…because of the cosmesis, often with antibiotic prophylaxis. Deep puncture wounds , where the base cannot be inspected or irrigated clean. Wounds with retained foreign material…

…is decided before the needle goes in: the choice of site, the use of ultrasound throughout the puncture, and maintaining maximal barrier precautions without shortcuts…

…or to resolution of the underlying cause. Contraindications Hypothermia with a body temperature below about 30 °C — the hypothermic myocardium is irritable and pacing can…

…the scan contributes. Only clinical signs of herniation halt the puncture, and antibiotics and a corticosteroid are then given immediately after blood cultures. For questions…

…contraindications — the procedure is life saving and necessary respectively. Otherwise: Type Contraindication : : Absolute No safe pocket of fluid to puncture (no ultrasound verified fluid) Relative…

…the puncture went. Indications Unexplained cytopenia in one or more cell lines. Suspected acute leukaemia, myelodysplastic syndrome or myeloproliferative neoplasm. Work up and staging of…

…disease. Contraindications Infection of the skin or soft tissues over the puncture site — use another approach or refrain. Bacteraemia without suspicion of joint infection (relative…

…choose a new site if in doubt Cellulitis over the insertion site Change the puncture site Preparation and equipment Ultrasound with a curved array probe…

…the puncture site. Osteogenesis imperfecta and severe osteoporosis (relative). An inability to identify the landmarks. Choice of vein and cannula size Choose the veins of…

…and note the direction. Disinfect and allow to air dry. 2. Anaesthetise the skin with a small amount of lidocaine without adrenaline (epinephrine). 3. Puncture…