Emergency Medicine

CENTRAL LINE INSERTION 476 Practical Procedures COMPLICATIONS 1 Myocardial damage, coronary artery laceration and cardiac arrhyt ...

CENTRAL LINE INSERTION Practical Procedures 477 3 Overlying skin cellulitis or burn. 4 Pneumothorax on opposite side (particular ...

CENTRAL LINE INSERTION 478 Practical Procedures 3 Position the patient for the route chosen and identify the anatomical landmark ...

CENTRAL LINE INSERTION Practical Procedures 479 10 Femoral vein insertion (i) Palpate the femoral artery two finger-breadths bel ...

INTRAOSSEOUS LINE INSERTION 480 Practical Procedures COMPLICATIONS 1 Immediate (early) (i) Arterial dissection, laceration or fa ...

INTRAOSSEOUS LINE INSERTION Practical Procedures 481 2 Position the limb: (i) Flex the knee to 45° and support with a sandbag or ...

LUMBAR PUNCTURE 482 Practical Procedures COMPLICATIONS 1 Failure – malposition (slips off bone). 2 Through-and-through penetrati ...

LUMBAR PUNCTURE Practical Procedures 483 (ii) Ask the patient to flex the hips, knees and neck as much as they can (i.e. fetal p ...

INDWELLING URETHRAL CATHETER INSERTION 484 Practical Procedures 7 Advance the needle through the skin, between the spinous proce ...

INDWELLING URETHRAL CATHETER INSERTION Practical Procedures 485 (ii) Measurement of urine output (e.g. volume resuscitation, sho ...

NASOGASTRIC TUBE INSERTION 486 Practical Procedures (b) use non-dominant gloved hand to gently separate labia minora and clean t ...

NASOGASTRIC TUBE INSERTION Practical Procedures 487 TECHNIQUE 1 Explain to the patient exactly what you are about to do, and why ...

488 Practical Procedures BIER’S INTRAVENOUS REGIONAL BLOCK INDICATIONS 1 Anaesthesia for the reduction of distal forearm fractur ...

FEMORAL NERVE BLOCK Practical Procedures 489 9 Continuously monitor the cuff pressure for leakage. Keep the cuff inf lated for a ...

FEMORAL NERVE BLOCK 490 Practical Procedures 3 Withdraw slightly if paraesthesiae are elicited down the leg, indicating proximit ...

DIGITAL NERVE RING BLOCK Practical Procedures 491 (ii) Inject 10 mL of local anaesthetic solution fan-wise, moving outwards up t ...

KNEE ASPIRATION 492 Practical Procedures KNEE ASPIRATION INDICATIONS 1 Diagnostic (i) Remove joint fluid for biochemical testing ...

KNEE ASPIRATION Practical Procedures 493 TECHNIQUE 1 Explain the procedure to the patient and position the patient comfortably o ...

FURTHER READING 494 Practical Procedures (iii) Remove all available fluid – this may be up to 70 mL or more (a) gently squeeze t ...

AAA abdominal aortic aneurysm ABG arterial blood gas AC alternating current ACE angiotensin-converting enzyme ACS acute coronary ...