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Injection technique — intramuscular, subcutaneous and intradermal

…the inverted triangle formed between the acromion and the lower tip of the muscle insertion. 3. Stretch the skin with the thumb and index finger…

Soft tissue corticosteroid injection

…40 mm for subacromial and trochanteric injection; 25–27 G, 25 mm for the carpal tunnel, de Quervain's and trigger finger. Syringes of 3…

Central venous catheter

…never happens, and to make sure the catheter does not become the patient's next focus of infection. Indications Infusion of vesicant solutions: vasopressors, concentrated…

Short Synacthen test

…sample : cortisol and plasma ACTH. The ACTH sample is taken before the injection and handled chilled. 4. Inject 0.25 mg of tetracosactide intravenously , slowly…

Endotracheal intubation

…fingerbreadths from hyoid to the upper border of the thyroid cartilage M allampati Class III–IV indicates increased risk O bstruction/Obesity Stridor, pharyngeal swelling…

Oesophageal ECG

…patient take a mouthful of water and hold it. Advance the electrode at the very moment the patient swallows — the pharyngeal muscles then guide the…

Opioid therapy in severe pain

…undiluted syringe of 10 mg/mL makes small adjustments impossible. Procedure Intravenous titration in acute severe pain Practical points during titration: Give the injection slowly…

Lumbar puncture

…the threshold, but the threshold varies between regions. Infection of the skin over the puncture site. Marked haemodynamic instability — stabilise the patient first. CT before…

Paracentesis

…first. Procedure Choice of insertion site The left lower quadrant is the first choice : the abdominal wall is thinner there than on the right, and…

Pulmonary embolism: quick reference for risk stratification and treatment

…infection, surgery, trauma and old age. A positive value is not a diagnosis. Risk grading in confirmed pulmonary embolism Risk Haemodynamics Right ventricular strain (echo…

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