…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…

…of ultrasound throughout the puncture, and maintaining maximal barrier precautions without shortcuts. The most common serious error is dilating a vessel that turns out to…

…pain of transcutaneous pacing. It is a bridge to a permanent pacemaker or to resolution of the underlying cause. Contraindications Hypothermia with a body temperature…

Procedurer What determines a lumbar puncture is rarely the needle itself. It is the decision whether to perform it now or after imaging, how the…

…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…

…it passes through muscle without major vessels or nerves, and the landmark — the posterior corner of the acromion — is easy to palpate even in a…

…lateral to the rectus sheath, and a cell count plus albumin on the sample. Indications Diagnostic paracentesis: Newly detected ascites — always. Every admission of a…

…swelling. A vein suspected of thrombosis or previously thrombophlebitic. Intraosseous access (absolute, for the bone in question): A fracture of the bone to be punctured…

…allow to air dry. 2. Anaesthetise the skin with a small amount of lidocaine without adrenaline (epinephrine). 3. Puncture 1–2 cm proximal to the…