…and sterile gel. Chlorhexidine in alcohol 5 mg/mL for skin disinfection. Allow it to air dry completely before puncture. Maximal barrier precautions: cap, mask…

…Often painless (neuropathy) Surrounding skin Hyperpigmentation, oedema, lipodermatosclerosis, eczema Pale, hairless, atrophic, cold Dry, hyperkeratotic Pulses Palpable Weak or absent May be palpable despite ischaemia…

…one from perilesional skin (immunofluorescence) The immunofluorescence biopsy goes into Michel's medium, not formalin Suspected vasculitis 4 mm punch from a lesion less than…

…Dark skin: a risk of permanent hypopigmentation. Areas with poor circulation, above all the lower leg in a patient with peripheral arterial disease or diabetes…

…a known or probable allergen , even if skin symptoms are absent [1,4]. Typical warning symptoms are: hoarseness, stridor, swelling of the tongue or throat…

…edge or a fold presses on a bony prominence until the skin breaks down. An acute, fresh injury is therefore immobilised in a backslab or…

…these measurement points are the skin electrodes. Thus, the electrical potential difference is the difference in the electrical potential detected by two (or more) electrodes…

…along the skin tension lines and make it long enough — as a rule of thumb, along the whole length of the abscess or at least…

…and in people under 18 years of age, where iso BMI or percentile charts should be used. Waist circumference Measure the waist between the lowest…

…the periosteum that hurts, not the skin. Aspiration needle (iliac crest or sternal needle with stylet) and a Jamshidi type biopsy needle. Syringes: a small…

…insertion. 3. Stretch the skin with the thumb and index finger, or compress the muscle in a slim patient. 4. Insert the needle perpendicularly , quickly…

…Examine the joint, locate the effusion and mark the puncture site with a pen or an indentation from a fingernail before cleaning the skin. 2…

…puncture site, clean in wide circles and apply the drape. 4. Anaesthetise the skin and the needle track. Wait a minute or so. 5. Advance…

…4. Insert the speculum under vision, to a maximum of about 8 mm. 5. Follow a systematic order: the skin of the ear canal →…

…G needle for the skin weal and a 21 G needle for the deeper layers. Diagnostic aspiration: a 21 G (green) or 22 G needle…

…with an effect equivalent to sedation and fewer adverse effects Digital nerve block The standard in finger dislocation Procedural sedation Propofol, ketamine or a combination…

…a bursa and 4–40 mg in tendinitis and epicondylitis . Higher doses than these add nothing documented but increase the risk of skin and fat…

…asthma attacks, angioedema, or urticaria with NSAIDs). Alcohol consumption may increase the risk of gastrointestinal bleeding. Serious skin reactions (e.g., Stevens Johnson syndrome, toxic…

…including the liver, lung, fat, and skin, with myocardial concentrations reaching 10 to 50 times those found in plasma. Plasma clearance is low, renal excretion…

…As a result, the electrical currents produced by the myocardium are transmitted through the body to the skin, where they can be detected using electrodes…

…within the heart and the resulting stimulation artifact becomes very discrete, or invisible. Figure 4. Stimulation artifact is seen as a spike preceding the QRS…

…young individuals. The severity of symptoms and presence of high risk arrhythmias on ECG guides the management of non acute or asymptomatic bradyarrhythmia. In patients…

…Thumb ECG or event recorder, 2–4 weeks Less often, with syncope Implantable loop recorder Contraindications None. Practical obstacles are skin disease or allergy to…

…the arm. 4. Posterior tibial artery — behind the medial malleolus. Measure. 5. Repeat on the other leg. If the signal is uncertain or borderline, the…

…4. When pulsatile blood appears in the hub: lower the angle to close to the plane of the skin and advance a further 1–2…

…Skin and soft tissue Diagnosis Agent Dose Duration : : : : Erysipelas phenoxymethylpenicillin 1 g × 3 (2 g × 3 if weight 90 kg) 10 days or benzylpenicillin 1…

…with a braked, workload controlled resistance; 12 lead ECG with continuous recording; automated or manual blood pressure measurement. Resuscitation trolley with defibrillator, oxygen, suction and…

…the flap of skin that extends from the proximal fold over the base of the plate. Preparation and equipment Chlorhexidine in alcohol or an iodine…

…days, or shorter neutropenia with clinical risk factors International guidelines generally use a single temperature of 38.3 degrees as the threshold [4,5]. Some…

…often lacks abdominal pain and peritonism and instead presents as encephalopathy, renal failure or simply deterioration. The procedure itself is straightforward: ultrasound to find the…

…most superficially, where the distance from the skin is shortest, and where no liver, lung or vessel lies in the path of the needle. Access…

…treatment matters more than the antidote [1,2]. Telephone your national or regional poison control centre , which in most countries is staffed around the clock…

…below 65 mmHg or the hypotension is marked. Do not wait for a central venous catheter Continuously Reassess the mental state, capillary refill, skin temperature…

…a benzodiazepine (midazolam or diazepam) is the commonest combination; propofol is used in units with airway expertise. Procedure 1. Dry the skin and shave where…

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

…pain The presence and extent of sensory loss Any motor deficit or paralysis Skin colour and temperature Capillary refill and venous filling Pulses proximal and…

…recommended for medical professionals. Evaluation of skin color is not necessary to confirm cardiac arrest. Skin color is pale or cyanotic, but this may be…

…this demographic on a global scale. Numerous substances possess the potential to induce cardiac arrest or cause profound cardiopulmonary depression. Table 1 delineates substances for…

…due to the gel. One or two fingers may be placed gently on the skin to fix the position of the transducer. The ultrasound gel…

…across the patient’s skin to a new position. Rock : Within the same imaging plane, the transducer changes orientation either toward or away from the…

…emitted in 1 to 2 milliseconds. These sound waves travel through the skin, chest, pericardium, myocardium, etc. In the transition between each medium (tissue, blood…