Occupational Emergency Medicine

289 Pages·2011·6.265 MB·English

Occupational Emergency Medicine
Occupational Emergency Medicine Edited by Michael I. Greenberg
© 2011 Blackwell Publishing Ltd. ISBN: 978-1-405-18071-9
*The views expressed in this book are those of the authors and do not refl ect the offi cial policy
of the Department of the Army, the Department of Defense, or the U.S. Government.
Occupational
Emergency
Medicine
EDITED BY
Michael I. Greenberg MD MPH FAAEM FACPM FACOEM
Professor of Emergency Medicine
Professor of Public Health
Drexel University College of Medicine
Philadelphia, PA
USA
Associate Editor
James M. Madsen MD MPH FCAP FACOEM*
United States Army Medical Research Institute of Chemical Defense
Aberdeen Proving Ground, MD and Uniformed Services University of the Health Sciences
Bethesda, MD
USA
This edition fi rst published 2011, © 2011 by Blackwell Publishing Ltd
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Library of Congress Cataloging-in-Publication Data:
Occupational emergency medicine / edited by Michael I. Greenberg ; associate editor, James M. Madsen.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-4051-8071-9
1. Occupational diseases. 2. Medical emergencies. 3. Industrial toxicology. 4. Toxicological emergencies. I. Greenberg, Michael I.
II. Madsen, James M.
[DNLM: 1. Emergencies. 2. Occupational Diseases—therapy. 3. Accidents, Occupational. 4. Emergency Service, Hospital.
5. Occupational Exposure—adverse effects. WA 400]
RC964.O253 2011
616.9’803—dc22
2010027212
ISBN: 978-1-4051-8071-9
A catalogue record for this book is available from the British Library.
This book is published in the following electronic formats: ePDF 9781444329636; Wiley Online Library 9781444329629;
ePub 9781444329643
Set in 9/12pt Meridien by MPS Limited, a Macmillan Company, Chennai, India
1 2011
Contents
List of Contributors, vii
1 Introduction, 1
James M. Madsen
2 Potentially Lethal Occupational Exposures, 13
Christina Price and Dennis P. Price
3 Occupational Dermatology: Issues for the Emergency Department, 29
David Vearrier
4 Occupational Infections, 46
Amy J. Behrman
5 Occupational Toxicology, 75
John A. Curtis and David A. Haggerty
6 Work-Related Trauma and Injury, 84
Mark Saks and Brad A. Rahaman
7 Occupationally Based Disaster Medicine, 96
James M. Madsen
8 Work-Related Ocular Injuries, 102
Joseph L. D’Orazio
9 Occupational Pulmonary Disease, 116
Michael G. Holland
10 Occupational Illness and Injury in Law Enforcement Personnel, 140
Richard T. Tovar
11 Occupational Illness and Injury in Firefi ghters, 152
Richard T. Tovar
12 Occupational Illness and Injury in Prehospital Care Personnel, 162
Derek L. Isenberg and Carin M. Van Gelder
13 Health Hazards and Emergency Care for Health Care Workers, 175
Amy J. Behrman
14 Occupational Concerns for Truckers and Drivers, 199
Natalie P. Hartenbaum
v
vi Contents
15 Unusual Problems in Occupational Emergency Medicine, 209
Edward A. Ramoska and Guneesh Saluja
16 Arts Medicine: An Overview for Emergency Physicians, 216
Robert T. Sataloff and Mary J. Hawkshaw
17 Occupational Hearing Loss: An Overview for Emergency Physicians, 225
Robert T. Sataloff, Mary J. Hawkshaw, and Joseph Sataloff
18 Voice Disorders: An Overview for Emergency Physicians, 239
Robert T. Sataloff and Mary J. Hawkshaw
Appendix, 260
Index, 269
The color plate section can be found facing p. 168
List of Contributors
Amy J. Behrman MD Derek L. Isenberg MD, Joseph Sataloff MD, DSc
Division of Occupational Medicine, NREMT-P Department of Otolaryngology, Head
Department of Emergency Medicine, Department of Emergency Medicine, and Neck Surgery,
University of Pennsylvania School of Yale University School of Medicine, Thomas Jefferson University,
Medicine, New Haven, CT, USA Philadelphia, PA, USA
Philadelphia, PA, USA
James M. Madsen MD, MPH, Robert T. Sataloff MD, DMA,
John A. Curtis MD FCAP, FACOEM FACS
Department of Emergency Medicine, United States Army Medical Research Department of Otolaryngology, Head
Drexel University College of Medicine, Institute of Chemical Defense, and Neck Surgery,
Philadelphia, PA, USA Aberdeen Proving Ground, MD and Drexel University College of Medicine,
Uniformed Services University of the Philadelphia, PA, USA
Joseph L. D’Orazio MD Health Sciences, Bethesda, MD
Division of Medical Toxicology, Richard T. Tovar MD, FACEP,
Department of Emergency Medicine, Christina Price MD FACMT
Albert Einstein Medical Center, Department of Emergency Medicine, Medical College of Wisconsin
Philadelphia, PA, USA University of New Mexico, and New Berlin Police and Fire
Santa Fe, NM, USA Department,
David A. Haggerty MD Delafi eld, WI, USA
Department of Emergency Medicine, Dennis P. Price MD
Drexel University College of Medicine, Department of Emergency Medicine, Carin M. Van Gelder MD
Philadelphia, PA, USA New York University, Department of Emergency Medicine,
New York, NY, USA Yale University School of Medicine,
Natalie P. Hartenbaum MD, New Haven, CT, USA
MPH, FACOEM Brad A. Rahaman MD, MS
OccuMedix, Inc., Dresher, PA and Department of Emergency Medicine, David Vearrier MD
Division of Occupational Medicine, Drexel University College of Medicine, Division of Medical Toxicology,
Department of Emergency Medicine, Philadelphia, PA, USA Department of Emergency Medicine,
University of Pennsylvania School of Albert Einstein Healthcare Network,
Medicine, Philadelphia, PA, USA Edward A. Ramoska MD, MPH, Philadelphia, PA, USA
FACEP
Mary J. Hawkshaw BSN, RN, Department of Emergency Medicine,
CORLN Drexel University College of Medicine,
Department of Otolaryngology, Head Philadelphia, PA, USA
and Neck Surgery,
Drexel University College of Medicine, Mark Saks MD, MPH
Philadelphia, PA, USA Department of Emergency Medicine,
Drexel University College of Medicine,
Michael G. Holland MD, FAACT, Philadelphia, PA, USA
FACMT, FACOEM, FACEP
Department of Emergency Medicine, Guneesh Saluja MD
SUNY Upstate Medical University, Department of Emergency Medicine,
Medical Toxicologist, Upstate New Drexel University College of Medicine,
York Poison Center, Syracuse Philadelphia, PA, USA
vii
Plate 12.1 Thirty minutes after
0.5 cm3 of 1:1,000 epinephrine injected
into the long fi nger fat at the black
dot, 0.5 cm3 of 1:10,000 epinephrine
into the ring fi nger (blue dot), and
0.5 cm3 of 1:100,000 epinephrine
injected into the small fi nger of the
left hand (red dot). Note that the distal
phalanx of the small fi nger is not pale,
and that the long and ring fi ngers
are completely white. (Reproduced
from ref. [52], with permission from
Springer.)
Plate 12.2 Twenty minutes after injection of 1 cm3
of pure 1:1,000 epinephrine into the little fi nger.
(Reproduced from ref. [52], with permission from Plate12.3 Same fi nger 6 h later. (Reproduced from ref.
Springer.) [52], with permission from Springer.)
Occupational Emergency Medicine Edited by Michael I. Greenberg
© 2011 Blackwell Publishing Ltd. ISBN: 978-1-405-18071-9
Plate 15.1 High-pressure injection injury to the hand. Plate 15.2 Wringer injury of the forearm.
CHAPTER 1
Introduction
James M. Madsen*
United States Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD and Uniformed Services University
of the Health Sciences, Bethesda, MD
Introduction the recognition, stabilization, evaluation, treatment,
and disposition of patients in response to acute
This book is designed primarily for the busy illness and injury,” and characterized the relevant
emergency physician in search of a practical guide patient population as unrestricted and presenting
to occupational medicine in the emergency depart- “with a full spectrum of episodic, undifferentiated
ment. Occupational physicians should also fi nd physical and behavioral conditions [4].” The last of
in it a useful perspective on the approach to occupa- six chief duties of an emergency physician as elabo-
tional medicine in a venue not traditionally consid- rated by this statement was “(6) the provision of
ered an occupational-medicine setting. Hopefully, this continuing occupational medical services, including
text will also throw light onto the heretofore-little- illness and injury prevention and management, and
illuminated interface between two crucial specialties. patient rehabilitation [4].” Subsequent defi nitions
of the specialty [5–9] have continued to empha-
size these principles, including the role of emer-
Emergency medicine, occupational gency providers in the provision of occupational
medicine, and their intersection medicine. The most recent ACEP policy statement
emphasizes the triple role of emergency physicians
In the 1970s and 1980s, emergency physicians in (a) providing “rapid assessment and treatment of
proposed several defi nitions of their unique role any patient with a medical emergency;” (b) “initial
in clinical medicine [1–3]. A special document assessment and care of any medical condition that
prepared by the American College of Emergency a patient believes requires urgent attention;” and
Physicians (ACEP) Practice Management Committee (c) “medical care for individuals who lack access to
and approved by the ACEP Board of Directors other avenues of care [9].”
defi ned emergency medicine as encompassing “the Occupational medicine has similarly seen a pro-
immediate decision making and action necessary to gression of defi nitions over the years [10]. One
prevent death or any further disability for patients useful perspective is to consider occupational medi-
in health crises,” described the specialty as “patient- cine “that practice of medicine which (i) focuses on
demanded, broadly available, and continuously enhancing and maintaining the health of people
accessible care by physicians trained to engage in at work, ensuring they operate safely considering
any health issues they may have; and (ii) contrib-
utes to organizational effectiveness of enterprises
*The views expressed in this chapter are those of the author
by providing expert medical advice to manage-
and do not refl ect the offi cial policy of the Department
of the Army, the Department of Defense, or the U.S. ment [11].” Strictly speaking, occupational medi-
Government. cine, often grouped with environmental medicine
as “occupational and environmental medicine,”
refers to the medical care, by properly trained
Occupational Emergency Medicine Edited by Michael I. Greenberg
© 2011 Blackwell Publishing Ltd. ISBN: 978-1-405-18071-9 physicians, of patients with health or safety
1