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Lumbar puncture

…the atraumatic needle — it is too soft to pass through the skin on its own. Local anaesthesia: lidocaine 10 mg/mL, a millilitre or two…

Wound suturing

…under pressure through a 20 mL syringe and a large bore needle. Chlorhexidine in alcohol to the skin around the wound — not into the wound…

Central venous catheter

…itself an indication for emergency insertion in an unstable situation: intraosseous access or a large bore peripheral cannula bridges the gap until conditions are controlled…

Pleural aspiration and chest drain

…a symptomatic or large pneumothorax, recurrent malignant effusion (often combined with pleurodesis), and in chest trauma and postoperatively. Emergency needle decompression: a clinical suspicion of…

Injection technique — intramuscular, subcutaneous and intradermal

…Injection Needle Angle Maximum volume per site : : : : Deltoid, adult 23–25 G, 25 mm 90° 1–2 mL Deltoid, BMI 35 or a large arm…

Peripheral venous cannula and intraosseous access

…A previous intraosseous attempt in the same bone within the past 24 hours — the fluid leaks out through the old hole. Infection or burns over…

Eye examination and corneal foreign body

…zygoma or the bridge of the nose. 4. Approach tangentially from the periphery , never through the visual axis, with a spud or a needle with…

Joint aspiration

…passes through muscle without major vessels or nerves, and the landmark — the posterior corner of the acromion — is easy to palpate even in a large…

Pericardiocentesis

…anaesthesia, 25 G and 21 G needles. An 18 G puncture needle, 7–9 cm (a spinal needle or the needle from a pericardiocentesis set)…

Cardiac arrest due to pneumothorax

…inserted into the 4th or 5th intercostal space along the anterior axillary line. Thoracostomy This method is generally deemed safer than using a needle due…

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