…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…

…puncture site, known thrombosis in the target vein. With a mechanical tricuspid prosthesis the lead must not be passed through the valve. The order of…

…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…

…not exclude Diastolic collapse of the right atrium and right ventricle The cardinal echocardiographic finding A dilated inferior vena cava without respiratory variation Strongly suggests…

…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…

…looking for right ventricular strain. If CT pulmonary angiography can be performed immediately, do it. Otherwise the echocardiographic findings plus the clinical picture are sufficient…

…interpretation of the Doppler signals. Figure 1. The image on the left shows many sample volumes within a Doppler sector. The picture on the right…

…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…

…1. Assess vital signs and level of consciousness immediately. 2. Check oxygen saturation and capillary glucose. 3. Exclude immediately treatable threats without delay: hypoxia, hypoglycaemia…

…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…