…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…

…a nerve injury was caused by the injury or by the treatment. Indications A clinically or radiologically confirmed dislocation of the shoulder, elbow, finger, patella…

…An open fracture of the distal phalanx with a subungual haematoma — manage it as an open fracture. The anatomy of the nail apparatus The terminology…

…dislocation. Immobilisation of a ligament injury, a tendon injury, or after suturing over a joint. Pain relief and stabilisation for transfer in a suspected fracture…

…swelling. A vein suspected of thrombosis or previously thrombophlebitic. Intraosseous access (absolute, for the bone in question): A fracture of the bone to be punctured…

…stricture or a known diverticulum Relative Recent nasal or pharyngeal surgery Signs that should raise the suspicion of a base of skull fracture: periorbital bruising…

…Aids to assessment The shock index is calculated as the heart rate divided by the systolic blood pressure. A value of around 0.9 to…

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

…effect varies tenfold between individuals, and the only way to find the right level is to give a small dose, wait until it has worked…

…surgery of the nose, pharynx or oesophagus. Marked nausea, anxiety or communication difficulties that prevent the patient from cooperating. Suspected base of skull fracture or…