Clinical guidelines

Clinical guidelines are used by the health professionals at Great Ormond Street Hospital for a wide range of conditions, treatments and tests.

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Clinical guidelines

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Surgical diathermy

The purpose of this guideline is to provide guidance about surgical diathermy at Great Ormond Street Hospital (GOSH).

NOTE: We review our guidelines regularly and this guideline is now past its review date. The content of the guideline below may not reflect the most recent evidence based practice. Please use with caution.

Halo traction

A halo-vest is used to immobilize and protect the cervical spine and neck after surgery or accident. The halo is a ring that surrounds the head and is attached by pins to the outer portion of the skull. It is used to stabilise the cervical spine, or to correct its alignment (Rationale 1, Rationale 2).

Halo vest traction is used infrequently for child and young people (CYP). It is usually a planned event, and in children is fitted under a general anaesthetic.

Skin preparation for the insertion of vascular access devices

This guideline details the best practice in preparing the patient's skin before undertaking the specified invasive procedures to minimise the risk of infection. 

This guideline no longer includes skin preparation for lumbar puncture. For information about skin preparation for lumbar punctures, see Intrathecal Cytotoxic Chemotherapy: administration via a lumbar puncture or Ommaya reservoir guideline.

Skin biopsy: punch method

The skin is complex with an array of functions. It is the body’s largest organ, protecting the deeper tissues and organs from mechanical damage, chemical damage, bacterial damage, ultraviolet radiation and thermal damage. The skin aids in regulating body temperature, in excretion of urea and uric acid and also synthesis of vitamin D (Marieb 2012).