…abrasions and small wounds under about 5 mm often do better with adhesive strips, tissue adhesive or a dressing alone. Contraindications Primary closure must be…

…clinical suspicion leads only to unnecessary antibiotics. 5. Biopsy any ulcer that has not healed within three months despite adequate treatment — malignancy (Marjolin's ulcer…

…a normal radiograph. Contraindications An open fracture or a wound that needs to be inspected — use a windowed splint or external fixation. Established or impending…

…BCG Slow, local effect Contraindications Absolute: Infection, a wound, scar tissue, a tattoo or skin disease at the injection site. Known hypersensitivity to the preparation…

Procedurer A corticosteroid injection into soft tissue gives rapid but time limited pain relief and rarely alters the natural history of the disease. In lateral…

…curves and a prostate that can grip; the female urethra is only 3–5 cm and almost straight, but the meatus can be hard to…

…benign tissue requires about −25 °C for reliable cell death, malignant tissue about −50 °C. The outer limit of the ice front is only at…

…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…

…requiring a view down into the larynx. The difficult airway rarely kills because the tube would not pass, but because the team keeps trying to…

Procedurer Spirometry is the only investigation that distinguishes obstructive from restrictive impairment of lung function, and COPD cannot be diagnosed without it . The quality of…

…of objectively demonstrating peripheral arterial disease, and it is needed more often than it is used — not only in claudication, but before every compression treatment…

…wave to synchronise to; sync mode would block the shock entirely The patient Awake or sedated — requires sedation Unconscious In polymorphic VT, sync must be…

…5 mm over 6 months. Such growth may justify consideration of repair at a smaller diameter than would otherwise be used. Women have growth rates…

…In this post I would like to discuss hot topics related to coronary artery disease and I will emphasize on issues that are typically raised…

…plaques at high risk of rupture, or determine whether ischaemia would occur at workloads greater than those achieved during testing. Exercise ECG has become less…

…precisely, FFR compares the pressure driving flow distal to a stenosis with the pressure that would be available in the absence of that stenosis. The…

…blunt force, lacerations, gunshot wounds) Asthmatic episodes Iatrogenic events (e.g., during central venous catheter insertion) Underlying lung pathologies In cases of benign pneumothorax, positive…

…maximum) capacity of the left ventricle, as this would require measuring the ejection fraction during submaximal exercise testing. Ejection fraction reserve is the available reserve…

…there should also be ST elevation in either V2 or V4, because it is unlikely that ischemia would only be detected in one lead. Thus…

…make sure that never happens, and to make sure the catheter does not become the patient's next focus of infection. Indications Infusion of vesicant…

…only monitoring and preparedness. Asystole with no electrical activity at all — pacing has no documented benefit there. Transcutaneous pacing: burns or wounds in the area…

…bradycardia should resolve with the onset of physical activity. Profound sinus bradycardia (<30 beats/min or sinus pauses ≥3 s) would warrant further investigation. 6…

…in unstable angina in the past two decades (many of those who would previously have been classified as unstable angina are now classified as NSTEMI…

…then males would have two times as great a risk. Although two times the risk may seem very much, it only amounts to one extra…

…repeatedly to the circumflex artery before a 60 minute occlusion of the left anterior descending coronary artery (LAD) would reduce the infarct size by 60%…

…sound waves can only propagate through a physical medium. This medium may consist of any matter, e.g air, water, metal, or tissue and fluids…

…supply would not result in ischemia, since the myocardium adapts and downregulates metabolism to avoid developing ischemia. According to this theory, ischemia occurs only if…

…wall motion abnormality and it may evidence of myocardial infarction, which would have implications for the management of this patient, regardless of the ejection fraction…

…the fact that the Purkinje fibers run through the endocardium. It is likely that conduction defects would have been more common in myocardial ischemia otherwise.