Key Topics in Accident and Emergency Medicine PDF
Preview Key Topics in Accident and Emergency Medicine
Cover Page i KEY TOPICS IN ACCIDENT AND EMERGENCY MEDICINE SECOND EDITION Page ii The KEY TOPICS Series Advisors: T.M.Craft Department of Anaesthesia and Intensive Care, Royal United Hospital, Bath, UK C.S.Garrard Intensive Therapy Unit, John Radcliffe Hospital, Oxford, UK P.M.Upton Department of Anaesthesia, Royal Cornwall Hospital, Treliske, Truro, UK Anaesthesia, Third Edition, Clinical aspects Obstetrics and Gynaecology, Second Edition Accident and Emergency Medicine, Second Edition Paediatrics, Second Edition Orthopaedic Surgery Otolaryngology, Second Edition Ophthalmology Psychiatry General Surgery Renal Medicine Trauma Chronic Pain Oral and Maxillofacial Surgery Oncology Cardiovascular Medicine Neurology Neonatology Gastroenterology Thoracic Surgery Respiratory Medicine Orthopaedic Trauma Surgery Critical Care Forthcoming titles include: Acute Poisoning Opthalmology, Second Edition Urology Evidence Based Medicine Page iii KEY TOPICS IN ACCIDENT AND EMERGENCY MEDICINE SECOND EDITION Rupert Evans Consultant in Emergency Medicine, University Hospital of Wales, Cardiff, UK Derek Burke Consultant in Accident and Emergency Medicine, The Children’s Hospital NHS Trust, Sheffield, UK Page iv © BIOS Scientific Publishers Limited, 2001 First published 1994 (ISBN 1 872748 67 8) This edition published in the Taylor & Francis eLibrary, 2004. Second Edition 2001 (ISBN 1 85996 132 0) All rights reserved. No part of this book may be reproduced or transmitted, in any form or by any means, without permission. A CIP catalogue record for this book is available from the British Library. ISBN 0203450353 Master ebook ISBN ISBN 0203461592 (OEB Format) ISBN 185996124X (Print Edition) BIOS Scientific Publishers Ltd 9 Newtec Place, Magdalen Road, Oxford OX4 1RE, UK Tel. 1–44 (0)1865 726286. Fax +44 (0)1865 246823 World Wide Web home page: http://www.bios.co.uk/ Important Note from the Publisher The information contained within this book was obtained by BIOS Scientific Publishers Ltd from sources believed by us to be reliable. However, while every effort has been made to ensure its accuracy, no responsibility for loss or injury whatsoever occasioned to any person acting or refraining from action as a result of information contained herein can be accepted by the authors or publishers. The reader should remember that medicine is a constantly evolving science and while the authors and publishers have ensured that all dosages, applications and practices are based on current indications, there may be specific practices which differ between communities. You should always follow the guidelines laid down by the manufacturers of specific products and the relevant authorities in the country in which you are practising. Production Editor: Andrea Bosher. Page v CONTENTS Abbreviations viii Names of Medical Substances x Preface xii Acknowledgements xiii Abdominal pain 1 Abdominal trauma 4 Accident and emergency landmarks 7 Acute limb ischaemia 10 Acute monoarthritis 13 Acute pancreatitis 20 Adder bites 24 Airway 28 Analgesia 32 Anaphylaxis 38 Ankle sprain 43 Anterior knee pain 48 Antibiotics 50 Antidotes 53 Asthma 57 Baby check 60 Back pain 62 Bites and evenomations 65 British Association for Accident and Emergency Medicine—Emergency Management of Radiation Casualties 68 British Association for Accident and Emergency Medicine—Guidelines for the Management of Chemical Incidents 71 Burns 74 Calf pain—musculoskeletal causes 78 Carbon monoxide poisoning 80 Cerebrovascular syndrome—acute 85 Cervical spine—acute neck sprain 90 Chronic obstructive pulmonary disease 92 Coma 97 Compartment syndrome 100 Core curriculum 103 CPR newborn 111 CS gas injury 115 Diabetic emergencies 117 Diabetic ketoacidosis 120 Drowning and near drowning 123 Ear, nose and throat 126 Eclampsia 133 Ecstacy 136 Page vi Ectopic pregnancy 141 Electrical injury 143 Endocrine emergencies 147 Factitious disorders 151 Febrile convulsion 153 Fractures—principles of treatment 155 Gamma—hydroxybutyrate (GHB) 158 Gastrointestinal haemorrhage—upper 160 Genitourinary trauma 164 Gynaecology 168 Haematological conditions 170 Head injury 173 Heart failure 180 Heat illness 183 Infectious gastroenteritis 186 Inhalational injuries 192 Interhospital transfer 194 Intraosseous infusion 197 Intravenous fluids 200 Limping child 204 Local anaesthesia 207 Major incident planning 213 Major injuries—initial management 215 Management of acute poisoning 220 Maxillofacial injury 226 Meningitis 231 Meningococcal disease 237 Missile injuries 241 Monitoring—pulse oximetry and endtidal carbon dioxide 244 Myocardial infarction 246 Obstetric emergencies 250 Opthalmic emergencies 255 Organ donation 261 Overuse injury 263 Paracetamol 265 Peripheral nerve injury 270 Pneunothorax—spontaneous 274 Posttraumatic stress disorder 278 Rapid sequence intubation 281 Scaphoid fracture 283 Sedation 286 Septic arthritis 289 Shock 291 Shoulder dislocation 295 Shoulder problems—soft tissue 299 Sickle cell disease 301 Page vii Singledose activated charcoal 305 Spine and spinal cord trauma 307 Sudden infant death syndrome 312 Syncope 315 Tetanus 317 Thoracic trauma 321 Transfusion reactions 325 Trauma scoring and injury scaling 329 Urological conditions 334 Wrist injury 337 Index 341 Page viii ABBREVIATIONS A&E Accident and Emergency AIS Abbreviated Injury Score ARDS acute/adult respiratory distress syndrome ATFL anterior talofibular ligament BAEM British Association for Accident and Emergency Medicine BHR bronchial hyperresponsiveness BLS basic life support CBF cerebral blood flow CCDC Consultant in Communicable Disease Control CFL calcaneofibular ligament COHb baseline carboxyhaemoglobin COPD chronic obstructive pulmonary disease CPPD calcium pyro phosphate dihydrate CPK creatine phosphokinase CPP cerebral perfusion pressure CPHM Consultant in Public Health Medicine CSA Casualty Surgeons Association CPAP continuous positive airways pressure DBP diastolic blood pressure DVT deep vein thrombosis ECG echocardiogram EMD electromechanical dissociation EMLA eutectic mixture of local anaesthetics EMRS Emergency Medicine Research Society ESR erythrocyte sedimentation rate FEV1 forced expiratory volume FFAEM Faculty of Accident and Emergency Medicine GABA gammaaminobutyric acid GCS Glasgow Coma Scale GHB gammahydroxybutyrate HUS haemolyticuraemic syndrome ICP intracranial pressure IFEM International Federation of Emergency Medicine ILCOR International Liaison Committee on Resuscitation IOFB intraocular foreign bodies IPCS International Programme on Chemical Safety ISS Injury Severity Score IUCD intrauterine contraceptive device MABP mean arterial blood pressure MIBK methyl isobutyl ketone NAI nonaccidental injury NIBP noninvasive automated blood pressure NIPPV noninvasive intermittent positive pressure ventilation Page ix OPG orthopantomographs ORS oral rehydration solution PEA pulseless electrical activity PEEP positive endexpiratory pressure PEF peak expiratory flow PTFL posterior talofibular ligament PTSD posttraumatic stress disorder RAPD relative afferent papillary response RTS Revised Trauma Score SAC Specialist Advisory Committee SHOT serious hazards of transfusion SIDS sudden infant death syndrome TRTS Triage Revised Trauma Score TRISS Trauma Score Injury Severity Score TS Trauma Score UTI urinary tract infection
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