, coronary steal, and myocardial ischaemia. Coronary fistulae create an abnormal connection between a coronary artery and a cardiac chamber or vessel. Clinical presentation…

…and irregular ventricular rate (oscillometric measurement becomes unreliable), lymphoedema or a dialysis fistula in both arms, an arm circumference too large for the available cuffs…

…as part of fluid management. Contraindications Infection, burn or trauma over the insertion site. Insufficient collateral circulation to the hand. Vascular disease in the limb…

…vaccination. Relative: Lymphoedema or previous axillary clearance on the same side. A paretic limb — poorer absorption. Injection into an arm with a dialysis fistula. Preparation…

…locally. Contraindications Peripheral venous cannula: Infection, burns or trauma at the puncture site. An arm with an arteriovenous fistula, previous axillary clearance or lymphoedema. A…