Table Of Content

CUMULATIVE INDEX 1998 Volume 16 February CONTEMPORARY ISSUES IN TRAUMA, pages 1-279 May EMERGENCY MANAGEMENT OF CARDIAC ARRHYTHMIAS, pages 281-494 August SELECTED TOPICS IN EMERGENCY CARDIAC CARE, pages 495-687 November DIFFICULT DIAGNOSES, pages 689-945 Note: Page numbers of issue and article titles are in boldface type Abciximab, in acute myocardial infarction, Airway, considerations of, in major trauma 568 to child, 231-232 Abdomen, evaluation of, after blunt difficult, in trauma patient, assessment trauma, 166-168 of, 45-50 exploration of, in thoracoabdominal management of, 45-61 trauma, 110-113 planning approach to, 47, 50-52 injury(ies) of, associated with penetrat- techniques for management of, 52-55 ing thoracic trauma, 108-110 failed, definition of, 55-56 in geriatric patient, in Emergency De- rescue techniques in, 56-59 partment, 266-267 management of, during cervical spine of child, anatomy of, 252 immobilization, 48-49 pain in. See Abdominal pain. in anterior neck trauma, 49 trauma to, in children, epidemiology of, in head trauma, 49-50 251-252 in hemodynamic compromise in evaluation of, 252 trauma patient, 50 management of, 252-254 in multiple trauma patient, 30-31 Abdominal pain, anatomy of, 878-880 in penetrating neck trauma, 96-98 prehospital management of, 9-10 chronic intermittent, 884 surgical, management of, in failed air- chronic intractable, 885 chronic recurrent, 877-894 way, 58-59 Alcoholism, immunosuppression in, 775 diagnostic testing in, 885-886 Alteplase, in acute myocardial infarction, differential diagnosis of, 883-885 566 disposition and treatment considera- Amidarone, baseline measurements in tions in, 886-892 patients receiving, 640 historical considerations in, 880-881 drug interactions with, 637-638, 639 physical examination in, 881-883 in ventricular arrhythmias, 634-635 chronic unrelenting, 884 prophylactic, after myocardial infarction, Accelerated idioventricular rhythm, 356, 635-637 585 side effects of, 637, 638 Age-related physiologic and chemical Aminophylline, in bradyarrhythmias, 378 changes, 271 Angiography, vs. color flow Doppler Aging, normal physiologic changes of, imaging, in penetrating trauma to 704-705 neck, 100-101 931 932 CUMULATIVE INDEX 1998 Angioplasty, coronary artery, in acute Asystole, 596 myocardial infarction, 553 Athlete(s), mature, sudden cardiac death direct, in acute myocardial infarction, in, 282-283 570-573, 575-576 sudden cardiac death in, 281-294 percutaneous transluminal coronary, res- role of emergency physician in, 291- cue, in acute myocardial infarction, 292 569-570 young, sudden cardiac death in, 282 Angiotensin-converting enzyme (ACE) Athletic heart syndrome, sudden cardiac inhibitors, in acute myocardial death and, 290 infarction, 557 Atrial contractions, premature, 588 Anisoylated plasminogen SK activator Atrial fibrillation, 589-590 complex, in acute myocardial anticoagulation in, 397-398 infarction, 551, 566 approaches to, in Emergency Depart- Antiarrhythmics, in acute myocardial ment, 393-398 infarction, 558 cardioversion in, 394-397 in ventricular arrhythmias, 633-634 evaluation and management of, in Emer- Antibiotic therapy, empiric, in emergency gency Department, 389-403 department, 766-767 heart rate control in, intravenous drugs Anticoagulation, in atrial fibrillation, for, 393-394 397-398 in Wolff-Parkinson-White syndrome, 321 Anticoagulation agents, in acute lone, 398 myocardial infarction, 556-557 rate control in, 393-397 Anticonvulsants, in head injury, 70, 75 recognition of, in Emergency Depart- Antimetabolites, in head injury, 75-76 ment, 389-393 Aorta, injury to, transesophageal treatment of, in Emergency Department, echocardiography in, 202-204 specific strategies for, 398-401 Aortic dissection, 718-719, 720 with moderate ventricular rate, 400-401 Arrhythmia(s), and chest pain, with rapid ventricular rate, 399-400 management of, in emergency with slow ventricular rate, 401 department, 281-489 Atrial flutter, 589 associated with drug toxicity, 405-417 Atrial stunning, 397 cardiac, and conduction disturbances, ba- Atrial tachycardia(s). See Tachycardia(s), sic mechanisms for, 584 atrial. syncope in, 603-604 Atrioventricular block, atrial tachycardia in thrombolysis in acute myocardial in- and, 317 farction, 583-600 clinical approach to, 384-386 reperfusion, 597 first-degree, 372-373, 591-592 ventricular, 584-587 second-degree, 592-593 in elderly, 627-648 second-degree Mobitz type I, 373 determinants of, 628 second-degree Mobitz type II, 374-375 prevalence of, 627-628 third-degree, 375, 593-595 prognostic significance of, and stratifi- Atrioventricular nodal reentrant cation of patients, 629-633 tachycardia, 302-303 sodium channel blockade in, 405-406 Atrioventricular reciprocating tachycardia, therapeutic options in, 633-638 303-309, 310 Arterial dissection, extracranial, 748-749 Atropine, in atrioventricular blocks, 592, Arteritis, giant cell, 840-841 593, 595 temporal, 754-755 in bradyarrhythmias, 375-377 Artery(ies), central retinal, occlusion of, Awake intubation techniques, in 836-838 management of difficult airway, 52 coronary. See Coronary artery(ies). injuries to, management of, following trauma, 136-138 Arthritis, rheumatoid, 726 Ballistics, civilian gunshot wounds and, juvenile, 923 17-28 septic, 920-921, 924 wound, 17 Aspirin, in acute myocardial infarction, Beck’s triad, 666 554, 568 Bedside ultrasonography, in trauma care, Asplenic patients, infection in, 774 165-189 CUMULATIVE INDEX 1998 933 Benign intracranial hypertension, 755-756 Capital femoral epiphysis, slipped, Beta-adrenergic blockers, in acute 923-924, 925 myocardial infarction, 555, 567 Cardiac arrest(s), characteristics of, Beta blockers, arrhythmias caused by, difference in, between age groups, 408-410 659-660 in ventricular arrhythmias, 634 in-hospital, cardiopulmonary resuscita- Bifascicular block, 595 tion in, 650-654 Biopsies, in fever in immunocompromised in nursing home, cardiopulmonary resus- patient, 766 citation in, 656-657 Bladder, injuries to, hematuria in, 155-156 out-of-hospital, cardiopulmonary resusci- management of, 159-161 tation in, 654-656 Blood cultures, in endocarditis, 675-676 survivors of, functional status of, 657- in fever in immunocompromised pa- 659 tient, 765-766 Cardiac arrhythmias. See Arrhythmia(s). Blood pressure, preoperative elevation of, Cardiac care, emergency, selected topics in, evidence against, 5-6 495-681 Blood substitutes, resuscitation with, 6-8 Cardiac death, sudden. See Sudden cardiac Blood vessels, injuries to, in children, death. 250-251 Cardiac enzymes and biomarkers, 507-509 Blunt head injury, prehospital care in, Cardiac events, future, in older patient, 11-12 ventricular arrhythmias and, 630 Blunt trauma, abdominal evaluation after, life-threatening, prevalence of, 498-499 166-168 Cardiac ischemia, acute, 495 evaluation of patient with, traumatic he- diagnosis and prognosis of, maturia and, 147-154 relationship of, 499-500 pediatric, traumatic hematuria in, 153- electrocardiographic features of, 154 502-504 to chest, transthoracic echocardiography history and physical examination in, 196-198 factors in, 501-502 Bowel disease, inflammatory, 726 predictive factors for complications or Bradyarrhythmias, 590 mortality in, 501-504 agents causing, 407-414 statistical methods to assess, 500-501 approach to patient with, 409 Cardiac neoplasms, 725 clinical approach to, 384-386 Cardiac pacemaker. See Pacemaker(s). electrocardiographic diagnosis of, 372- Cardiac pacing, classification of, and 375 common pacing modes, 425-432 etiology and pathophysiology of, 361- diaphragmatic, 445 371 history of, 419-420 evaluation and management of, in Emer- indications and contraindications for, gency Department, 361-388 423-425, 426 treatment of, 375-383 modes, permanent, 419-462 Bradycardia, clinical approach to, 384 Cardiac rhythm, as cause of syncope in definition of, 372, 373 children, 621-623 junctional, 591 reflex-mediated, 367-368 Cardiac tamponade, echocardiographic features of, 194-196 sinus, 372, 590-591 in children, 250 Bradycardia syndrome, ictal, 368-369 Cardiac troponin I (cTnl), 527-529 Brain, protection of, in head injury, 70-71 Brown-Sequard syndrome, 815-816 Cardiac troponin T (cTnT), 529 Bullard laryngoscope, in management of Cardiogenic shock, in acute myocardial difficult airway, 53-55 infarction, 573-575 Cardiomyopathy, dilated, 729 Bullet, jacketed, 19 hypertrophic, 729-730 yawing, 19 sudden cardiac death and, 284-285 Cardiopulmonary resuscitation, implantable cardioverter defibrillators Calcium channel blockers, in acute in, 483 myocardial infarction, 557, 567 in cardiac arrest in nursing home, 656- toxicity of, cardiac manifestations of, 657 ' 410-411 in elderly, 649-663 934 CUMULATIVE INDEX 1998 Cardiopulmonary resuscitation (Continued) Cerebral venous thrombosis, 746-748 in in-hospital cardiac arrest, 650-654 Cervical spine, immobilization of, airway in out-of-hospital cardiac arrest, 654-656 management in, 48-49 Cardiopulmonary stabilization, in injury to, in children, 242-246 endocarditis, 676 epidemiology of, 243 Cardiovascular disease, ischemic, 363-366 evaluation of, 244-245 nonischemic, 366 management of, 245-246 Cardiovascular toxins, sudden cardiac typical presentation of, 242-243 death and, 290 of child, anatomy of, 243 Cardioversion, in atrial fibrillation, Chest, blunt trauma to, transthoracic 394-397 echocardiography in, 196-198 Cardioverter defibrillators, implantable, injury to, of geriatric patient in emer- 463-489 gency department, 265-266 and driving, 485 penetrating trauma to, transthoracic and electrically hostile work site, 485 echocardiography in, 198-200 and electrocautery, 484-485 trauma to, in children, mechanism of, and magnetic resonance imaging, 484 247 and quality of life, 485-486 relevant anatomy and, 246-247 cardiopulmonary resuscitation in, 483 specific forms of, 247-251 cellular telephones and, 485 Chest pain, and cardiac arrhythmias, defibrillation in, 483 management of, in emergency description of, 464-472 department, 281-489 first-generation, 466-467 atypical, 717-740 follow-up of patients with, 478 causes of, features of, 734-737 frequent and recurrent discharges by, general approach to, 732-733 480-482 differential diagnosis of, 738 historical development of, 463-464, in emergency department, computer pro- 465, 466 tocols in, 504-507 household appliances and, 485 evaluation and risk stratification of pa- illness unrelated to, 486 tients with, 495-517 indications for implantation of, risk stratification with echocardiography 472-474, 475 in, 511-513 inefficacy of, management in, 480 Chest radiography, in fever in infection and, 483 immunocompromised patient, 766 interaction with magnet, 483-484 in pericarditis, 668 issues associated with, in emergency Child(ren), blunt trauma in, traumatic department, 480-486 hematuria in, 153-154 noncommitted, 467-468, 470, 471 cervical spine of, anatomy of, 243 results of therapy with, 478-480 injury of, 242-246 second-generation, 467-468, 469, 470 dizziness in. See Dizziness, pediatric. techniques for implantation of, head trauma in, 233-242 474-478 disposition in, 242 third-generation, 468-472 epidemiology of, 233-234 internal, in ventricular arrhythmias, 639- evaluation of child in, 236-238 643 management of child in, 240 thoracotomy implantation of, 464, 474 patterns of, 238-240 transvenous subpectoral implantation of, relevant anatomy and, 234-236 465, 474-478 limping. See Limping child. Carnett’s test, 883 major trauma to, airway considerations Carotid sinus syndrome, hypersensitive, in, 231-232 367 epidemiology of, 230 Cauda equina and conus medullaris evaluation and management of, 229- lesions, 819 256 Central cord syndrome, 815 initial assessment priorities in, 230 Central nervous system, infection of, in resuscitation efforts during surveys of, cell-mediated immunity, 773 232-233 neuro-imaging of, in emergency, 746 pneumothorax in, 247-249 Cerebral cortex, disorders of, 835-836 syncope in, 617-626 Cerebral protection, in head injury, 75 thoracic trauma in, 246-251 CUMULATIVE INDEX 1998 935 Child abuse, limb pain in, 928 evaluation of, history taking in, 897-898 Circulation, assessment of, in multiple laboratory tests for, 901, 904 trauma patient, 31 physical examination in, 898-901 establishment of, in penetrating neck Cultural challenges, as challenges in trauma, 98 emergency department, 695 Circulatory arrest, trauma-associated, 10 Clonidine, toxicity to, cardiac symptoms of, 411-412 Colic, definition of, 905-906 Defibrillators, cardioverter. See Cardioverter diagnosis of, 906 defibrillators. Delirium, 706 etiology of, theories of, 906 intervention in, 907 and dementia, differentiation of, 706-707 Dementia, 705-706 spectrographic analysis of, 906 Colloids, resuscitation with, 6-8 and delirium, differentiation of, 706-707 Diabetes mellitus, immunosuppression in, Color flow Doppler, vs. angiography, in 775 penetrating trauma to neck, 100-101 Diagnoses, difficult, 689-929 Coma, hypothermic/induced, in head Diaphragm, hernia of, traumatic, in injury, 70-71 children, 250 Combitube, esophageal tracheal, in management of difficult airway, 58 injuries to, in thoracoabdominal trauma, 118-120 Commodio cordis, in children, 250-251 Difficult diagnoses, 689-929 sudden cardiac death and, 288 Digestive tract, injuries to, in penetrating Compartment syndrome, in penetrating neck trauma, 94-95 vascular trauma, 135, 139-141 Digital intubation, in management of Competition-enhancing agents, sudden difficult airway, 57-58 cardiac death and, 288-289 Digoxin, for heart rate control, in atrial Computed tomography, in blunt trauma of fibrillation, 394 abdomen, 166-167 mechanism of action of, 412 scanning, in multiple trauma patient, 34 toxicity to, factors contributing to, 412- in pediatric head-injured patient, 241 413 Concussion, 239 symptoms of, 413 Conduction disturbances, as cause of treatment of, 413-414 syncope in children, 621-623 Discitis, 922 in acute myocardial infarction, pacing Diving reflex, 368 in, 594 Dizziness, 845-875 Conduction system, anatomy of, 371-372 diagnostic tests in, 869-870, 871-872 Congenital disorders, sudden cardiac differential diagnosis of, 856-857 death and, 290 disposition in, 858, 870 Cornea, disorders of, 830-831 history taking in, 846-849 Coronary artery(ies), anomalies of, sudden laboratory tests in, 854-855 cardiac death and, 286-287 nonvertiginous, causes of, 868-869 disease of, atherosclerotic, sudden coro- pediatric, 858-869 nary death and, 285-286 differential diagnosis of, 863-864 spasm of, sudden cardiac death and, 286 disposition in, 873 tunneled, sudden cardiac death and, 287 history taking in, 859-860, 861 Coronary artery angioplasty, in acute physical examination in, 860-863 myocardial infarction, 553 physical examination in, 849-854 Coronary artery bypass graft surgery, in radiographic imaging in, 855-856 ventricular arrhythmias, 639-643 systematic approach to, 846-856 Coronary artery disease, symptoms of, treatment of, 857-858, 873 assessment of, 496, 497 Dressler’s syndrome, 667 Costochondritis, 731-732 Drug abuse, endocarditis associated with, Cricothyrotomy, in failed airway, 58-59 673 Cry research, 895-897 intravenous, immunosuppression in, Crying infant, 895-910 775-776 colic and, 905-907 myocarditis associated with, 671 cry research and, 895-897 Drug therapy, in emergency management differential diagnosis of, 901-903 of acute myocardial infarction, disposition of, 904-905 541-563, 567-568 936 CUMULATIVE INDEX 1998 Drug therapy (Continued) chest pain in, evaluation and risk strati- in ventricular arrhythmias, 633-638 fication of patients with, 495-517 Drugs, causing syncope, 606, 623-624 course in, for elderly patient with altred Dyspepsia, functional (nonulcer), 889-892 mental status, 712 environment of, 692-693 evaluation and management of atrial fibrillation in, 389-403 Echocardiography, in endocarditis, 675 evaluation and management of bradyar- in myocarditis, 672 rhythmias in, 361-388 in pericarditis, 668 evaluation of headache in, 743 in syncope, 609 geriatric patient in. See Geriatric trauma in thoracic trauma, 191-207 patient(s), in emergency department. risk stratification with, in chest pain, immunocompromised patient in, 767— 511-513 776 transesophageal, 201-204 issues associated with implantable cardi- transthoracic, 194-201 overter defibrillators and, 480-486 in blunt trauma to chest, 196-198 management of cardiac arrhythmias and in penetrating trauma to chest, 198- chest pain in, 281-489 200 testing with technetiuim—99m-labeled indications for, 196-201 sestamibi in, 509-511 two-dimensional, 192, 193 Emergency Medical Service, geriatric Elder abuse, 271-272 trauma and, 260-261 Elderly patient(s). See also Geriatric Emergency physician, role of, in patients. endocarditis, 679 cardiopulmonary resuscitation in, 649- in sudden cardiac death in athlete, 291-292 663 ventricular arrhythmias in, 627-648 Emotional/effective disorders, as with altered mental status, 701-715 challenges in emergency department, acute intervention for, 711-712 694 Encephalitis, viral, acute, 749-751 agitated, control of, 713 Endocarditis, cardiac conditions associated diagnostic tests for, 704 with, 677, 679 difficult diagnosis of, 704-712 clinical evaluation of, 673-674 emergency department course for, 712 diagnostic evaluation in, 675-676 evaluation of, 702-704 emergency physician’s role in, 679 medical conditions in, 707-709 incidence of, 673 physical examination in, 702-704 mortality associated with, 672-673 polypharmacy and medication effects pathophysiology of, 673 in, 709-710 physical findings in, 674-675 psychiatric conditions in, 710 prophylaxis, in dental procedures, indica- Electrocardiogram, in syncope, 609 tions for, 677, 679 Electrocardiography, in acute myocardial surgical procedures requiring, 678, 679 infarction, 519 prosthetic valve, 673 in myocarditis, 671 treatment of, 676-679 in pericarditis, 667-668 Enzymes, cardiac, and biomarkers, signal-averaged, in ventricular arrhyth- 507-509 mias, 632-633 Epididymitis, 802-804 Electrocautery, and implantable Epilepsy, abdominal, 887 cardioverter defibrillators, 484-485 Esophageal perforation, 731 Electrophysiologic abnormalities, sudden Esophageal tracheal Combitube, in cardiac death and, 288 management of difficult airway, 58 Excitotoxins, 64-65 Electrophysiologic studies, in ventricular arrhythmias, 632-633 Exercise testing, in syncope, 610 Extremities, injured, penetrating vascular Emergency cardiac care, seiected topics in, trauma and, diagnosis and 495-681 management of, 129-144 Emergency department, challenges in, Eyes, motility and alignment of, 828-830 cultural challenges as, 695 emotional/effective disorders as, 694 social factors as, 694-695 vague complaints as, 693-694 FAST examination, 170-181 CUMULATIVE INDEX 1998 937 in clinical practice, 182-183 vital signs in, 262-263 Femoral epiphysis, capital, slipped, Giant cell arteritis, 840-841 923-924, 925 Glasgow coma scale, modified for Femur, in multiply injured patient, 36 pediatric patients, 238 Fever, in immunocompromised host, Glaucoma, acute angle-closure, 751-752, 761-779 839-840 diagnostic tests in, 764-766 Glioblastoma multiforme, 752 disposition in, 776 Glucagon, in bradyarrhythmias, 378-379 history and physical examination in, mechanism of action of, 410 763-764 Granulocytopenia, 767-771 Fiberoptic intubation, in management of Guillain-Barre syndrome, 369 difficult airway, 55 Gunshot wounds, attaining blood level of Firearms, ignorance about, and broad-spectrum penicillin in, 24-25 exaggeration of effects of, by news civilian, and ballistics, 17-28 media, 24 emergency care of, guidelines for, 24-26 ignorance about, and exaggeration of ef- high-velocity myth and, 18-23 fects of, by entertainment industry, penetrating trauma to neck in, 101-102 23-24 Fistula testing, 854 Fluid resuscitation, in multiple trauma patient, 31-32 Head, injury to, emergency resuscitation preoperative, complications of, 8 in, 67-68 role of, in moribund patient, 6 management of, clinical considerations Fractures, in child abuse, 928 in, 66-71 Free radicals, 64 current trends in, 63-83 recommendations for, in field, 71 in hospital, 71-76 technological advances and, 65-66 Gait, patterns of, abnormal, motor of geriatric patient in emergency development and, 911-912 department, 265-265 phases of, 911-912 severe, treatments for, 77-79 Gentamicin, in endocarditis, 676, 678 trauma to, airway management in, 49-50 Geriatric patients, categories of, 257 in children. See Child(ren), head trauma falls by, factors predisposing to, 258 in. immunosuppression in, 774-775 in multiply injured patient, evaluation motor vehicle accidents and, 259 of, 35 sites of injury in, 264-269 Headache(s), differential diagnosis of, 741, syncope in, causes of, 259 742 trauma in. See Geriatric trauma patient(s). emergency department evaluation of, Geriatric trauma, 257-274 743 emergency department evaluation fol- history and physical examination in, 746 lowing, 261-264 migraine, abdominal, 887 Emergency Medical Service and, 260-261 basilar artery, 867 long-term outcome following, 270-271 secondary, 741-743 mechanisms of, 258-260 signs and symptoms of, 744-745 mortality rates associated with, 269-270 unusual, 741-760 by anatomic location, 270 Heart, inflammatory disorders of, 665-681 prehospital evaluation in, 260 injury(ies) to, in children, 250-251 Geriatric trauma patient(s), in emergency transesophageal echocardiography in, department, abdominal injury in, 201-202 266-267 structural abnormalities of, as cause of chest injury in, 265-266 syncope in children, 621 evaluation of, 261-264 Heart disease, ischemic, 717-718 fluid administration in, 263-264 underlying, in elderly persons, ventricu- head injury in, 264-265 lar arrhythmias and, 629-631 musculoskeletal injury in, 267-268 in younger and middle-aged persons, primary survey in, 261-262 ventricular arrhythmias and, 629 skin and soft tissue injury in, 268-269 valvular, sudden cardiac death and, 289 spinal injury in, 267 Hematoma, subdural, 239 938 CUMULATIVE INDEX 1998 Hematuria, definition of, 145 implantable cardioverter defibrillators traumatic, and evaluation of patient and, 483 with blunt trauma, 147-154 in asplenic patients, 774 detection of, 145-146 in transplant patients, 772-773 gross, 151-153 of central nervous system, in cell-medi- history and physical examination in, ated immunity, 773 146-147 Infectious disease, as cause of in hemodynamically stable patient, bradyarrhythmias, 369-370 154 Inflammatory bowel disease, 726 in hemodynamically unstable patient, Inflammatory disorders, cardiac, sudden 156 cardiac death and, 289 in pediatric blunt trauma, 153-154 of heart, 665-681 in penetrating trauma, evaluating for, Interventional invasive therapy, in 154-156 ventricular arrhythmias, 639-643 in rapid deceleration injuries, 153 Intracranial neoplasms, 752-754 microscopic, with pelvic fracture, 150- Intravenous resuscitation, current 51 recommendations for use of, 8-9 with shock, 149-150 Intraventricular block, 595-596 without shock, 148-149 Intubation, digital, in management of workup and management of, 145-164 difficult airway, 57-58 Hemodynamic compromise, in trauma fiberoptic, in management of difficult air- patient, airway management in, 50 way, 55 Hemorrhage, post-traumatic, 1-2 in penetrating neck trauma, 97-98 retrobulbar, acute, 841-842 retrograde, in management of difficult Hemothorax, residual, treatment of, airway, 53 121-122 Isoproterenol, in bradyarrhythmias, traumatic, in children, 248 377-378 Heparin, in acute myocardial infarction, 556, 568 Hip, transient synovitis of, 922-923 Hirudin, in acute myocardial infarction, Junctional bradycardia, 591 556-557, 568 Junctional rhythm, accelerated, 590 Hypertension, benign intracranial, 755-756 Junctional tachycardia, nonparoxysmal, in head injury, management of, 74-75 590 Hypotension, postural, causes of, 604 Juvenile rheumatoid arthritis, 923 Hypothermia, in multiply injured patient, 38-39 Hypothyroidism, bradycardia and, 370 Hypovolemia, syncope in, 604 Kidneys, injuries to, hematuria in, 154-155 management of, 157-159, 160 Knee disorders, gait in, 912 Ibutilide, for cardioversion in atrial fibrillation, 395-396 Idioventricular rhythm, accelerated, 356, Laboraiory tests, in multiply injured 585 patient, 37-38 Immune system, 761-762 in myocarditis, 672 Immunity, cell-mediated defects in, in pericarditis, 668 771-774 Laparoscopy, in blunt trauma of abdomen, causes of, 772-773 167 diagnosis of, 771-772 in multiple trauma patient, 34-35 Immunocompromised patient(s), fever in, in thoracoabdominal trauma, 122-125 761-779 Laparotomy, following trauma in in emergency department, 767-776 pregnancy, 218-219 Immunodeficiency, causes of, 769 Laryngeal mask airway, in management of Immunosuppression, from underlying difficult airway, 57 process, 774-776 Laryngoscope, Bullard, in management of Infant, crying. See Crying infant. difficult airway, 53-55 Infection, and occult immunocompromise, Left ventricular hypertrophy, idiopathic, without fever, 776 sudden cardiac death and, 285 CUMULATIVE INDEX 1998 939 Legg-Calve-Perthes disease, 924-926 Mobitz type I atrioventricular block, 592 Lenegre’s disease, 362 Mobitz type II atrioventricular block, Lev’s disease, 362-363 592-593 Lidocaine, in acute myocardial infarction, Morphine sulfate, in acute myocardial 558 infarction, 567 Lighted stylet, in management of difficult Motor development, and abnormal gait airway, 53 patterns, 911-912 Limb pain, in child abuse, 928 Multiple trauma patient, hypothermia in, in sickle cell disease, 927-928 38-39 Limping, causes of, 912 initial assessment of, 30-33 Limping child, 911-929 laboratory tests and x-rays in, 37-38 conditions to be considered in, 920-928 orthopedic injuries in, 36-37 diagnoses causing, age and, 912-913 priorities in, 29-43 diagnostic tests for, 916-919 therapeutic procedures in, 37 differential diagnosis of, 915-916 thoracoabdominal trauma in, 33-35 disposition of, 919-920 trauma to head in, evaluation of, 35 emergency department evaluation of, Musculoskeletal injury, in geriatric patient, 917-919 in emergency department, 267-268 evaluation of motor development and Myocardial infarction, acute, adjunctive gait patterns of, 911-912 devices for percutaneous coronary history taking in, 912-913 intervention in, 573 laboratory tests for, 917-918 adjunctive pharmacologic therapy in, physical examination of, 913-915 554-555, 567-568 radiographic studies for, 918-919 and thrombolysis, arrhythmias Lithium, toxicity of, 414 associated with, 583-600 Lyme disease, cardiac manifestations of, biochemical markers for diagnosis of, 369-370 520 Lymphocytes, 762 cardiogenic shock in, 573-575 Lymphokines, 762 conduction disturbances in, pacing in, 594 coronary artery angioplasty in, 553 creatine kinase, CK-MB isoenzymes, Magnesium, in acute myocardial and CK-MB isoforms in, 522-526 infarction, 557-558, 567-568 definition of, 519 in polymorphic ventricular tachycardia, direct angioplasty in, 570-573, 575-576 407 early laboratory indicators of, 519-539 Magnetic resonance imaging, and emergency management of, 544-545, implantable cardioverter defibrillators, 546-547 484 pharmacologic therapy in, 541-563, Marfan’s syndrome, sudden cardiac death 567-568 and, 290 high-risk subgroups for, 558 Maxillofacial reflex, 368 ideal cardiac marker for, Meatus, blood at, in blunt trauma, characteristics of, 520-522 147-148, 149 incidence of, 565 Mechanical ventilation, in children, 251 initial evaluation in, 542-544 Medications, as cause of integration of markers in diagnostic bradyarrhythmias, 366-367 protocols for, 532-535 response to, and QRS tachycardias, 323- mortality associated with, 541 325, 326 pericarditis related to, 669 Mediterranean fever, familial, 888-889 progression to complete heart block, Medullary syndrome, lateral, 818 365 Meniere’s disease, in children, 866 rapid identification of patients with, Meningitis, vertigo following, 867 542 Mental status exam, for elderly patient rescue percutaneous transluminal with altered mental status, 702 coronary angioplasty in, 569-570 Metabolic problems, cardiac manifestations temporary and permanent pacing in, of, 370-371 indications for, 596 Migraine headaches, abdominal, 887 thrembolysis in, 545, 565-566 basilar artery, 867 agents for, 549-553 940 CUMULATIVE INDEX 1998 Myocardial infarction (Continued) Normotension, stable, in head injury, patient selection for, 545-549 management of, 73-74 troponins as markers of, 527-530 unstable, in head injury, management of, Myocarditis, 727-729 74 causes of, 670 Nylen-Barany (Hallpike-Dix) maneuver, clinical manifestations of, 671 853, 863 diagnostic evaluation of, 671-672 Nystagmus, dizziness and, 851-852 drug-related, 671 head-shaking, 854 in Lyme disease, 671 pathophysiology of, 670-671 peripartum, 671 treatment of, 669-670, 672 Ocular media, disorders of, 830-832 viral infections associated with, 369 Oculocardiac reflex, 368 Myocardium, reperfusion of, acute Oculosympathetic paresis, 748 interventions for, 565-581 On-scene time, impact of, on trauma Myoglobin, as serum marker for diagnosis patients, 10-11 of myocardial infarction, 530-532 Optic chiasm, disorders of, 835 Optic nerve, disorders of, 834-835 Optic tract, disorders of, 835 Orthopedic injuries, in multiple trauma Nafcillin, in endocarditis, 676, 678 patient, 36-37 Neck, anterior, trauma to, airway Osteoid osteoma, 927 management in, 49 Osteomyelitis, 921-922 penetrating trauma to, 85-105 Osteosarcoma, in children, 926-927 angiography vs. color flow Doppler Oxygen, in acute myocardial infarction, imaging in, 100-101 555 assessment of weapon characteristics in, 90-91 clinical examination in, protocol in, 98-99 Pacemaker(s), crosstalk and, 444 evaluation of, 88-95 dual-chamber, 430-432 gunshot wounds vs. stab wounds in, complications of, 443-445 101-102 failure to capture by, 451-453 management of, 96-99 failure to pace by, 451, 452 controversies in, 100-102 far-field sensing by, 445 mandatory exploration vs. selective implantation techniques, 432-433 conservatism in, 100 leads, 421-423 physical examination in, 91-95 magnet application in, 435, 436 prehospital care in, 88-90 oversensing by, 449-451 transcervical gunshot wounds in, 102 Neoplasms, cardiac, 725 pectoral muscle stimulation and, 446 permanent, clinical approach to patient causing limp in children, 926-927 with, 453-458 intracranial, 752-754 Nerves, peripheral, and dermatomes, complications of, 436, 437, 438 ancillary evaluation in, 455-456 sensory distribution of, 814, 816-817 Nervous system, injuries to, in penetrating disposition in, 457-458 neck trauma, 95 treatment of, 456-457 Neurologic disorders, syncope associated history taking in, 454 with, 623 lead complications associated with, Neurologic examination, in multiple 438-441 trauma patient, 32 pacemaker pocket and, 441-442 in penetrating vascular trauma, 135 physical examination in, 455 Neuronitis, vestibular, in children, 865 venous access and, 437 Neurosurgical consultation, in head injury, problems of, troubleshooting of, 446-453 indications for, 76 programming of, 436 Neurotransmitters, excitatory, 65 pulse generator, 420-421, 442-443 Nitroglycerin, in acute myocardial rate responsive, 429 infarction, 555, 567 scheduled evaluation of, 433-436 Nonparoxysmal junctional tachycardia, selection of, 431-432 301-302 single-chamber, 427-429, 430