Atlas of Primary Care Procedures - download pdf or read online

By Thomas J. Zuber MD MPH MBA, E. J. Mayeaux Jr MD

Atlas of basic Care Procedures is a finished, hands-on source at the clinical techniques most ordinarily played in an place of work environment. The textual content offers practitioners with step by step directions for appearing greater than 70 tactics. greater than seven hundred pictures absolutely illustrate each one process. Plus, universal pitfalls are mentioned in addition to recommendations to prevent them whilst acting sure tactics. every one bankruptcy comprises: ordering info for worthwhile fabrics or gear, CPT codes, and typical charges for every procedure.

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The 2-mm punch biopsy sites frequently do not require suture closure, and Monsel's solution can be used for hemostasis if the wound is allowed to granulate. Punch biopsy is generally performed to evaluate lesions of uncertain origin or to confirm or exclude the presence of malignancy. This biopsy technique is considered the method of choice for many flat lesions. Suspected melanomas can be evaluated by this technique, especially when the lesion is too large for easy removal. The yield may be improved if the most suspicious or abnormal-appearing area (darkest, most raised, or most irregular contour) is biopsied.

Release the pressure on the skin after the needle enters the peritoneum. Advance the catheter until a “pop” is felt and the catheter penetrates the peritoneum (Figure 2B). Remove the stylette, attach to a Luer-lock 20-mL syringe, and advance the catheter into the abdominal cavity (Figure 2C ). Draw the fluid into the syringe. If no fluid returns, rotate, slightly withdraw, or advance the catheter until fluid is obtained. If still no fluid returns, abort the procedure, and try an alternative site or method.

PITFALL: Avoid movement of the needle after it enters the skin. Many physicians hold the syringe like a pencil for needle insertion. After insertion, they stop stretching the skin with the nondominant hand and grab the syringe, shift the dominant hand back onto the plunger, and pull back on the plunger to check for vascular entry of the needle tip. They then shift the hands again and move the dominant hand into a position for injection. All of these shifts cause movement of the needle tip in the skin and increase the discomfort for the patient substantially.

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Atlas of Primary Care Procedures by Thomas J. Zuber MD MPH MBA, E. J. Mayeaux Jr MD


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