…often with antibiotic prophylaxis. Deep puncture wounds , where the base cannot be inspected or irrigated clean. Wounds with retained foreign material or devitalised tissue that…

…disinfection. Allow it to air dry completely before puncture. Maximal barrier precautions: cap, mask, sterile gown, sterile gloves and a large full body drape. Lidocaine…

…underlying cause. Contraindications Hypothermia with a body temperature below about 30 °C — the hypothermic myocardium is irritable and pacing can precipitate ventricular fibrillation. Prioritise rewarming…

…the roots of the cauda equina. If in doubt: choose a level lower, never higher. 3. Mark the puncture site, clean in wide circles and…

…Relative Skin infection, herpes zoster or burns over the puncture site Relative Mechanical ventilation with a high PEEP (an increased risk of pneumothorax; ultrasound guidance…

…around the puncture site , and wait a few minutes. 4. Make a small skin incision with the scalpel. 5. Aspiration: advance the needle with the…

…Examine the joint, locate the effusion and mark the puncture site with a pen or an indentation from a fingernail before cleaning the skin. 2…

…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 hand is suitable for finer cannulae. Avoid the lower limb in adults. In shock with collapsed vessels, the antecubital fossa or the external jugular…

…Anaesthetise the skin with a small amount of lidocaine without adrenaline (epinephrine). 3. Puncture 1–2 cm proximal to the wrist crease at an angle…