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Injection technique — intramuscular, subcutaneous and intradermal

…poorer absorption. Injection into an arm with a dialysis fistula. Preparation and equipment Hand disinfection; gloves where there is a risk of blood contact. An…

Opioid therapy in severe pain

…phase. Severe breathlessness in the palliative phase (at lower doses than for pain). An opioid is rarely the right choice in nociplastic or neuropathic pain…

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…

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…

Soft tissue corticosteroid injection

…the injection has gone to the right place — immediate pain relief is a diagnostic finding — and appears to reduce the risk of a post injection…

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

…and respiratory acidosis, or a markedly increased work of breathing with impending exhaustion. Threatened airway obstruction: inhalation injury, anaphylaxis, deep neck infection, an expanding haematoma…

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…

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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