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Gynaecological examination and cervical smear

…all examinations of the breasts, the genitalia and the rectum. Ask about pregnancy, menstrual status, previous smear results and any previous conisation. Procedure Inspection The…

Abscess incision and drainage

…loss of function Orthopaedic or hand surgeon, urgently Perianal and perirectal Often larger than it appears; risk of fistula Surgeon, often operative management Breast Cosmesis…

Nail procedures — paronychia, ingrown toenail and subungual haematoma

…feel nail spicules are left behind — which is the commonest cause of recurrence. Indications Condition Procedure : : Acute paronychia with fluctuance or visible pus Incision and…

Central venous catheter

…clean with a tracheostomy or copious secretions Subclavian vein Most comfortable for the patient, the most stable dressing, lowest risk of infection and thrombosis with…

Wound suturing

…usually visible on plain films. Irrigation fluid: a copious volume of drinking quality tap water or sodium chloride 9 mg/mL. The volume matters more…

Short Synacthen test

…insufficiency in pituitary disease, after pituitary surgery or radiotherapy, or with suspected suppression of the HPA axis after long term glucocorticoid treatment. A basal morning…

Oesophageal ECG

…range of about 15–40 Hz , and adjust the gain so that the atrial deflections are clear without clipping. 4. Estimate the depth of insertion…

Common laboratory tests

…a large change in TSH. During acute illness the TSH can be falsely low or high in the absence of thyroid disease; repeat it once…

Pulmonary Hypertension: Classification and Treatment Principles

…from pulmonary vascular disease, left sided cardiac disease, chronic lung disease or hypoxia, chronic thromboembolic obstruction, or a range of miscellaneous conditions. Because several mechanisms…

Paracentesis

…renal failure or simply deterioration. The procedure itself is straightforward: ultrasound to find the fluid, an insertion site in the left lower quadrant lateral to…

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