Acute Medical Emergencies, Second Edition, Second Edition PDF
Preview Acute Medical Emergencies, Second Edition, Second Edition
FM BLBK246-ALSG May26,2010 14:40 CharCount= Acute Medical Emergencies FM BLBK246-ALSG May26,2010 14:40 CharCount= Useful website addresses AdvancedLifeSupportGroup http://www.alsg.org BestEvidenceinEmergencyMedicine http://www.bestbets.org Evidencebasedon-call http://cebm.jr2.ox.ac.uk/eboc/eboc.html RoyalCollegeofPhysicians http://www.rcplondon.ac.uk/ FM BLBK246-ALSG May26,2010 14:40 CharCount= Acute Medical Emergencies The Practical Approach SECOND EDITION Advanced Life Support Group A John Wiley & Sons, Ltd., Publication FM BLBK246-ALSG May26,2010 14:40 CharCount= Thiseditionfirstpublished2010,(cid:1)c 2010byBlackwellPublishingLtd BMJBooksisanimprintofBMJPublishingGroupLimited,usedunderlicencebyBlackwell PublishingwhichwasacquiredbyJohnWiley&SonsinFebruary2007.Blackwell’spublishing programmehasbeenmergedwithWiley’sglobalScientific,TechnicalandMedicalbusinesstoform Wiley-Blackwell. 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LibraryofCongressCataloging-in-PublicationData Acutemedicalemergencies:thepracticalapproach/AdvancedLifeSupportGroup.–2nded. p.;cm. Includesindex. ISBN978-0-7279-1854-3 1.Medicalemergencies–Handbooks,manuals,etc. 2.Emergencymedicine–Handbooks,manuals, etc. I.AdvancedLifeSupportGroup(Manchester,England) [DNLM:1.EmergencyTreatment–methods.2.Emergencies.WB105A18952010] RC86.7.A2822010 616.02’5–dc22 2009046382 ISBN:9780727918543 AcataloguerecordforthisbookisavailablefromtheBritishLibrary. Setin10/13ptMeridienbyAptara(cid:1)R Inc.,NewDelhi,India PrintedandboundinSingapore 1 2010 FM BLBK246-ALSG May26,2010 14:40 CharCount= Contents WorkingGroup,vii Contributorstofirstedition,viii Contributorstosecondedition,ix Prefacetosecondedition,x Prefacetofirstedition,xi Acknowledgments,xii Part I: Introduction Chapter1 Introduction,3 Chapter2 Recognitionofthemedicalemergency,7 Part II: Structured Approach Chapter3 Astructuredapproachtomedicalemergencies,15 Chapter4 Airwayassessment,33 Chapter5 Breathingassessment,43 Chapter6 Circulationassessment,55 Chapter7 Disabilityassessment,67 Part III: Presenting Complaints Chapter8 Thepatientwithbreathingdifficulties,87 Chapter9 Thepatientwithshock,121 Chapter10 Thepatientwithchestpain,147 Chapter11 Thepatientwithalteredconsciouslevel,159 Chapter12 The‘collapsed’patient,187 Chapter13 Theoverdosepatient,203 Chapter14 Thepatientwithaheadache,215 Chapter15 Thepatientwithabdominalpain,233 Chapter16 Thepatientwithhotredlegsorcoldwhitelegs,261 Chapter17 Thepatientwithhotand/orswollenjoints,269 Chapter18 Thepatientwitharash,281 Chapter19 Thepatientwithacuteconfusion,293 Part IV: Organ Failure Chapter20 Organfailure,309 v FM BLBK246-ALSG May26,2010 14:40 CharCount= vi CONTENTS Part V: Special Circumstances Chapter21 Theelderlypatient,345 Chapter22 Transportationoftheseriouslyillpatient,355 Chapter23 Thepregnantpatient,369 Chapter24 Theimmunocompromisedpatient,377 Chapter25 Thepatientwithacutespinalcordcompression,381 Part VI: Interpretation of Emergency Investigations Chapter26 Acid–basebalanceandbloodgasanalysis,387 Chapter27 Dysrhythmiarecognition,409 Chapter28 ChestX-rayinterpretation,431 Chapter29 Haematologicalinvestigations,437 Chapter30 Biochemicalinvestigations,449 Part VII: Practical Procedures Chapter31 Practicalprocedures:airwayandbreathing,457 Chapter32 Practicalprocedures:circulation,469 Chapter33 Practicalprocedures:medical,477 Part VIII: Appendix Appendix:Drugscommonlyusedinthemanagementofmedicalemergencies,487 Answerstotimeoutquestions,493 Index,505 FM BLBK246-ALSG May26,2010 14:40 CharCount= Working group PDriscoll EmergencyMedicine,Manchester PDyer GeneralMedicine,Birmingham CDuffy ALSG,Manchester RKishen Anaesthesia/ICU,Manchester KMackway-Jones EmergencyMedicine,Manchester GMcCarthy EmergencyMedicine,Cork TDWardle GeneralMedicine,Chester JWhitaker CareoftheElderly,Harrogate SWieteska ALSG,Manchester REVIEWERS PDriscoll EmergencyMedicine,Manchester MEmons EmergencyMedicine,Rijen,Netherlands AEriksson Medicine,Stockholm,Sweden RKishen Anaesthesia/ICU,Manchester DMacKechnie EmergencyMedicine,Rochdale GMcCarthy EmergencyMedicine,Cork TDWardle GeneralMedicine,Chester EDITORIAL GROUP PDriscoll EmergencyMedicine,Manchester TDWardle GeneralMedicine,Chester SWieteska CEO,ALSG,Manchester vii FM BLBK246-ALSG May26,2010 14:40 CharCount= Contributors to first edition MBhushan Dermatology,Manchester PDavies EmergencyMedicine,Bristol PDriscoll EmergencyMedicine,Manchester CEMGriffiths Dermatology,Manchester CGwinnutt Anaesthesia,Manchester JHanson EmergencyMedicine,Preston RKishen Anaesthesia/ICU,Manchester KMackway-Jones EmergencyMedicine,Manchester AMcGowan EmergencyMedicine,Leeds GMcMahon EmergencyMedicine,Manchester FMorris EmergencyMedicine,Sheffield CMoulton EmergencyMedicine,Bolton KReynard EmergencyMedicine,Manchester PSammy GeneralPractice,Manchester PTerry EmergencyMedicine,Manchester DWallis EmergencyMedicine,London TDWardle GeneralMedicine,Chester BWaters Anaesthesia/ICU,NorthWales JWhitaker CareoftheElderly,Harrogate viii FM BLBK246-ALSG May26,2010 14:40 CharCount= Contributors to second edition ZLBorrill GeneralMedicine,Manchester PDavies EmergencyMedicine,Bristol PDriscoll EmergencyMedicine,Manchester PDyer GeneralMedicine,Birmingham RDowdle GeneralMedicine,Glamorgan JHanson EmergencyMedicine,Preston RHardern EmergencyMedicine,Durham PHormbrey EmergencyMedicine,Oxford SJHutchison Cardiology,Abergavenny KJones RespiratoryMedicine,Bolton TJordan RespiratoryMedicine,Liverpool RKishen IntensiveCare,Manchester GLloyd EmergencyMedicine,Exeter AMacNab EmergencyMedicine,Swansea GMcCarthy EmergencyMedicine,Cork DWallis EmergencyMedicine,London TDWardle GeneralMedicine,Chester JWhitaker CareoftheElderly,Harrogate DWWrathall IntensiveCare,Dumfries ix FM BLBK246-ALSG May26,2010 14:40 CharCount= Preface to second edition Sinceitsfirstpublicationin2001,thistexthasbeenakeycomponentofanedu- cational package that has trained in excess of 600 providers in the management of acute medical emergencies. The course is now running in the UK, Eire, the NetherlandsandSweden. Over this time,new guidelines and changes in practice have provided impetus toproducethesecondedition.Thechallengeofupdatingthiswitheverevolving guidelines has now been met. However, despite evidence-based developments and improvement in medical practice, the foundation of MedicALS – the struc- turedapproach–remainsunchanged,reassuringly. The second edition will continue to promote the essence of MedicALS, which is to ensure that the candidate leaves the course equipped with a ‘Practical Ap- proach’thatissafetopatientswithanykindofacutemedicalemergency. As new or updated guidelines become available, we will provide those on the ALSGwebsitewww.alsg.orgtoensurethatyourAcuteMedicalEmergenciestext remainscurrent. Overtheyears,anincreasingnumber ofexpertshavecontributedtothework andweextendourthanksbothtothemandtoourinstructors,whounceasingly providehelpfulfeedback.Consultationwithinstructorshasgreatlycontributedto thisneweditionandtotherevisedcourse. x
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