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Practical procedures 

Practical procedures
Chapter:
Practical procedures
DOI:
10.1093/med/9780199681907.003.0045
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date: 20 August 2019

This chapter gives clear guidance on practical procedures which most medical students would be expected to be competent at by the end of their training. The beginning of the chapter advises on the importance of strict hand hygiene in protecting patients from unnecessary infection. The chapter also explains how to measure blood pressure manually. Advice is given on how to place a nasogastric tube and how to place a urethral catheter, with radiographs and illustrations to help clarify anatomy and ensure against false passage. Clear advice is given on how to set up for and perform both venepuncture and intravenous cannulation, with advice on common anatomical sites for these procedures, contraindications, and first aid for needle-stick injuries. For emergencies, interosseous access is also discussed. How to obtain an arterial blood gas is explained, including the Allen test to ensure adequate ulnar arterial blood flow if sampling from the radial artery. The chapter also explains how to measure the ankle–brachial pressure index and basic plastering. Adequate supervision by senior staff is emphasized throughout.

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