…patient at risk of rapid deterioration. Intraosseous access: Cardiac arrest where venous access is not immediately available. Shock, severe trauma, burns or status epilepticus when…

…over the injection site. Bacteraemia or suspected septic bursitis or arthritis. A joint prosthesis in the adjacent joint. Known hypersensitivity to the preparations. Relative: Poorly…

…that pacing hurts a great deal in a conscious patient. Indications Immediate (transcutaneous) pacing in bradycardia with haemodynamic compromise — hypotension, shock, impaired consciousness, heart failure…

…of endocarditis. Endocarditis gives three typical findings on echocardiography: Vegetations. Abscesses. Prosthetic detachment. These three findings constitute the main criteria for diagnosing endocarditis. Traditionally, it…

…always weighs more heavily). A joint prosthesis: the aspiration must be performed by an orthopaedic surgeon under strictly sterile conditions. For corticosteroid injection there is…

…elbow, finger, patella, jaw or hip prosthesis. A dislocation with neurovascular compromise or skin tenting — reduce promptly, before radiography. The longer a joint remains dislocated…

…a straddle injury Relative Recent urethral or prostatic surgery — contact a urologist before attempting Relative A known urethral stricture Relative Acute prostatitis or urethritis Relative…

…whoever starts the drug is responsible for the first week. Indications A mechanical valve prosthesis — warfarin is mandatory, and direct oral anticoagulants (DOACs) are contraindicated…

…2 An oral anticoagulant is recommended A DOAC is preferred to warfarin except in a mechanical valve prosthesis and in moderate to severe mitral stenosis…

…strokes are caused by cardiac embolism. This figure does not include paradoxical embolism (discussed below) and emboli from the proximal aorta. Stroke and TIA (Transient…