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Injection technique — intramuscular, subcutaneous and intradermal

…pull the skin and subcutaneous tissue 2–3 cm to one side, inject, wait 10 seconds, withdraw the needle and release the skin. The displaced…

Bone marrow aspiration and biopsy

…that is the posterior superior iliac spine. Mark it. 3. Clean the skin and apply the drape. Anaesthetise skin, subcutaneous tissue and then the periosteum…

Skin biopsy — punch, shave and excision

…an inflammatory dermatosis: the active edge , not the burnt out centre. 2. Clean the skin and infiltrate the anaesthetic intradermally and subcutaneously until a weal…

Sepsis and septic shock: quick reference for the first hour

…the fluid bolus and the start of the vasopressor. Time Action : : 0 to 5 min ABCDE, continuous monitoring, activate the sepsis pathway according to local…

Pleural aspiration and chest drain

…to local practice Relative Skin infection, herpes zoster or burns over the puncture site Relative Mechanical ventilation with a high PEEP (an increased risk of…

Abscess incision and drainage

…Local anaesthesia works poorly in inflamed tissue — the acidic environment inactivates the anaesthetic. Place a field block in healthy skin around the abscess instead of…

Transcutaneous and transvenous pacing

…block in acute anterior infarction, and before drugs or procedures with a known risk of bradycardia. Transvenous pacing is chosen when the need is more…

Central venous catheter

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

Wound suturing

…at normal concentrations; be cautious nonetheless in known peripheral vascular disease and follow local practice. Inject through the wound edge , not through intact skin — it

Joint aspiration

…joints. Local anaesthesia of the skin and subcutis where needed, lidocaine 10 mg/mL. Sample tubes: an EDTA tube for the cell count and crystals…

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