…not the skin. Aspiration needle (iliac crest or sternal needle with stylet) and a Jamshidi type biopsy needle. Syringes: a small 5–10 mL syringe…

…one, a cuff manometer. A videolaryngoscope with both a Macintosh like and a hyperangulated blade, and a stylet shaped to match the hyperangulated blade. A…

…s phenomenon, thromboangiitis obliterans. An arm with an AV fistula or with planned vascular access for dialysis. Previous vascular surgery in the area. Coagulopathy and…

…and in patients with diabetes or renal failure the index may be falsely normal because of medial sclerosis — in that case add toe pressure measurement…

…the puncture site Relative Mechanical ventilation with a high PEEP (an increased risk of pneumothorax; ultrasound guidance is mandatory) Relative A very small or loculated…

…conduction may be blocked in unusual accessory pathways that possess long conduction times or decremental conduction properties. Furthermore, adenosine binds to four types of receptors…

…Contraindications Cautery: Type Contraindication : : Absolute The source of bleeding cannot be identified Relative A pacemaker or ICD when monopolar electrocautery is used Relative A cochlear…

…Mobitz type 2, newly discovered complete heart block without current symptoms, alternating bundle branch block in acute anterior infarction, and before drugs or procedures with…

…equipment used during surgery, particularly electrosurgery. EMI may produce inappropriate sensing, activation of rate responsive functions, device resetting, inhibition of pacing, inappropriate ICD therapy, or…

…dynamic, immune mediated fibroproliferative response to endothelial injury [2] . The process initiates with endothelial dysfunction, a state provoked by systemic risk factors such as hypertension…

…emergency — but it should be changed or removed once the situation has stabilised. Preparation and equipment A central line set with a triple lumen catheter…

…surgeon The following locations must not be handled routinely in primary care or in the emergency department without contacting the appropriate specialty: Location Risk Management : …

…Follow the local protocol Ileus with distended bowel loops Ultrasound guidance mandatory; choose another site Scars, hernia or visible abdominal wall collaterals (caput medusae) Puncture…

…and thrombosis interact to produce focal arterial lesions. Although epicardial coronary arteries are a major site of disease, atherosclerosis is systemic and may affect multiple…

…angiography alone. It is particularly useful when ACS occurs without significant obstructive CAD or when more than one potential culprit lesion is present. Clinical Indications…

…high quality medical education simply. Life in the Fast Lane Australian site with one of the most impressive ECG libraries available. A must for anyone…

…PEF or FEV1 if the patient can manage it without delaying treatment. 10. Call anaesthetics and intensive care early with life threatening features or an…

…an arm with a dialysis fistula. Preparation and equipment Hand disinfection; gloves where there is a risk of blood contact. An alcohol or chlorhexidine swab…

…patient sits with the arm hanging relaxed and slightly internally rotated. The posterior approach is preferable: it passes through muscle without major vessels or nerves…

…lumbar puncture in suspected bacterial meningitis — not even with a reduced level of consciousness, focal neurological signs or seizures — because the delay costs more than…

…burns or trauma at the puncture site. An arm with an arteriovenous fistula, previous axillary clearance or lymphoedema. A limb with paresis or marked swelling…

…to reduce the risk of a post injection flare. Lidocaine 10 mg/mL without adrenaline is used; larger volumes are needed subacromially and trochanterically to…

…limb salvage. Evaluation and physical examination ALI requires immediate clinical assessment by a vascular specialist or urgent transfer to a facility with vascular expertise. The…

…and access site complications Radial and femoral access Radial access is generally preferred for coronary angiography and PCI because it is associated with fewer vascular…

…digoxin improves hemodynamics without increasing heart rate or decreasing blood pressure, making it a consideration for patients with low blood pressure secondary to a low…

…When performing emergency echocardiography, or any examination without a proper examination table, it may be difficult to acquire images in the left lateral decubitus position…

…with possible residual unsteadiness. No hearing loss, tinnitus or neurological deficits. In horizontal positional vertigo (lateral semicircular canal) the supine roll test is used for…

…about a previous perforation or grommets. 2. Instil a cerumenolytic and wait 15–30 minutes. 3. The patient sits upright with a towel over the…

…and always urgent. A large pericardial effusion with symptoms despite medical treatment. Diagnostic drainage in suspected purulent pericarditis, tuberculosis or malignancy. Tamponade is a clinical…

…the reduction , together with the distal pulse and sensation throughout the arm. External rotation (the Hennepin technique). The patient lies supine or sits. The upper…

…Preparation and equipment Chlorhexidine in alcohol or an iodine solution. Lidocaine 10 mg/mL with adrenaline 5 µg/mL (adrenaline gives a bloodless field and…

…is used as the height. Procedure 1. Explain and demonstrate. Show for yourself what a maximal blow looks like. The patient sits upright with both…

…was sutured over without being found. Indications A traumatic wound that gapes and cannot be expected to heal with good function or cosmesis without apposition…

…worsen with inspiration, coughing, lying supine, or swallowing and typically improves when the patient sits up and leans forward. Pain may be retrosternal or left…

…hypotension or shock, respiratory failure, severe anaemia, sustained bradyarrhythmia, tachyarrhythmia, or severe hypertension with or without left ventricular hypertrophy. Among patients with NSTE ACS undergoing…