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Injection technique — intramuscular, subcutaneous and intradermal

…with a high BMI, and that the deltoid injection is placed too high — which causes the shoulder injury known as SIRVA. Both are avoided with…

Clinical application of ECG in chest pain & acute myocardial infarction

…may be caused by myocardial ischemia. Other symptoms include dyspnea, pain radiating to the left arm/shoulder/throat, palpitations, back pain and selected cases of…

Reduction of dislocations

…or by the treatment. Indications A clinically or radiologically confirmed dislocation of the shoulder, elbow, finger, patella, jaw or hip prosthesis. A dislocation with neurovascular…

Endotracheal intubation

…any decision to limit treatment when time allows. There is complete upper airway obstruction where laryngoscopy will not succeed; plan for a surgical airway or…

Joint aspiration

…always weighs more heavily). A joint prosthesis: the aspiration must be performed by an orthopaedic surgeon under strictly sterile conditions. For corticosteroid injection there is…

Otoscopy and ear syringing

Procedurer Cerumen should be removed when it causes symptoms or obscures the tympanic membrane — not routinely . The wax has a protective function, and the commonest…

Skin biopsy — punch, shave and excision

…be biopsied. Hypersensitivity to local anaesthetics. Areas at high risk of unsightly or hypertrophic scars: the sternum, the shoulder, the jawline, the ears. Anatomically hazardous…

Post-Infarction Pericarditis and Dressler Syndrome

…Dressler syndrome. A pericardial effusion measuring more than 10 mm at end diastole after AMI should prompt investigation for possible subacute cardiac rupture, particularly when…

Approach to patients with chest pain: differential diagnoses, management & ECG

…pain is usually described as pressure, squeezing, or a crushing sensation across the precordium and may radiate to the neck, shoulder, jaw, back, upper abdomen…

Chest Pain in the Emergency Department: Diagnostic Pathways

…ischaemia, including severe oesophageal spasm and acid reflux. Clinical Presentation and Symptoms Characterising the presenting symptom The symptom should be classified as cardiac , possibly cardiac …

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