™ DEJA REVIEW Emergency Medicine NOTICE Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the information contained herein with other sources. 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Contents Contributors Reviewers Preface Acknowledgments Chapter 1 INTRODUCTION TO EMERGENCY MEDICINE Emergency Medical Services Airway Management Shock Fluids Electrolytes Chapter 2 NEUROLOGIC EMERGENCIES Headaches Cerebral Venous Sinus Thrombosis Post-Lumbar Puncture Headache Seizures Meningitis Cerebrovascular Accident Vertigo Peripheral Neurologic Lesions Lower Back Pain Syncope Clinical Vignettes—Make the Diagnosis Chapter 3 OPHTHALMOLOGIC EMERGENCIES Basic Ophthalmology Trauma of the Eye Infections of the Eye Acute Visual Loss Clinical Vignettes—Make the Diagnosis Chapter 4 ENT AND DENTAL EMERGENCIES Acute Otitis Media Otitis Externa (Swimmer’s Ear) Acute Hearing Loss Nasal ENT Infections Dental Emergencies Clinical Vignettes—Make the Diagnosis Chapter 5 PULMONARY EMERGENCIES Asthma Chronic Obstructive Pulmonary Disease Pneumonia Hemoptysis Pleural Effusion and Empyema Lung Abscess Tuberculosis Spontaneous Pneumothorax Clinical Vignettes—Make the Diagnosis Chapter 6 CARDIOVASCULAR AND VASCULAR EMERGENCIES Dysrhythmias Cardiac Devices Peripheral Arteriovascular Disease Acute Coronary Syndrome Congestive Heart Disease and Pulmonary Edema Thromboembolic Disease Cardiomyopathies Endocarditis Myocarditis Pericardial Disease Valvular Disease Thoracic Aortic Dissection Abdominal Aortic Aneurysms Clinical Vignettes—Make the Diagnosis Chapter 7 GASTROINTESTINAL EMERGENCIES Esophagus Gastrointestinal Bleeding Peptic Ulcer Disease Appendicitis Gallbladder Disease Pancreatitis Colitis and Ileitis Mesenteric Ischemia Diverticular Disease Hernia Anorectal Diarrhea Clinical Vignettes—Make the Diagnosis Chapter 8 GENITOURINARY EMERGENCIES Acute Renal Failure Chronic Renal Failure Nephrolithiasis Urinary Tract Infections Male Genital Problems Clinical Vignettes—Make the Diagnosis Chapter 9 ORTHOPEDIC EMERGENCIES General Principles Basic Pediatric Orthopedic Principles Hand and Wrist Injuries Shoulder Injuries Elbow and Radial/Ulnar Injuries Pelvis Injuries Knee Injuries Lower Leg Injuries Clinical Vignettes—Make the Diagnosis Chapter 10 ENDOCRINE EMERGENCIES Disorders of Glucose Regulation Disorders of Thyroid and Adrenal Gland Function Clinical Vignettes—Make the Diagnosis Chapter 11 HEMATOLOGY AND ONCOLOGY Selected Oncologic Emergencies Selected Hematologic Emergencies Clinical Vignettes—Make the Diagnosis Chapter 12 INFECTIOUS DISEASES Influenza and Herpes Viruses HIV/AIDS Sexually Transmitted Diseases Malaria Soft Tissue Infections Gas Gangrene Toxic Shock Syndrome Occupational Postexposure Prophylaxis Infectious Disease Appendices Clinical Vignettes—Make the Diagnosis Chapter 13 PEDIATRIC EMERGENCIES High-Yield Pediatric Charts Cardiopulmonary Resuscitation Neonatal/Infant-Specific Conditions Congenital Heart Disease Airway Emergencies Pediatric Gastrointestinal Infectious Disease Child Abuse Clinical Vignettes—Make the Diagnosis Chapter 14 OBSTETRIC AND GYNECOLOGIC EMERGENCIES Normal Pregnancy Ectopic Pregnancy (EP) Emergencies During Early Pregnancy Emergencies During Later Pregnancy Emergencies During Postpartum Vaginal Bleeding In Reproductive Women (Nonpregnant) Pelvic/Abdominal Pain In Nonpregnant Women Vulvovaginitis Pelvic Inflammatory Disease Clinical Vignettes—Make the Diagnosis Chapter 15 TRAUMA General Approach Head Injury Neck Trauma Bony Oral-Maxillofacial Injury Spinal Trauma Thoracic Trauma Abdominal Trauma Genitourinary Trauma Orthopedic Trauma Trauma in Pregnancy Clinical Vignettes—Make the Diagnosis Chapter 16 ENVIRONMENTAL EXPOSURES High-Altitude Illnesses Dysbarism Hypothermia Heat Illness Burns Electrical, Lightning, and Chemical Injuries Drowning Radiation Clinical Vignettes—Make the Diagnosis Chapter 17 TOXICOLOGICAL EMERGENCIES Toxicology Supplement General Approach Over-the-Counter Drugs Prescription Medications Psychiatric Medications Neuroleptics Drugs of Abuse Metals, Chemicals, and Gases Clinical Vignettes—Make the Diagnosis Chapter 18 BEHAVIORAL EMERGENCIES Medical Evaluation and Clinical Approach Depression and Suicide Acute Psychosis Mania Panic Attacks Eating Disorders Dementia and Delirium Intoxication and Withdrawal Psychopharmacology Clinical Vignettes—Make the Diagnosis Chapter 19 STIMULUS SECTION Bibliography Index Contributors Peter H. Adler, MD Emergency Physician University of Pittsburgh Medical Center Shadyside Hospital Pittsburgh, Pennsylvania Gastrointestinal Emergencies Amy E. Betz, MD Acting Instructor Division of Emergency Medicine Harborview Medical Center University of Washington Medical Center Seattle, Washington Trauma Pediatric Emergencies Jason M. Biggs, MD Attending Physician Department of Emergency Medicine St. Clair Hospital Pittsburgh, Pennsylvania Genitourinary Emergencies Behavioral Emergencies Isaac S. Bruck, MD, PhD Resident Department of Emergency Medicine Metropolitan Hospital Center New York, New York Infectious Diseases Alan Lo, MD Inova Fairfax Hospital Department of Emergency Medicine Associate Professor of Emergency Medicine Virginia Commonwealth University School of Medicine Falls Church, Virginia Ophthalmologic Emergencies ENT and Dental Emergencies