…aspiration. Press the fluid from the medial towards the lateral side with your free hand. The needle is inserted directed medially and slightly caudally, parallel…

…one injection medial and one lateral to the base of the phalanx, 2–3 mL on each side, with the needle tip directed volarly until…

CPR Pneumothorax Pneumothorax is characterized by the presence of free air in the thoracic cavity. While this can occasionally be benign and manifest even in…

…Confirm at least 2–3 cm of free fluid depth with no bowel in the path of the needle and measure the skin to peritoneum…

…result in hemorrhage within the pericardium. Ventricular rupture : A transmural infarction can cause a rupture in the left ventricular free wall. Mediastinal trauma : Penetrating injuries…

…Suspected subarachnoid haemorrhage with a normal or non diagnostic CT. Suspected neuroborreliosis, neurosyphilis or another CNS infection. Suspected inflammatory disease: multiple sclerosis, Guillain–Barré syndrome…

Procedurer The result of a repair is determined before the first needle goes in. A wound that has not been irrigated clean, has not been…

Procedurer What determines the outcome of a central venous catheter insertion is decided before the needle goes in: the choice of site, the use of…

…5 and a platelet count below 50 × 10⁹/L before drain insertion, while diagnostic aspiration with a fine needle is tolerated at considerably worse values…

…oxygen, and the ability to lay the patient down. Injection Needle Angle Maximum volume per site : : : : Deltoid, adult 23–25 G, 25 mm 90° 1…

…be given intravenously , at the same dose. Blood samples can be taken at insertion; a blood gas and electrolytes can be interpreted, but some laboratories…

…on the slit lamp, or a hand held device (iCare, Tono Pen). Procedure Systematic examination 1. Visual acuity in each eye separately , with the patient…

…With ultrasound guidance, the point at which the fluid lies most superficially is chosen and the needle is followed all the way in, which has…

…Greater extension makes the artery harder to palpate. Procedure Catheter over needle (direct technique) 1. Palpate the course of the artery with two fingertips and…

…low platelet counts, followed by compression. Infection in the skin overlying the puncture site. Previous pelvic irradiation on the intended side (yields fibrotic, unrepresentative marrow…

…stopped for small biopsies, but have diathermy or aluminium chloride available. Infection in the area to be biopsied. Hypersensitivity to local anaesthetics. Areas at high…

…abscess, a markedly unwell patient with fever and systemic upset, suspected necrotising soft tissue infection, a child who cannot tolerate the procedure while awake. Suspected…

…mg/mL without adrenaline , 2–5 mL. Needles: 21–25 G, 40 mm for subacromial and trochanteric injection; 25–27 G, 25 mm for the…