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Otoscopy and ear syringing

…a hearing aid. Recurrent otitis externa in which the wax retains moisture. Contraindications Absolute contraindications to irrigation: A known or suspected perforation of the tympanic…

Dix–Hallpike test and Epley manoeuvre

…tilting the head backwards. A symptom free interval between attacks, with possible residual unsteadiness. No hearing loss, tinnitus or neurological deficits. In horizontal positional vertigo…

Spirometry

…many laboratories and spirometers still use it as a benchmark. 6. A maximal inspiration back to TLC to close the flow volume loop — the in

Acute vertigo: quick reference for HINTS and differential diagnosis

…neurological examination, hearing, cardiac examination, ECG, selective vascular imaging Traumatic or toxic syndrome Onset after trauma, a change in medication or an exposure Concussion, temporal…

Ankle-brachial index (ABI)

…assessment in known coronary or cerebrovascular disease. Follow up after vascular surgery or endovascular intervention. Assessment of healing potential in ulcers and before deciding the…

Nail procedures — paronychia, ingrown toenail and subungual haematoma

…consider referral in: Diabetes with neuropathy or peripheral arterial disease — a risk of osteomyelitis and poor healing. Check the ankle brachial index and the foot…

Urinary catheterisation

…and continuous irrigation in macroscopic haematuria with clots (a three way catheter). Instillation therapy and contrast studies of the urinary tract. Wound healing with a…

Wound suturing

…alone. Contraindications Primary closure must be avoided or considered carefully in: Bite wounds — particularly cat and human bites, and all bites on the hand. These…

P-wave, PR interval, PR segment: physiology, criteria & ECG findings

…the negative deflection is also seen in lead V2. lead V5 only notes vectors heading towards the exploring electrode (albeit with somewhat varying angles) and…

Leg ulcers — wound debridement and compression therapy

…a ruler in the image. A reduction in size of 40% within four weeks predicts healing — failure to shrink should prompt reconsideration of the diagnosis…

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