…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…

…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…

…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…

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

…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…

…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…

…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…

…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)…

…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…

…that an arterial line must never be confused with a venous access. Indications Continuous blood pressure monitoring in haemodynamic instability or during ongoing vasoactive treatment…

…sternum — the needle may perforate into the mediastinum. The anterior superior iliac spine is a second line alternative in marked obesity or when the supine…

…a 27 G needle, a 5 mL syringe. A tourniquet: a Penrose drain with artery forceps, or the cut off finger of a sterile glove…

…layers. Diagnostic tap: 21–22 G needle, 20 mL and 50 mL syringes. Therapeutic drainage: a commercial paracentesis set or a catheter over needle, 16…

…subcutis. 5. Lift the specimen gently with a needle tip or fine forceps applied to its edge , not by gripping across the whole biopsy, and…

…of collapse. Pericardiocentesis , performed using a large needle introduced either via the subxiphoid or apical window, is generally considered less effective than thoracotomy. This is…

…abscess or at least half its diameter. Too small an incision is the commonest technical error. 4. Cut straight into the cavity with a no…

Procedurer A corticosteroid injection into soft tissue gives rapid but time limited pain relief and rarely alters the natural history of the disease. In lateral…