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Urinary catheterisation

…before attempting Relative A known urethral stricture Relative Acute prostatitis or urethritis Relative Latex allergy (choose an all silicone catheter) Where urethral injury is suspected…

Opioid therapy in severe pain

… avoid morphine Morphine has an active renally excreted metabolite that causes late sedation and respiratory depression Marked liver failure A reduced dose of all of…

Liver parameters

…the liver are the prothrombin time (INR) , the albumin and the bilirubin — and they become abnormal late. A cirrhotic liver can have entirely normal transaminases…

Fourth Universal Definition of Myocardial Infarction: Types 1–5

…the past century. Initial post mortem observations in the late 19th century first linked thrombotic occlusion of a coronary artery with myocardial necrosis. Although early…

Myocardial ischemia and infarction: lack of oxygen or imbalance between supply/demand

…tissues and organs. A few decades later Cohnheim demonstrated that ligation of the left anterior descending artery in dogs resulted in myoardial infarction. An important…

Post-Infarction Pericarditis and Dressler Syndrome

…which develops from several hours to approximately 4 days after infarction and is usually transient. Late post acute myocardial infarction pericarditis , traditionally termed Dressler syndrome …

Blood transfusion and massive haemorrhage

…with haemodynamic compromise, whatever the current haemoglobin — haemoglobin falls late in acute haemorrhage and a normal value does not exclude significant blood loss. Massive haemorrhage…

Electrical cardioversion

…can precipitate ventricular fibrillation, and cardioversion of fibrillation of unknown duration without anticoagulation can cause a stroke hours to weeks later. Everything else in the…

Gastric lavage and activated charcoal

…release preparations, anticholinergics, opioids and salicylate — where gastric emptying is delayed — may justify charcoal later, in some cases up to 6 hours or more. Discuss…

Joint aspiration

…send a culture, await the result and inject later. Preparation and equipment Chlorhexidine in alcohol 5 mg/mL: clean with 3–4 swabs in wide…

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