Category: Procedures

Wound Management in A&E

Wounds are a very common presentation to A&E and minor injuries departments. Wound management is very clinician dependent and there is a lot of variation in practice. It is important to be accurate when assessing and documenting wounds as it can have medico-legal implications, should your assessment later come up in a court case. Types

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Suturing

Sutures are placed to aid with wound healing following a traumatic laceration or surgical incision and to promote haemostasis. In this article, we will look at the different types of suture classifications, the indications for each type of suture and the common suturing techniques that are used. Alternative methods of tissue closure Steri-strips Often used

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Gynaecological Examination

If the thought of conducting an intimate examination or attempting to wield (without any embarrassing pitfalls) the contraption that is the speculum is enough to fill you with apprehension- fear not! The good news is that junior doctors are not typically expected to perform speculum/bimanual examinations unless you are on an O&G or GP placement.

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Lumbar Puncture

A lumbar puncture uses a fine needle inserted between the vertebrae in the lower back to take samples of CSF from the subarachnoid space. The CSF that is obtained can aid the diagnosis of infections, subarachnoid haemorrhage & neurological disorders including Guillan-Barré Syndrome (GBS) or MS. Check out our article on CSF interpretation for more

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How to use an Ophthalmoscope

Being able to use an ophthalmoscope confidently is very important to junior doctors, especially when identifying eye emergencies. In this article, we will go through the steps of eye examination using an ophthalmoscope. When is ophthalmoscopy used? In clinical practice, ophthalmoscopy is commonly performed for posterior segment diseases affecting the vitreous, macula, retina or optic

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Femoral Stab

Femoral puncture is typically used to acquire blood from a patient in an emergency setting as both the veins and arteries are large vessels. In profound hypotension, unlike the radial, the femoral artery remains palpable. In a cardiac arrest, good quality CPR should result in a palpable pulsation. Typically a venous sample is preferred as

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Ascitic Tap and Drain

Ascitic aspiration (tap) is routinely performed for every patient admitted with ascites to identify the underlying cause. The most urgent reason to do it would be to consider the diagnosis of spontaneous bacterial peritonitis (SBP). Occasionally a patient may have a therapeutic aspiration where a larger volume is aspirated to relieve pressure if a drain

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Nasogastric Tubes

NG tubes are passed from the nose to the stomach. Depending on the material, they can stay between 2 to 6 weeks. However, they quite easily can fall out either being accidentally tugged at night or the tube might get caught. Due to this, they sometimes fall out within a week or two. Wide-bore NGT

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Urinary Catheterisation

In this article, we discuss when a catheter might be needed and top tips on male & female catheterisation. Before attempting catheterisation, always review the following Procedure Male Catheterisation10. Cleaning the penis – using a sterile piece of gauze, use your non-dominant hand to hold the penis ensuring you retract the foreskin. Using your dominant

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