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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…

Injection technique — intramuscular, subcutaneous and intradermal

…deltoid injection is placed too high — which causes the shoulder injury known as SIRVA. Both are avoided with the right landmark and the right needle…

Endotracheal intubation

…team, not in your head. Functioning suction within reach under the pillow or by the right shoulder. A reservoir mask with a tight fitting seal…

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…

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…

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…

Oesophageal ECG

…effect of adenosine, which can be given during the recording and unmask the atrial activity. The investigation is diagnostic, not therapeutic. An unstable patient should…

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…

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…

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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