Manual of Emergency Medicine PDF
Preview Manual of Emergency Medicine
MANUAL OF EMERGENCY MEDICINE 6th Edition Editor G. Richard Braen, MD, FACEP Professor and Chair, Department of Emergency Medicine, Assistant Dean, Graduate Medical Education, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York Editor Emeritus Jon L. Jenkins, MD, FACEP Former Chairman, Department of Emergency Medicine Wakefi eld Hospital, Melrose, Massachusetts Assistant Editors Jeanne Basior, MD, FACEP Associate Professor of Clinical Emergency Medicine, Assistant Residency Director, Department of Emergency Medicine, School of Medicine and Biomedical Sciences, University of Buffalo, Buffalo, New York Samuel Cloud, DO, FACEP Assistant Professor of Clinical Emergency Medicine, Assistant Residency Director, Department of Emergency Medicine, School of Medicine and Biomedical Sciences, University of Buffalo, Buffalo, New York Christian DeFazio, MD, FACEP Assistant Professor of Clinical Emergency Medicine, Residency Director, Department of Emergency Medicine, School of Medicine and Biomedical Sciences, University of Buffalo, Buffalo, New York Robert McCormack, MD, FACEP Associate Professor of Clinical Emergency Medicine, Department of Emergency Medicine School of Medicine and Biomedical Sciences, University of Buffalo, Buffalo, New York; Director, Department of Emergency Medicine, Buffalo General Hospital, Buffalo, New York BBrraaeenn__FFMM..iinndddd ii 22//2266//22001111 77::5588::4422 AAMM Senior Acquisitions Editor: Frances DeStefano Product Director: Julia Seto Vendor Manager: Bridgett Dougherty Senior Manufacturing Manager: Benjamin Rivera Senior Marketing Manager: Angela Panetta Design Coordinator: Terry Mallon Production Services: SPi Global © 2011 by LIPPINCOTT WILLIAMS & WILKINS, a WOLTERS KLUWER business Two Commerce Square 2001 Market Street Philadelphia, PA 19103 USA LWW.com All rights reserved. This book is protected by copyright. No part of this book may be reproduced in any form by any means, including photocopying, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their offi cial duties as U.S. government employees are not covered by the above-mentioned copyright. Printed in China Library of Congress Cataloging-in-Publication Data Manual of emergency medicine / editor, G. Richard Braen. — 6th ed. p. ; cm. Includes index. ISBN 978-1-60831-249-8 1. Emergency medicine—Handbooks, manuals, etc. I. Braen, G. Richard. [DNLM: 1. Emergency Medicine—Handbooks. 2. Emergencies —Handbooks. WB 39] RC86.8.J46 2010 616.02'5—dc22 2010045968 Care has been taken to confi rm the accuracy of the information presented and to describe gener- ally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of the information in a particular situation remains the professional responsibility of the practitioner. The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant fl ow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in the publication have Food and Drug Admin- istration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice. To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax orders to (301) 223-2320. International customers should call (301) 223-2300. Visit Lippincott Williams & Wilkins on the Internet: at LWW.com. Lippincott Williams & Wilkins customer service representatives are available from 8:30 am to 6 pm, EST. 10 9 8 7 6 5 4 3 2 1 BBrraaeenn__FFMM..iinndddd iiii 22//2266//22001111 77::5588::4422 AAMM To our spouses from whom we get our love and support: Kate, Brian, Heather, Marsilia, and Maria. BBrraaeenn__FFMM..iinndddd iiiiii 22//2266//22001111 77::5588::4422 AAMM Contents Contributors xi Preface xiii Editor’s Note xiv Acknowledgment xiv Part I Cardiopulmonary Resuscitation 1 Cardiopulmonary Resuscitation 1 1 Rapid Sequence Intubation 18 2 Part II Trauma 27 Initial Assessment of the Multiple 3 Trauma Patient 27 Head, Neck, and Facial Trauma 40 4 Eye and Periorbital Trauma 58 5 Chest Trauma 64 6 Abdominal Trauma 78 7 Pelvic Trauma 82 8 Genitourinary Trauma 84 9 Extremity Trauma 87 10 Trauma in Pregnancy 124 11 iv BBrraaeenn__FFMM..iinndddd iivv 22//2266//22001111 77::5588::4422 AAMM CONTENTS v Part III Eye, Ear, Nose, and Throat Disorders 129 Ear Pain 129 12 Epistaxis 139 13 Facial Pain—Atraumatic 142 14 Hoarseness 146 15 Sore Throat 149 16 Red Eye 156 17 Visual Disturbances 164 18 Part IV Respiratory Disorders 173 Cough 173 19 Hemoptysis 182 20 Shortness of Breath 187 21 Mechanical Ventilation 205 22 BBrraaeenn__FFMM..iinndddd vv 22//2266//22001111 77::5588::4422 AAMM vi CONTENTS Part V Cardiovascular Disorders 211 Chest Pain 211 23 Hypertension 230 24 Palpitations 234 25 Part VI Gastrointestinal Disorders 243 Abdominal Pain 243 26 Constipation and Diarrhea 260 27 Gastrointestinal Bleeding 270 28 Hiccups (Singultus) 275 29 Jaundice 276 30 Nausea and Vomiting 282 31 Part VII Genitourinary and Pregnancy-Related Disorders 287 Hematuria 287 32 Sexually Acquired Disorders 291 33 BBrraaeenn__FFMM..iinndddd vvii 22//2266//22001111 77::5588::4422 AAMM CONTENTS vii HIV Disease and AIDS 301 34 Sexual Assault 317 35 Testicular, Scrotal, and Inguinal Pain or 36 Swelling 322 Vaginal Bleeding 327 37 Childbirth and Emergency Delivery 334 38 Part VIII Neurologic Disorders 339 Coma, Seizures, and Other Disorders of 39 Consciousness 339 Stroke and Syncope 354 40 Dizziness 367 41 Headache 372 42 Weakness 382 43 BBrraaeenn__FFMM..iinndddd vviiii 22//2266//22001111 77::5588::4433 AAMM viii CONTENTS Part IX Musculoskeletal and Soft-Tissue Disorders 395 Abscesses 395 44 Back Pain 398 45 Extremity Pain and Swelling— 46 Atraumatic 409 Joint Pain—Atraumatic 436 47 Abrasions, Avulsions, Lacerations, and 48 Puncture Wounds 447 Part X Environmental Emergencies 467 Diving Accidents 467 49 Near Drowning 471 50 Electrical and Lightning Injuries 474 51 High-Altitude Illness 480 52 Radiation Injury 486 53 Smoke Inhalation 499 54 BBrraaeenn__FFMM..iinndddd vviiiiii 22//2266//22001111 77::5588::4433 AAMM CONTENTS ix Burns 503 55 Heat Illness and Cold Exposure 511 56 Bites and Stings 521 57 Part XI Selected Pediatric Emergencies 537 Child Abuse 537 58 Fever 541 59 Pediatric Sedation 544 60 Part XII Other Emergencies 551 Foreign Bodies 551 61 Oncologic Emergencies 559 62 Pain Management 566 63 Poisoning and Ingestions 569 64 Rashes 624 65 BBrraaeenn__FFMM..iinndddd iixx 22//2266//22001111 77::5588::4433 AAMM x CONTENTS Part XIII Psychiatric Emergencies 643 Evaluation of Psychiatric Patients in the 66 Emergency Department 643 Managing Agitation and Aggression in the 67 Emergency Department 655 Evaluating the Suicidal Patient in the 68 Emergency Department 658 Evaluation and Management of Drug 69 and Alcohol Problems in the Emergency Department 665 Index 679 BBrraaeenn__FFMM..iinndddd xx 22//2266//22001111 77::5588::4433 AAMM
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