…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…

…complete heart block without current symptoms, alternating bundle branch block in acute anterior infarction, and before drugs or procedures with a known risk of bradycardia…

…bacterial CNS infections states that CT must not be performed before lumbar puncture in suspected bacterial meningitis — not even with a reduced level of consciousness…

…Otherwise: Type Contraindication : : Absolute No safe pocket of fluid to puncture (no ultrasound verified fluid) Relative Uncorrected coagulopathy or thrombocytopenia Relative Ongoing anticoagulant treatment — plan…

…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…

…first. Procedure Choice of insertion site The left lower quadrant is the first choice : the abdominal wall is thinner there than on the right, and…

…the puncture site. An arm with an arteriovenous fistula, previous axillary clearance or lymphoedema. A limb with paresis or marked swelling. A vein suspected of…

…a small amount of lidocaine without adrenaline (epinephrine). 3. Puncture 1–2 cm proximal to the wrist crease at an angle of 30–45 degrees…

…liver, lung or vessel lies in the path of the needle. Access Puncture site Direction Comment : : : : Subxiphoid 1–2 cm below and to the left

…septic shock, or a need for high dependency or intensive care 3 Take at least two sets of blood cultures from separate peripheral punctures. Also…

Procedurer The value of the exercise test lies not in ST depression alone but in the overall picture : exercise capacity, symptoms, blood pressure response, heart…

…the clinical picture, medication, fluid balance, renal function, electrolytes and supplemental oxygen [1]. Distinguish between: Acidaemia and alkalaemia , which describe the current pH of the…

… cellulitis instead gives a diffuse oedematous picture without a demarcated fluid collection. Ultrasound also shows the depth of the cavity and its distance to vessels…

Psykiatri Akutsjukvård Lathundar Rapid summary Alcohol withdrawal occurs after an abrupt reduction or cessation of prolonged and heavy alcohol intake. The condition can develop despite…

…the ratio between the body's exchangeable sodium and potassium and the total body water. In hypotonic hyponatraemia the amount of water is too great…

…cent. An sPESI of 0 indicates low risk. Anticoagulation A DOAC is the first choice in pulmonary embolism without malignancy and without antiphospholipid syndrome. The…

…The picture on the right shows color Doppler located across the mitral valve and the left atrium. The main advantage of color Doppler is that…

…initially in both arms if this can be done without losing time. 7. Perform urgent CT of the brain and CT angiography from the aortic…

…The absence of urticaria must therefore not be used to exclude the diagnosis [1]. Isolated urticaria, localised angio oedema or itching without compromise of the…

…Subtype Typical picture Clinical significance : : : Hyperactive Agitation, motor restlessness, picking, calling out, irritability, hallucinations More easily detected, but accounts for a minority of cases Hypoactive…

…L pH < 7.00 or bicarbonate < 10 mmol/L Stupor or coma may occur Mixed picture of DKA and HHS Overlap is common…

…assess renal function and the rate of rise. Often outpatient or brief inpatient follow up depending on the clinical picture Moderate 6.0 to 6…

…does not fit the clinical picture, repeat the sample and send a venous plasma glucose, but do not delay treatment of a neurologically compromised patient…

…The anatomy of the nail apparatus The terminology is hard to follow without a picture, and several of the steps below refer to structures that…

…have no recognized history of angina or MI, making the distinction from primary dilated cardiomyopathy particularly difficult. When present, the clinical picture may include: Symptoms…

…permitted when assessing dietary electrolyte intake, because it can increase blood pressure and may affect interpretation of the clinical picture. A 24 hour urine collection…