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Injection technique — intramuscular, subcutaneous and intradermal

…preparations and irritant drugs: pull the skin and subcutaneous tissue 2–3 cm to one side, inject, wait 10 seconds, withdraw the needle and release…

Skin biopsy — punch, shave and excision

…becomes oval when the skin is released, which allows neater closure. 4. Place the punch perpendicular to the skin and rotate under even pressure until…

Diagnostic Criteria for Acute Myocardial Infarction: Cardiac troponins, ECG & Symptoms

…This is explained by the fact that there is no (or very little) turnover of myocardial cells and therefore myocardial troponins should not be detected…

Unstable Angina: Definition and Contemporary Management

…infarction (AMI), in which myocardial ischaemia is accompanied by cardiomyocyte necrosis and cardiac troponin release meeting the criteria of the universal definition of MI. Clinically…

Gastric lavage and activated charcoal

…including carbamazepine, theophylline and quinine. Repeated dosing may also be appropriate after large ingestions of modified release preparations. Contraindications Measure Contraindication : : Medicinal charcoal A reduced…

Hyperkalaemia: quick reference for emergency treatment

…1. Perform an ABCDE assessment, attach cardiac monitoring, secure intravenous access and record an ECG. 2. Confirm the potassium with a repeat sample, but do…

Opioid therapy in severe pain

…must be taken into account). Known allergy to the preparation — rare; itching and urticaria are usually due to histamine release, not allergy. Concurrent MAO inhibitor…

Poisoning: quick reference for antidotes and initial management

…with modified release preparations, mixed poisoning, pregnancy, children, a need for an antidote or dialysis, and whenever the clinical course deviates from what was expected…

Acute Coronary Syndrome: Definitions and Initial Triage

…in symptoms or clinical signs, with or without diagnostic electrocardiographic abnormalities and with or without an acute rise in cardiac troponin. The spectrum ranges from…

Chest Pain in the Emergency Department: Diagnostic Pathways

…injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated troponin…

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