P O C K E T • NOTEBOOK Pocket Emergency M E D I C I N E Fourth Edition E A M , MD RICA SHLEY ORSE G I , MD RAHAM NGALSBE Denver Health Residency in Emergency Medicine AMY FOLLMER HILDRETH, MD Naval Medical Center San Diego DAVID SILVESTRI, MD, MBA National Clinician Scholars Program Yale School of Medicine Edited by R D. Z , MD, FAAEM ICHARD ANE The George B. Boedecker Professor and Chair Department of Emergency Medicine University of Colorado School of Medicine Executive Director, Emergency Services University of Colorado Health Aurora, Colorado J M. K , MD, FACEP OSHUA OSOWSKY Assistant Professor Harvard Medical School Department of Emergency Medicine Brigham and Women’s Hospital Boston, Massachusetts Senior Acquisitions Editor: Sharon Zinner Development Editor: Ashley Fischer Editorial Coordinator: Emily Buccieri Strategic Marketing Manager: Rachel Mante Leung Books Production Manager: David Orzechowski Production Coordinator: Sadie Buckallew Design Coordinator: Terry Mallon Manufacturing Coordinator: Beth Welsh Prepress Vendor: Aptara, Inc. 4th edition Copyright © 2019 Wolters Kluwer. © 2015 by WOLTERS KLUWER All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, 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. 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Description: Fourth edition. | Philadelphia : Wolters Kluwer, [2019] | Series: Pocket notebook | Includes index. | Preceded by Pocket emergency medicine / John D. Anderson … [et al.]; edited by Richard D. Zane, Joshua M. Kosowsky. 3rd. ed. Philadelphia : Lippincott Williams & Wilkins, c2015. Identifiers: LCCN 2017046469 | ISBN 9781975103651 Subjects: | MESH: Emergencies | Emergency Medicine | Handbooks Classification: LCC RC86.8 | NLM WB 39 | DDC 616.02/5–dc23 LC record available at https://lccn.loc.gov/2017046469 This work is provided “as is,” and the publisher disclaims any and all warranties, express or implied, including any warranties as to accuracy, comprehensiveness, or currency of the content of this work. 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LWW.com CONTRIBUTORS Amy Follmer Hildreth, MD* Emergency Medicine Physician Naval Medical Center San Diego San Diego, California Graham Ingalsbe, MD Chief Resident, 2016–2017 Department of Emergency Medicine University of Colorado School of Medicine Denver Health Residency in Emergency Medicine Denver, Colorado Erica Ashley Morse, MD Resident Physician Department of Emergency Medicine University of Colorado School of Medicine Denver Health Residency in Emergency Medicine Denver, Colorado David Silvestri, MD, MBA National Clinician Scholars Program Department of Emergency Medicine Yale School of Medicine New Haven, Connecticut *The views expressed in this publication are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government. ACKNOWLEDGMENTS Practicing medicine is like having a front row seat at the play of life. If that is true, and I believe it is, emergency medicine is like being back stage. This book is for the dedicated men and women who are often back stage making life and death decisions without a net knowing that the expectation is that they get it right the first time, every time, without blinking. Siobhan, Jake, Gaby, Finn, for whom I exist, thank you for tolerating my passion of academic medicine. RICHARD D. ZANE, MD To all those from whom I continue to gain wisdom—my teachers, my colleagues, my students, and perhaps foremost, my patients. And to Devorah, Harry, Jake, and Judah, whose support means the world to me. JOSHUA M. KOSOWSKY, MD