2 3 Contents Disclaimer and Copyright Notice About the Editors Dedications Acknowledgments Contributors Foreword Preface Chapter 1: Undifferentiated Shock Chapter 2: The Difficult Airway Chapter 3: The Crashing Ventilated Patient Chapter 4: Fluid Management Chapter 5: Cardiac Arrest Updates Chapter 6: Postcardiac Arrest Management Chapter 7: Deadly Arrhythmias Chapter 8: Cardiogenic Shock Chapter 9: Extracorporeal Membrane Oxygenation Chapter 10: Cardiac Tamponade Chapter 11: Aortic Catastrophes Chapter 12: Severe Sepsis and Septic Shock Chapter 13: The Crashing Morbidly Obese Patient Chapter 14: Pulmonary Hypertension Chapter 15: Left Ventricular Assist Devices Chapter 16: The Critically Ill Poisoned Patient Chapter 17: The Crashing Trauma Patient Chapter 18: Emergency Transfusions Chapter 19: Intracerebral Hemorrhage Chapter 20: Subarachnoid Hemorrhage Chapter 21: The Crashing Anaphylaxis Patient Chapter 22: Bedside Ultrasonography Chapter 23: The Difficult Emergency Delivery Chapter 24: Neonatal Resuscitation Chapter 25: Pediatric Resuscitation Index 4 Disclaimer and Copyright Notice The American College of Emergency Physicians (ACEP) makes every effort to ensure that contributors to its publications are knowledgeable subject matter experts. Readers are nevertheless advised that the statements and opinions expressed in this publication are provided as the contributors’ recommendations at the time of publication and should not be construed as official College policy. ACEP recognizes the complexity of emergency medicine and makes no representation that this publication serves as an authoritative resource for the prevention, diagnosis, treatment, or intervention for any medical condition, nor should it be the basis for the definition of, or standard of care that should be practiced by all health care providers at any particular time or place. Drugs are generally referred to by generic names. In some instances, brand names are added for easier recognition. Device manufacturer information is provided according to style conventions of the American Medical Association. ACEP received no commercial support for this publication. To the fullest extent permitted by law, and without limitation, ACEP expressly disclaims all liability for errors or omissions contained within this publication, and for damages of any kind or nature, arising out of use, reference to, reliance on, or performance of such information. To contact ACEP, write to PO Box 619911, Dallas, TX 75261-9911; call toll free 800-798-1822, or 972-550- 0911. Copyright 2017, American College of Emergency Physicians, Dallas, Texas. All rights reserved. Except as permitted under the US Copyright Act of 1976, no part of this publication may be reproduced, stored, or transmitted in any form or by any means, electronic or mechanical, including storage and retrieval systems, without permission in writing from the publisher. Printed in the USA. eBook ISBN 978-0-9988912-4-8 ACEP Bookstore PO Box 619911, Dallas, TX 75261-9911 800-798-1822, 972-550-0911 www.acep.org.bookstore http://bookstore.acep.org/ AMERICAN COLLEGE OF EMERGENCY PHYSICIANS SENIOR EDITOR Rachel Donihoo PUBLICATIONS ASSISTANT Jessica Hamilton EDUCATIONAL PRODUCTS DIRECTOR Marta Foster DESIGN AND PRODUCTION Susan McReynolds INDEXING Sharon Hughes DIGITAL PROJECT OVERSIGHT Ram C. Khatri PRINT DESIGN ADAPTATION AND EBOOK DEVELOPMENT Kevin Callahan/BNGO Books, New York 5 About the Editors 6 Michael E. Winters, MD, FACEP, FAAEM. Dr. Winters is an associate professor of emergency medicine and medicine at the University of Maryland School of Medicine. He is the Director of the Combined Emergency Medicine/Internal Medicine Residency Program and the founder and Co-Director of the Combined Emergency Medicine/Internal Medicine/Critical Care Residency Program. Dr. Winters has received numerous teaching awards, including the National Emergency Medicine Faculty Teaching Award from the American College of Emergency Physicians (ACEP), the Young Educators Award from the American Academy of Emergency Physicians, and the 2014-2015 Honorable Mention Outstanding Speaker of the Year from ACEP. He has lectured nationally and internationally, authored numerous articles and textbook chapters, and hosts a monthly podcast on the management of the critically ill emergency department patient, Critical Care Perspectives in Emergency Medicine. Dr. Winters completed a combined emergency medicine/internal medicine residency at the University of Maryland, after which he completed a teaching fellowship with a special focus on emergency critical care. 7 Michael C. Bond, MD, FACEP, FAAEM. Dr. Bond is an associate professor and the Residency Program Director in the Department of Emergency Medicine at the University of Maryland. He was guest editor of an Emergency Medicine Clinics of North America edition on orthopedic emergencies; has written several book chapters on cardiology emergencies, specifically pericarditis, myocarditis, Wolff- Parkinson-White syndrome, and temporary pacing; and has coauthored multiple orthopedic and cardiology literature summaries. In June 2005, Dr. Bond completed the combined Emergency Medicine/Internal Medicine Residency Program at Allegheny General Hospital, where he found it particularly rewarding to care for the most critical of patients while teaching new interns to do the same. 8 9 Peter DeBlieux, MD, FACEP. Dr. DeBlieux is a professor of clinical medicine and an attending physician in emergency medicine and the medical intensive care unit of Louisiana State University Health Sciences Center (LSUHSC) Charity Hospital, where has served for 25 years. He also is the Chief Medical Officer and Director of Quality at University Medical Center and a clinical professor of surgery at Tulane University Medical School, both in New Orleans. He is the former Program Director of the LSUHSC Charity Hospital Emergency Medicine Residency and former Director of Resident and Faculty Development—positions he held for a decade each. Dr. DeBlieux earned his medical degree from LSUHSC, where he later completed an internship in internal medicine. He has remained at his alma mater, where he completed an emergency medicine residency followed by a pulmonary critical care fellowship. 10
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