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Assessment of Pacemaker Malfunction

…dislodgement, lead fracture or inadequate myocardial contact. It may also be due to the low amplitude (voltage) of the potentials generated by activated myocardium. Functional…

Reduction of dislocations

…becomes and the greater the risk of chondral and neurovascular injury. Aim for reduction within a few hours. Contraindications A fracture dislocation requiring operative treatment …

Nail procedures — paronychia, ingrown toenail and subungual haematoma

…from the dorsal aspect, one injection medial and one lateral to the base of the phalanx, 2–3 mL on each side, with the needle…

Peripheral venous cannula and intraosseous access

…many times the flow of a fine needle, and collapsed veins mean that the fine needle is in addition the only one that will go…

Epistaxis — compression, cautery and anterior nasal packing

…Relative The contralateral side of the septum already cauterised — bilateral cautery carries a risk of perforation Anterior packing: Suspected base of skull fracture or a…

Nasogastric tube

…choose the more patent one. Ask the patient about a previous nasal fracture or unilateral nasal obstruction. 2. Measure the depth of insertion by laying…

Massive haemorrhage and transfusion: quick reference

…the presumed cause of bleeding, and how the products are to be delivered. 2. Designate a team leader and one person responsible for recording the…

Opioid therapy in severe pain

…find the right level is to give a small dose, wait until it has worked, and assess the effect before the next one is given…

Urinary catheterisation

…hard to find in older women. Two things separate the safe catheterisation from the harmful one: never forcing against resistance, and never catheterising urethrally when…

Oesophageal ECG

…than one who is taken by surprise. Procedure 1. Connect the patient to the 12 lead ECG as usual and record a resting ECG of…

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