Tintinalli's Emergency Medicine Manual 7/E (Emergency Medicine

988 Pages·2012·17.98 MB·English

by  David Cline

Tintinalli’s
Emergency Medicine Manual
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Tintinalli’s
Emergency Medicine Manual
David M. Cline, MD
Professor and Director of Departmental Research
Department of Emergency Medicine
Wake Forest University School of Medicine
Winston-Salem, North Carolina
O. John Ma, MD
Professor and Chair
Department of Emergency Medicine
Oregon Health & Science University
Portland, Oregon
Rita K. Cydulka, MD, MS
Professor and Vice Chair
Department of Emergency Medicine
MetroHealth Medical Center
Case Western Reserve University
Cleveland, Ohio
Garth D. Meckler, MD, MSHS
Associate Professor
Assistant Section Chief and Fellowship Director
Department of Emergency Medicine and Pediatrics
Oregon Health & Science University
Portland, Oregon
Stephen H. Thomas, MD, MPH
George Kaiser Family Foundation Professor & Chair
Department of Emergency Medicine
University of Oklahoma School of Community Medicine
Tulsa, Oklahoma
Daniel A. Handel, MD, MPH
Associate Professor
Department of Emergency Medicine
Oregon Health & Science University
Portland, Oregon
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ISBN: 978-0-07-178520-4
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Contents
Contributors xi
Preface xvii
Section 1 Resuscitative Problems and Techniques 1
1 Advanced Airway Support Robert J. Vissers 1
2 Arrhythmia Management James K. Takayesu 8
3 Resuscitation of Children and Neonates Marc F. Collin 26
4 Fluids, Electrolytes, and Acid-Base Disorders Mary A. Wittler 33
5 Therapeutic Approach to the Hypotensive Patient John E. Gough 47
6 Anaphylaxis, Acute Allergic Reactions, and Angioedema Alix L. Mitchell 52
Section 2 Analgesia, Anesthesia, and Sedation 55
7 Acute Pain Management and Procedural Sedation Boris Garber 55
8 Management of Patients With Chronic Pain David M. Cline 64
Section 3 Emergency Wound Management 69
9 Evaluating and Preparing Wounds Timothy Reeder 69
10 Methods for Wound Closure David M. Cline 73
11 Lacerations to the Face and Scalp J. Hayes Calvert 80
12 Injuries of the Arm, Hand, Fingertip, and Nail David M. Cline 86
13 Lacerations to the Leg and Foot Henderson D. McGinnis 93
14 Soft Tissue Foreign Bodies Rodney L. McCaskill 97
15 Puncture Wounds and Mammalian Bites David M. Cline 100
16 Post Repair Wound Care Eugenia B. Quackenbush 107
Section 4 Cardiovascular Diseases 111
17 Chest Pain: Cardiac or Not Thomas Rebbecchi 111
18 Acute Coronary Syndromes: Management of Myocardial
Infarction and Unstable Angina Jim Edward Weber 117
19 Cardiogenic Shock Brian Hiestand 124
20 Low Probability Acute Coronary Syndromes Chadwick D. Miller 127
21 Syncope Michael G. Mikhail 131
22 Congestive Heart Failure and Acute Pulmonary Edema Lori Whelan 135
23 Valvular Emergencies Boyd Burns 138
24 The Cardiomyopathies, Myocarditis, and Pericardial Disease N. Stuart Harris 144
25 Thromboembolism Christopher Kabrhel 150
26 Systemic and Pulmonary Hypertension David M. Cline 156
27 Aortic Dissection and Aneurysms David E. Manthey 160
28 Occlusive Arterial Disease Carolyn K. Synovitz 165
Section 5 Pulmonary Emergencies 167
29 Respiratory Distress Joshua T. Hargraves 167
30 Bronchitis, Pneumonia, and SARS Jeffrey M. Goodloe 172
31 Tuberculosis Amy J. Behrman 177
32 Spontaneous and Iatrogenic Pneumothorax Rodney L. McCaskill 181
33 Hemoptysis Jeffrey Dixon 183
34 Asthma and Chronic Obstructive Pulmonary Disease Joshua Gentges 185
v
vi Contents
Section 6 Gastrointestinal Emergencies 189
35 Acute Abdominal Pain David M. Cline 189
36 Nausea and Vomiting Jonathan A. Maisel 193
37 Disorders Presenting Primarily With Diarrhea Jonathan A. Maisel 196
38 Acute and Chronic Constipation Jonathan A. Maisel 204
39 Gastrointestinal Bleeding Mitchell C. Sokolosky 207
40 Esophageal Emergencies Mitchell C. Sokolosky 209
41 Peptic Ulcer Disease and Gastritis Matthew C. Gratton 215
42 Pancreatitis and Cholecystitis Casey Glass 218
43 Acute Appendicitis Charles E. Stewart 223
44 Diverticulitis James O’Neill 226
45 Intestinal Obstruction and Volvulus Mark Hess 228
46 Hernia in Adults and Children Dave W. Lu 230
47 Anorectal Disorders Chad E. Branecki 233
48 Jaundice, Hepatic Disorders, and Hepatic Failure Joshua Gentges 239
49 Complications of General Surgical Procedures Daniel J. Egan 247
Section 7 Renal and Genitourinary Disorders 251
50 Acute Renal Failure Marc D. Squillante 251
51 Rhabdomyolysis Michael D. Levine 256
52 Emergencies in Renal Failure and Dialysis Patients Jonathan A. Maisel 258
53 Urinary Tract Infections and Hematuria Ann T. McIntosh 261
54 Acute Urinary Retention Casey Glass 265
55 Male Genital Problems Eric J. Brown 268
56 Urologic Stone Disease Geetika Gupta 273
57 Complications of Urologic Devices William K. Gray 276
Section 8 Gynecology and Obstetrics 279
58 Vaginal Bleeding and Pelvic Pain in the Nonpregnant
Patient Thomas W. Lukens 279
59 Ectopic Pregnancy and Emergencies in the First
20 Weeks of Pregnancy Robert Jones 284
60 Comorbid Diseases in Pregnancy Abigail D. Hankin 289
61 Emergencies After 20 Weeks of Pregnancy and the
Postpartum Period Howard Roemer 295
62 Emergency Delivery Stacie Zelman 299
63 Vulvovaginitis Stacie Zelman 304
64 Pelvic Infl ammatory Disease and Tubo-Ovarian Abscess Paul W. Beck 307
65 Complications of Gynecologic Procedures Anitha Mathew 310
Section 9 Pediatrics 313
66 Fever and Serious Bacterial Illness in Children Milan D. Nadkarni 313
67 Common Neonatal Problems Lance Brown 319
68 Common Infections of the Ears, Nose, Neck, and Throat David M. Spiro 325
69 Upper Respiratory Emergencies—Stridor and Drooling Kathleen M. Adelgais 332
70 Wheezing in Infants and Children Donald H. Arnold 339
71 Pneumonia in Infants and Children Lance Brown 344
72 Pediatric Heart Disease Garth D. Meckler 347
73 Vomiting and Diarrhea in Infants and Children Stephen B. Freedman 353
74 Pediatric Abdominal Emergencies Mark R. Zonfrillo 357
75 Pediatric Urinary Tract Infections Lance Brown 363
76 Seizures and Status Epilepticus in Children Maya Myslenski 365
77 Headache and Altered Mental Status in Children Kathleen M. Adelgais 369
78 Syncope and Sudden Death in Children and Adolescents Derya Caglar 373
Contents vii
79 Hypoglycemia and Metabolic Emergencies in
Infants and Children Matthew Hansen 376
80 The Diabetic Child Adam Vella 380
81 Fluid and Electrolyte Therapy Lance Brown 382
82 Musculoskeletal Disorders in Children Mark X. Cicero 386
83 Rashes in Infants and Children Lance Brown 394
84 Sickle Cell Anemia in Children Ilene Claudius 404
85 Hematologic-Oncologic Emergencies in Children Ilene Claudius 409
86 Renal Emergencies in Infants and Children Deborah R. Liu 415
Section 10 Infectious and Immunologic Diseases 419
87 Sexually Transmitted Diseases David M. Cline 419
88 Toxic Shock Vicky Weidner 427
89 Septic Shock John E. Gough 431
90 Soft Tissue Infections Chris Melton 436
91 Disseminated Viral Infections Matthew J. Scholer 442
92 HIV Infections and AIDS Scott Felten 447
93 Infective Endocarditis John C. Nalagan 453
94 Tetanus and Rabies Vincent Nacouzi 456
95 Malaria David M. Cline 460
96 Foodborne and Waterborne Diseases David M. Cline 464
97 Zoonotic Infections Christopher R. Tainter 466
98 World Travelers David M. Cline 473
99 The Transplant Patient David M. Cline 480
Section 11 Toxicology and Pharmacology 489
100 General Management of the Poisoned Patient L. Keith French 489
101 Anticholinergic Toxicity O. John Ma 497
102 Psychopharmacologic Agents C. Crawford Mechem 499
103 Sedatives and Hypnotics L. Keith French 507
104 Alcohols Michael P. Kefer 512
105 Drugs of Abuse Jeanmarie Perrone 516
106 Analgesics Joshua N. Nogar 521
107 Xanthines and Nicotine Jean C.Y. Lo 529
108 Cardiac Medications D. Adam Algren 533
109 Anticonvulsants Alicia Minns 545
110 Iron O. John Ma 549
111 Hydrocarbons and Volatile Substances Allyson A. Kreshak 553
112 Caustics Christian A. Tomaszewski 556
113 Pesticides Christian A. Tomaszewski 558
114 Metals and Metalloids D. Adam Algren 562
115 Industrial Toxins and Cyanide Christian A. Tomaszewski 568
116 Herbals and Vitamins Stephen L. Thornton 572
117 Dyshemoglobinemias B. Zane Horowitz 574
Section 12 Environmental Injuries 577
118 Frostbite and Hypothermia Michael C. Wadman 577
119 Heat Emergencies T. Paul Tran 581
120 Bites and Stings Burton Bentley II 585
121 Trauma and Envenomation from Marine Fauna Christian A. Tomaszewski 593
122 High-Altitude Medical Problems Shaun D. Carstairs 597
123 Dysbarism and Complications of Diving Christian A. Tomaszewski 600
124 Near Drowning Richard A. Walker 602
125 Thermal and Chemical Burns Sandra L. Werner 604
viii Contents
126 Electrical and Lightning Injuries Sachita Shah 611
127 Carbon Monoxide Christian A. Tomaszewski 617
128 Mushroom and Plant Poisoning B. Zane Horowitz 620
Section 13 Endocrine Emergencies 627
129 Diabetic Emergencies Michael P. Kefer 627
130 Alcoholic Ketoacidosis Michael P. Kefer 635
131 Thyroid Disease Emergencies Katrina A. Leone 637
132 Adrenal Insuffi ciency and Adrenal Crisis Michael P. Kefer 641
Section 14 Hematologic and Oncologic Emergencies 645
133 Evaluation of Anemia and the Bleeding Patient Daniel A. Handel 645
134 Acquired Bleeding Disorders Aaron Barksdale 651
135 Hemophilias and von Willebrand Disease Daniel A. Handel 656
136 Sickle Cell Disease and Other Hereditary Hemolytic Anemias Jason B. Hack 662
137 Transfusion Therapy T. Paul Tran 667
138 Anticoagulants, Antiplatelet Agents, and Fibrinolytics Jessica L. Smith 673
139 Emergency Complications of Malignancy Ross J. Fleischman 678
Section 15 Neurology 685
140 Headache and Facial Pain Steven Go 685
141 Stroke, Transient Ischemic Attack, and Subarachnoid Hemorrhage Steven Go 691
142 Altered Mental Status and Coma C. Crawford Mechem 706
143 Ataxia and Gait Disturbances Ross J. Fleischman 712
144 Vertigo and Dizziness Steven Go 715
145 Seizures and Status Epilepticus in Adults C. Crawford Mechem 721
146 Acute Peripheral Neurological Lesions Jeffrey L. Hackman 726
147 Chronic Neurologic Disorders Sarah Andrus Gaines 729
148 Central Nervous System and Spinal Infections O. John Ma 734
Section 16 Eye, Ear, Nose, Throat, and Oral Emergencies 739
149 Ocular Emergencies Steven Go 739
150 Face and Jaw Emergencies Jeffrey G. Norvell 752
151 Ear, Nose, and Sinus Emergencies Medley D. Gatewood 756
152 Oral and Dental Emergencies Steven Go 762
153 Neck and Upper Airway Disorders Aaron Barksdale 769
Section 17 Disorders of the Skin 773
154 Dermatologic Emergencies Daniel A. Handel 773
155 Other Dermatologic Disorders Daniel A. Handel 780
Section 18 Trauma 787
156 Trauma in Adults Jonathan S. Ilgen 787
157 Trauma in Children Matthew Hansen 791
158 Trauma in the Elderly O. John Ma 795
159 Trauma in Pregnancy Nicole M. DeIorio 798
160 Head Trauma in Adults and Children O. John Ma 801
161 Spine and Spinal Cord Injuries in Adults and Children Todd W. Ellingson 807
162 Facial Injuries Jonathan S. Ilgen 813
163 Trauma to the Neck Katrina A. Leone 818
164 Cardiothoracic Trauma Ross J. Fleischman 822
165 Abdominal Injuries O. John Ma 828
166 Penetrating Trauma to the Flank and Buttocks Christine Sullivan 833
Contents ix
167 Genitourinary Injuries Matthew C. Gratton 835
168 Penetrating Trauma to the Extremities Amy M. Stubbs 839
Section 19 Injuries to the Bones, Joints, and Soft Tissue 843
169 Initial Evaluation and Management of Orthopedic Injuries Michael P. Kefer 843
170 Hand and Wrist Injuries Michael P. Kefer 847
171 Forearm and Elbow Injuries Sandra L. Najarian 852
172 Shoulder and Humerus Injuries Sandra L. Najarian 856
173 Pelvis, Hip, and Femur Injuries Jeffrey G. Norvell 861
174 Knee and Leg Injuries Sandra L. Najarian 867
175 Ankle and Foot Injuries Sarah Andrus Gaines 871
176 Compartment Syndromes Sandra L. Najarian 875
Section 20 Nontraumatic Musculoskeletal Disorders 877
177 Neck and Thoracolumbar Pain Amy M. Stubbs 877
178 Shoulder Pain Andrew D.Perron 882
179 Hip and Knee Pain Jeffrey L. Hackman 885
180 Acute Disorders of the Joints and Bursae Andrew D. Perron 889
181 Emergencies in Systemic Rheumatic Diseases Michael P. Kefer 894
182 Infectious and Noninfectious Disorders of the Hand Michael P. Kefer 899
183 Soft Tissue Problems of the Foot Robert L. Cloutier 902
Section 21 Psychosocial Disorders 907
184 Clinical Features of Behavioral Disorders Lance H. Hoffman 907
185 Emergency Assessment and Stabilization of
Behavioral Disorders Lance H. Hoffman 910
186 Panic and Conversion Disorders Lance H. Hoffman 914
Section 22 Abuse and Assault 919
187 Child and Elderly Abuse Jonathan Glauser 919
188 Sexual Assault and Intimate Partner Violence and Abuse Sara Laskey 922
Index 927