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Bone marrow aspiration and biopsy

…Clean the skin and apply the drape. Anaesthetise skin, subcutaneous tissue and then the periosteum at several points around the puncture site , and wait a…

Lumbar puncture

…the threshold, but the threshold varies between regions. Infection of the skin over the puncture site. Marked haemodynamic instability — stabilise the patient first. CT before…

Transcutaneous and transvenous pacing

…Chronotropic support is given as an infusion of isoprenaline, adrenaline or dopamine according to local practice, and does not replace pacing when the patient is…

Abscess incision and drainage

…inflamed tissue — the acidic environment inactivates the anaesthetic. Place a field block in healthy skin around the abscess instead of injecting into it, and expect…

Central venous catheter

…the most stable dressing, lowest risk of infection and thrombosis with prolonged dwell time Highest risk of pneumothorax, the vessel cannot be compressed after arterial…

Neutropenic fever: quick reference for emergency management

…the only signs of infection. Corticosteroids and other immunosuppressive treatments can blunt the febrile response. A neutropenic patient with a suspected infection and organ dysfunction…

Soft tissue corticosteroid injection

…modification of loading, eccentric exercise, an NSAID, an orthosis — has not given a sufficient effect. Contraindications Absolute: Cellulitis, a skin wound or other infection over…

Eletrical alternans: the ECG in pericardial effusion & cardiac tamponade

…numerous local and systemic disorders. Accumulation of fluid in the pericardial space may lead to increased intrapericardial pressure, which in turn affects ventricular relaxation (and…

Pericarditis, myocarditis & perimyocarditis: ECG, criteria & treatment

…myocardial tissue) and because they tend to accompany each other, the term perimyocarditis is often used. Image by Bruce Blausen, Blausen Gallery 2014. Causes of…

Alcohol withdrawal and delirium tremens: quick reference

…The management of complicated withdrawal varies between regions and units. Follow the local protocol for choice of drug, dosing, route of administration and criteria for…

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