Emergency Medicine - An International Perspective

230 Pages·8.51 MB·english

by  Blaivas Michael (Ed.)

EMERGENCY MEDICINE –
AN INTERNATIONAL
PERSPECTIVE

Edited by Michael Blaivas
Emergency Medicine – An International Perspective
Edited by Michael Blaivas

Published by InTech
Janeza Trdine 9, 51000 Rijeka, Croatia

Copyright © 2012 InTech
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Statements and opinions expressed in the chapters are these of the individual contributors
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Technical Editor Teodora Smiljanic
Cover Designer InTech Design Team

First published March, 2012
Printed in Croatia

A free online edition of this book is available at www.intechopen.com
Additional hard copies can be obtained from [email protected]

Emergency Medicine – An International Perspective, Edited by Michael Blaivas
p. cm.
ISBN 978-953-51-0333-2

Contents

Preface IX
Chapter 1 Intensive Care Management
of the Traumatic Brain Injury 3
Akarsu Ayazoglu Tülin and Özden Nihan
Chapter 2 Lumbar Puncture: Techniques,
Complications and CSF Analyses 17
Ali Moghtaderi, Roya Alavi-Naini and Saleheh Sanatinia
Chapter 3 Delays in the Diagnosis of Pulmonary
Thromboembolism and Risk Factors 63
Savas Ozsu
Chapter 4 Emergency Medicine in China 73
Xiang-Yu Hou
Chapter 5 Emergent Procedure Training in the 21st Century 95
Ernest E. Wang
Chapter 6 Emergency Medicine in the Czech Republic 109
Jiri Pokorny
Chapter 7 Medical Instructions of
the XVIII Century to Resuscitate
the Apparently Dead: Rescuing the Drowned
to Define the Origins of the Emergency Medicine 121
Silvia Marinozzi, Giuliano Bertazzoni and Valentina Gazzaniga
Chapter 8 Considerations in Mass Casualty
and Disaster Management 143
Peter Aitken and Peter Leggat
Chapter 9 Prehospital Airway Management 183
Flavia Petrini, Maurizio Menarini and Elena Bigi
VI Contents

Chapter 10 Procedural Sedation
and Analgesia in Emergency Department 199
Balwinder Singh, Akhilesh Kumar Tiwari, Sanjay Kumar Verma,
Pedro Whatts, Dipti Agarwal and Subhash Chandra
Chapter 11 Traumatic Brain Injury 209
Zahra Gardezi

Preface

Emergency medicine is, by its nature, borne out of necessity and through painful
lessons that specialized care is required for many patients presenting to hospital “ERs”
with complaints ranging from minor ailments to life threatening illness and even in
peri-arrest states. While individual medical specialists can often provide care for a
specific disease process, none are able to one minute treat a poly-trauma patient by
intubating them and placing a chest tube and then move on to treating a patient with
myocardial infarction, diagnose an ectopic pregnancy or resuscitate a septic shock
patient. It is this diversity that makes emergency medicine exiting for its practitioners
and also creates challenges for the field as it develops in the midst of established older
specialties all of whom have to interact with emergency patients as well. In fact, it is
exactly this fact that weighs on many students who are in the process of making
decisions about their future in the final year of medical school. Like many students, I
was interested in multiple different fields. Surgery was exciting and active, internal
medicine and its sub-specialties required rigorous thought and analysis,
anesthesiology allowed control of patients' pain and vital functions, while radiology
held the capability to look within the body without penetrating it.
The common theme that attracts many to emergency practice is an interested in all of
the most exciting aspects of each major specialty but a reluctance to giving up on what
other specialties offered at the same time. Emergency medicine, unlike any other field,
combines all of these aspects for its practitioners. However, while offering a
combination of skills and knowledge found nowhere else, it offers unusual challenges
at the same time. There are few opportunities to develop long term relationships with
patients and the need to be ready to meet any challenge from psychiatric to surgical or
medical disasters can be stressful while at the same time stimulating. Thus a broad
core knowledge of anatomy, pathophysiology, pharmacology and a variety of non-
invasive and invasive procedures is critical.
Having watched emergency medicine develop in the United States over the last
twenty years I realize how much I have seen of the foundation a major new specialty
and what a critical role it plays. In addition, over the last decade I have had the
privilege of being involved with a multitude international colleagues. This has been
one of the most eye opening and professionally inspiring experiences I have had. The
diverse nature of emergency practice and growth around the world highlights the
X Preface

basic principle of emergency medicine, any time, anything and for many this also
includes anywhere. Multiple specialists practice emergency medicine around the globe
and in some cases are asked to provide care that would challenge and inspire
colleagues in North America, the birthplace of emergency medicine.
This book is unique among its peers as it offers a broad international perspective and
discusses practice approaches from around the globe. In addition, key elements of
emergency medicine practice are covered for the reader discussing historical and
cutting edge approaches and their scientific basis. The chapters that make up this
textbook should be of interest to any reader who treats or is interested in the treatment
of the emergency patient whether the patient is located in the pre-hospital, emergency
department or in-hospital settings.

Dr. Michael Blaivas
Department of Emergency Medicine,
Northside Hospital Forsyth Atlanta,
Georgia