Additional Information
Book Details
Abstract
The ultimate emergency medicine textbook from the renowned Professor Gordian Fulde now in a new edition.
Emergency Medicine 6e presents evidence-based clinical management and treatment advice for emergency medicine students and practitioners in Australasia. The vast range of topics include paediatric, geriatric, gynaecology, psychiatric, dental, rural and Indigenous presentations, ensuring readers are well prepared for any eventuality in the Emergency Department.
This outstanding text combines expertise and experience with fully up-to-date content. It is authored by Professor Gordian Fulde, Emergency Department director at Sydney’s St Vincent's Hospital, with contributions from Dr Sascha Fulde and over 60 other notable emergency medicine clinicians.
Readers will gain a solid understanding of effective procedural and management skills in the ED. Practical tips relate to: patient transport and retrieval; seriously ill patients; advanced nursing roles; general practitioners; working with IT; administration, legal matters, governance and quality care; and interns and students in the emergency department.
The ideal complement to hands-on emergency medicine training, this new edition of Emergency Medicine also prepares readers to apply key emergency medicine skills to unique incidents such as mass casualty and chemical, biological and radiological hazard contingencies.
Topics included in this edition of Emergency Medicine include: • securing the airway • resuscitation • arrhythmia management • pain management • imaging • dermatology • trauma • poisoning • envenomation • overdose
- Coverage of important controversies with evidence based recommendations.
- Editor comments contained in relevant chapters to provide clinical tips and advice for practice.
- Increased coverage of topical issues such as deep vein thrombosis (economy class syndrome) and street drugs.
- Practical rapid reference appendix.
- Detailed glossary and index.
- The Quick Reference Guide is updated and included in this book. It is also made available as an app
- Updating all chapters – particularly toxicology, IT, Paediatrics
- New resuscitation guidelines – Cardiopulmonary Resuscitation; External Automated Defibrillation in BLS; Compressions; Breathing; Airway; Unconsciousness; Priorities in an Emergency; Principles and Format for Developing Guidelines (all revised 12/2010 following ILCOR)
- More comprehensive content for Indigenous and Rural Emergencies chapter
- Moderate repetition arising from so many contributors
- The CT Brain and C spine Rules have been added to the Quick Reference Guide.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front\rCover | Cover | ||
| Emergency Medicine: The Principles of Practice | III | ||
| Copyright Page | IV | ||
| Table of\rContents | VI | ||
| Preface | V | ||
| Acknowledgements | V | ||
| Contributors | XVI | ||
| Reviewers | XXIV | ||
| Chapter 1.\rCardiopulmonary resuscitation | 1 | ||
| Basic life support (BLS) | 1 | ||
| Adult advanced life support (ALS) | 3 | ||
| Advanced life support in children | 7 | ||
| Resuscitation of the newborn | 8 | ||
| Foreign body airway obstruction | 11 | ||
| Chapter 2.\rSecuring the airway, ventilation and procedural sedation | 13 | ||
| Securing the airway | 13 | ||
| Surgical airway | 29 | ||
| Ventilators | 29 | ||
| Procedural sedation | 35 | ||
| Chapter 3.\rResuscitation and emergency procedures | 38 | ||
| Intravenous access techniques | 39 | ||
| Ultrasound guidance | 40 | ||
| Arterial access techniques | 45 | ||
| Chest drainage procedures | 46 | ||
| Urinary catheterisation | 51 | ||
| Suprapubic cystostomy | 53 | ||
| Cricothyroidotomy | 54 | ||
| Lumbar puncture (LP) | 55 | ||
| Emergency department thoracotomy | 56 | ||
| Chapter 4.\rDiagnostic imaging in emergency patients | 58 | ||
| Imaging modalities | 58 | ||
| Intravenous contrast reaction | 68 | ||
| Imaging of the head | 70 | ||
| Emergencies in the neck | 77 | ||
| Emergencies in thoracic and lumbar spine | 82 | ||
| Chest emergencies | 83 | ||
| Radiology in abdominal emergencies | 90 | ||
| Some obstetric emergencies | 96 | ||
| Fractures of pelvis and limbs | 97 | ||
| Radiation issues | 98 | ||
| Chapter 5.\rUltrasound in emergency medicine | 101 | ||
| Basic physical principles | 101 | ||
| Ultrasound equipment | 104 | ||
| Common applications in the ED | 105 | ||
| Other applications | 108 | ||
| Training, credentialling and quality review | 110 | ||
| Chapter 6.\rThe approach tothe patient with chest pain, dyspnoea or haemoptysis | 112 | ||
| Chest pain | 112 | ||
| Dyspnoea | 119 | ||
| Haemoptysis | 124 | ||
| Reference | 126 | ||
| Chapter 7.\rAcute coronary syndromes | 127 | ||
| Safe assessment | 127 | ||
| Management of STEMI | 129 | ||
| Stratifying ACS without diagnostic ECG changes: NSTEACS patients | 134 | ||
| Management of NSTEACS | 135 | ||
| Additional management (STEMI and NSTEACS) | 136 | ||
| Cocaine-inducedchest pain | 136 | ||
| Patient transfer | 137 | ||
| Chapter 8.\rClinical electrocardiography and arrhythmia management | 143 | ||
| Indications | 143 | ||
| ECG interpretation | 143 | ||
| Chapter 9.\rRespiratory emergencies: the acutely breathless patient | 167 | ||
| General principles | 167 | ||
| Oxygen therapy | 167 | ||
| Investigations in respiratory emergencies | 170 | ||
| Life-threateningconditions presenting\rwith breathlessness | 175 | ||
| Chapter 10.\rAcute pulmonary oedema | 187 | ||
| Overview | 187 | ||
| Pathophysiology | 187 | ||
| Clinical features | 189 | ||
| Differential diagnosis | 190 | ||
| Investigations | 190 | ||
| Management of APO | 191 | ||
| Disposal | 193 | ||
| Chapter 11.\rVenous thromboembolic disease—deep venous thrombosis and pulmonary embolism | 194 | ||
| Introduction | 194 | ||
| Pathophysiology | 195 | ||
| Clinical features | 196 | ||
| Diagnostic approach and clinical\rdecision rules | 197 | ||
| Investigations | 199 | ||
| Treatment | 201 | ||
| Disposition | 202 | ||
| References | 203 | ||
| Chapter 12.\rShock | 206 | ||
| Causes and effects | 206 | ||
| Overview of management | 208 | ||
| Hypovolaemic shock | 209 | ||
| Cardiogenic shock | 210 | ||
| Distributive shock | 212 | ||
| Obstructive shock | 214 | ||
| Summary | 215 | ||
| Chapter 13.\rPain management in the emergency department | 216 | ||
| The approach to pain management | 216 | ||
| Establishing a pain management process in the ED | 218 | ||
| Assessment of pain | 218 | ||
| The rational use of analgesics and sedatives | 220 | ||
| Local anaesthesia | 225 | ||
| Non-pharmacologicalmethods | 227 | ||
| Analgesia in the elderly | 229 | ||
| Analgesia in pregnancy and breastfeeding | 230 | ||
| Drug-seekingpatients | 230 | ||
| Analgesia in special situations | 230 | ||
| Patient monitoring | 231 | ||
| Patient discharge | 231 | ||
| Summary | 233 | ||
| Definitions | 234 | ||
| Chapter 14.\rTrauma | 235 | ||
| Definition of major injury | 235 | ||
| Pre-hospitaltriage | 236 | ||
| Preparation | 238 | ||
| Systematic assessment and management | 240 | ||
| Primary survey | 240 | ||
| Resuscitation | 247 | ||
| Management of life-threatening conditions | 249 | ||
| History | 250 | ||
| Specific injuries | 253 | ||
| Definitive care | 267 | ||
| Trauma service performance improvement | 267 | ||
| Conclusion | 269 | ||
| Chapter 15.\rNeurosurgical emergencies | 271 | ||
| General concepts | 271 | ||
| Traumatic neurosurgical emergencies | 276 | ||
| Non-traumaticneurosurgical emergencies | 288 | ||
| Chapter 16.\rAortic and vascular emergencies | 298 | ||
| Acute aortic dissection | 298 | ||
| Ruptured abdominal aortic aneurysm | 299 | ||
| Non-aorticabdominal aneurysms | 301 | ||
| Acute arterial insufficiency | 301 | ||
| Atheroembolism | 303 | ||
| Chronic arterial insufficiency | 303 | ||
| Deep venous thrombosis | 303 | ||
| Chapter 17.\rOrthopaedic principles—fractures and dislocations | 304 | ||
| General principles | 304 | ||
| Upper limb injuries | 306 | ||
| Pelvic fractures | 324 | ||
| Lower limb injuries | 326 | ||
| Chapter 18.\rHand injuries and care | 343 | ||
| Assessment | 343 | ||
| Examination | 343 | ||
| Treatment | 344 | ||
| Soft-tissueinjuries | 345 | ||
| Nails | 346 | ||
| Tendons | 347 | ||
| Nerve injuries | 347 | ||
| Vascular injuries | 348 | ||
| Bony injuries | 348 | ||
| Specific conditions | 350 | ||
| Chapter 19.\rUrological emergencies | 356 | ||
| Balanitis | 356 | ||
| Common post-proceduralproblems | 356 | ||
| Epididymo-orchitis | 357 | ||
| Fournier’s gangrene | 359 | ||
| Hydrocele | 361 | ||
| Paraphimosis | 362 | ||
| Phimosis | 362 | ||
| Priapism | 363 | ||
| Prostate disease | 365 | ||
| Renal/ureteric calculus | 366 | ||
| Testicular torsion | 369 | ||
| Urinary tract infections (UTIs) | 371 | ||
| Urine retention | 376 | ||
| Urological trauma | 379 | ||
| Varicocele | 385 | ||
| Chapter 20.\rBurns | 386 | ||
| Types of burns | 386 | ||
| Assessment of the burns patient | 386 | ||
| Assessment of depth and extent of burn | 388 | ||
| General management | 388 | ||
| Fluid requirements | 390 | ||
| Admission and transfer to specialised\rburns unit | 390 | ||
| Specific burns | 391 | ||
| Prevention of infection | 392 | ||
| Specific other factors | 393 | ||
| Chapter 21.\rPatient transport and retrieval | 395 | ||
| Indications for retrieval | 395 | ||
| The retrieval team | 396 | ||
| Equipment | 396 | ||
| The retrieval environment | 397 | ||
| Retrieval vehicles | 397 | ||
| Preparing a patient for retrieval | 398 | ||
| In transit | 399 | ||
| Hand-over | 399 | ||
| Pre-hospitalcare | 400 | ||
| Chapter 22.\rMass-casualty incidents, chemical, biological and radiological hazard contingencies | 403 | ||
| Aims and objectives | 403 | ||
| Phases of a disaster | 404 | ||
| Administrative and legislative mandates | 405 | ||
| Medical response plans and agencies | 407 | ||
| Pre-hospital\rmedical coordination and disaster scene control | 409 | ||
| Triage | 413 | ||
| Communication | 420 | ||
| Code Brown: hospital external disaster or\remergency response plan | 420 | ||
| Stages of response | 423 | ||
| Chemical, biological and radiological hazards | 429 | ||
| Acknowledgements | 441 | ||
| Chapter 23.\rThe seriously ill patient—tips and traps | 443 | ||
| Warning—red lights—beware | 444 | ||
| Decision-makingtips | 445 | ||
| Emergency department ‘laws’ | 448 | ||
| Do not feed the lawyers | 450 | ||
| The fun bits | 450 | ||
| Chapter 24.\rNeurological emergencies | 453 | ||
| Coma or impaired consciousness | 453 | ||
| Epilepsy | 455 | ||
| Cerebrovascular disease | 457 | ||
| Headache | 460 | ||
| Bell’s palsy | 468 | ||
| Paraplegia | 468 | ||
| Confusion | 470 | ||
| Chapter 25.\rGastrointestinal emergencies | 472 | ||
| Acute abdomen | 472 | ||
| Specific surgical conditions | 477 | ||
| Gastrointestinal bleeding | 480 | ||
| Acute pancreatitis | 483 | ||
| Gastro-oesophageal\rreflux disease (GORD)—oesophagitis | 485 | ||
| Mesenteric ischaemia/infarction | 486 | ||
| Vomiting | 488 | ||
| Constipation | 490 | ||
| Hepatic failure—portosystemic encephalopathy | 492 | ||
| Chapter 26. Endocrine emergencies | 497 | ||
| Emergencies in patients with diabetes | 497 | ||
| Adrenal emergencies | 506 | ||
| Thyroid emergencies | 508 | ||
| Chapter 27.\rAcid–base and electrolyte disorders | 513 | ||
| Electrolyte emergencies | 513 | ||
| Disorders of acid–base balance | 516 | ||
| Osmolarity, osmolar gap | 522 | ||
| Urine osmolarity and other urine electrolytes | 523 | ||
| Disorders of serum sodium | 524 | ||
| Disorders of serum potassium | 527 | ||
| Disorders of calcium | 528 | ||
| Disorders of phosphate | 530 | ||
| Disorders of magnesium | 531 | ||
| Rough correction factors for electrolyte abnormalities | 532 | ||
| Acute renal failure | 532 | ||
| Controversies in electrolyte management | 535 | ||
| Chapter 28.\rPoisoning, overdosage, drugs and alcohol | 536 | ||
| Poisoning and overdosage | 536 | ||
| Toxidromes and specific overdoses | 543 | ||
| Drugs and alcohol | 566 | ||
| Chapter 29.\rDrowning | 582 | ||
| Epidemiology | 582 | ||
| Pathophysiology | 582 | ||
| Precipitating events | 584 | ||
| Outcome | 584 | ||
| Examination | 584 | ||
| Management (ABCDE) | 586 | ||
| Chapter 30.\rEnvenomation | 592 | ||
| Introduction | 592 | ||
| Snakebite | 592 | ||
| Spider bites | 598 | ||
| Marine envenomation | 601 | ||
| Tick bites | 604 | ||
| Centipedes and scorpions | 605 | ||
| Additional resources | 605 | ||
| Chapter 31.\rElectrical injuries | 607 | ||
| Overview | 607 | ||
| Low- and high-voltage electrical injury | 609 | ||
| Lightning injuries | 612 | ||
| TASERs and electrical weapons | 615 | ||
| Chapter 32. Hypothermia\rand hyperthermia | 617 | ||
| Physiology | 617 | ||
| Hypothermia | 617 | ||
| Hyperthermia | 624 | ||
| Controversies | 628 | ||
| Chapter 33. Childhood emergencies | 629 | ||
| Immunisation in childhood | 630 | ||
| Resuscitation | 630 | ||
| Identifying the sick child | 635 | ||
| Airway emergencies | 636 | ||
| Respiratory emergencies | 637 | ||
| The unconscious child | 639 | ||
| The febrile child | 641 | ||
| Common infections | 646 | ||
| Convulsions | 647 | ||
| Gastroenteritis | 649 | ||
| Fluid therapy | 652 | ||
| Rehydration | 652 | ||
| Diabetic ketoacidosis and hypoglycaemia | 653 | ||
| Development | 656 | ||
| Feeding | 656 | ||
| The inconsolable infant | 656 | ||
| Jaundice | 657 | ||
| Child abuse | 660 | ||
| Sudden infant death syndrome (SIDS) | 661 | ||
| Surgical abdominal emergencies | 662 | ||
| Burns | 664 | ||
| Orthopaedic problems | 666 | ||
| Pain management | 667 | ||
| Prescribing for the paediatric patient | 668 | ||
| Procedures | 669 | ||
| Toxicology, poisoning and envenomation | 672 | ||
| Chapter 34.\rGeriatric care | 673 | ||
| Physiological changes | 674 | ||
| The approach to the elderly patient | 676 | ||
| Common presentations | 676 | ||
| Geriatric trauma | 685 | ||
| Syncope | 690 | ||
| The ‘not-coping’ patient | 694 | ||
| Resuscitation8 | 696 | ||
| References | 698 | ||
| Chapter 35.\rGynaecological emergencies | 699 | ||
| General principles | 699 | ||
| Common presentations | 699 | ||
| Other complications of later pregnancy | 707 | ||
| Prescribing in pregnancy | 711 | ||
| Anti-D prophylaxis | 711 | ||
| Sexual assault | 711 | ||
| Post-coital contraception: morning-after pill | 711 | ||
| Acknowledgement | 712 | ||
| Chapter 36.\rOphthalmic emergencies | 713 | ||
| Principles of examination | 713 | ||
| Use of the slit lamp | 713 | ||
| Trauma | 715 | ||
| The painful red eye | 720 | ||
| Sudden painless monocular visual loss | 723 | ||
| Postoperative problems | 725 | ||
| Ophthalmic conditions needing referral | 726 | ||
| Common ophthalmic medications | 726 | ||
| Chapter 37.\rEar, nose and throat (ENT) emergencies | 728 | ||
| Ear emergencies | 728 | ||
| Nose emergencies | 736 | ||
| Throat emergencies | 741 | ||
| Epiglottitis | 743 | ||
| References | 747 | ||
| Chapter 38.\rManagement of dental emergencies | 748 | ||
| Toothache | 748 | ||
| Infected gums | 750 | ||
| Impacted teeth | 750 | ||
| Mouth sores and ulceration | 751 | ||
| Neoplasia | 752 | ||
| Facial swellings | 752 | ||
| Heart disease and dental care | 753 | ||
| Antibiotic guidelines for dental procedures in\rhigh-risk patients1 | 754 | ||
| Post-extraction instructions | 754 | ||
| Dry socket | 755 | ||
| Oral bleeding | 756 | ||
| Traumatic injuries to teeth | 757 | ||
| Trismus and temperomandibular joint (TMJ) dysfunction | 759 | ||
| Dental nomenclature | 760 | ||
| References | 761 | ||
| Chapter 39.\rPsychiatric presentations | 762 | ||
| Triage | 762 | ||
| Control of aggression | 766 | ||
| History and assessment | 770 | ||
| Initial approach | 771 | ||
| Further assessment and management | 776 | ||
| Common drugs used in psychiatry | 777 | ||
| Diagnoses in psychiatry | 783 | ||
| Anxiety | 784 | ||
| Chapter 40.\rDermatological presentations to emergency | 786 | ||
| Assessing patients with dermatological emergency presentations | 786 | ||
| Morphological classification of dermatological presentations | 789 | ||
| Common lower leg emergency presentations—ulcers/wounds | 818 | ||
| Other common skin infections | 821 | ||
| Bites11 | 821 | ||
| Common medications in the ED | 826 | ||
| Wound and ulcer care in the ED | 827 | ||
| References | 831 | ||
| Chapter 41.\rInfectious diseases | 832 | ||
| Antibiotic prescribing | 832 | ||
| CNS infections | 832 | ||
| Gastrointestinal infections | 836 | ||
| Viral hepatitis | 837 | ||
| Genitourinary infections | 839 | ||
| Sexually transmitted infection (STI) | 842 | ||
| Needle-stick injuries and body fluids exposures | 845 | ||
| Respiratory tract infection | 846 | ||
| Tuberculosis (TB) | 847 | ||
| Severe sepsis | 849 | ||
| Meningococcal infection | 850 | ||
| MRSA and NORSA | 852 | ||
| Skin infections | 853 | ||
| Wound infections | 856 | ||
| Water-related infections | 856 | ||
| Herpes zoster (shingles) | 857 | ||
| Tetanus prophylaxis | 857 | ||
| The overseas traveller | 858 | ||
| Acknowledgements | 861 | ||
| Chapter 42.\rThe immunosuppressed patient | 862 | ||
| Overview | 862 | ||
| Cancer patients | 864 | ||
| Non-infectious complications of cancer and its treatment | 866 | ||
| HIV infection | 869 | ||
| Malignancy in HIV/AIDS | 878 | ||
| Immune reconstitution inflammatory\rsyndrome (IRIS) | 879 | ||
| Antiretroviral drugs | 880 | ||
| Post-exposure prophylaxis in HIV | 882 | ||
| Solid-organ transplants | 884 | ||
| Immunosuppression for non-malignant disease | 888 | ||
| Asplenia | 889 | ||
| Chapter 43.\rEmergency department haematology | 890 | ||
| Common haematological emergencies | 890 | ||
| The anaemic patient | 892 | ||
| The patient with abnormal bleeding | 893 | ||
| Anticoagulant therapy | 895 | ||
| Blood transfusion | 898 | ||
| Inappropriate use of blood components | 901 | ||
| Chapter 44.\rRural and Indigenous emergencies | 903 | ||
| Rural and remote Australia | 903 | ||
| Approach to the rural patient | 903 | ||
| Patient travel, transport and retrieval | 903 | ||
| Indigenous patients | 904 | ||
| Communication | 905 | ||
| Alcohol and substance abuse | 906 | ||
| Chapter 45.\rAdvanced nursing roles | 908 | ||
| The triage nurse | 908 | ||
| Clinical initiatives nurse (CIN) | 911 | ||
| Aged service emergency team (ASET) | 912 | ||
| Rapid assessment team (RAT) or immediate initiation of care (IIOC) | 913 | ||
| The nurse practitioner (NP) | 915 | ||
| References | 920 | ||
| Chapter 46.\rThe general practitioner; Working with IT | 922 | ||
| The ED and the GP | 922 | ||
| The ED and IT | 926 | ||
| Chapter 47.\rAdministration, legal matters, governance and quality care in the ED | 930 | ||
| How the law affects the practice of emergency medicine | 930 | ||
| Legal issues in medicine | 931 | ||
| How do you avoid a law suit? | 934 | ||
| Some clinical administration issues | 937 | ||
| Quality and governance in the ED | 941 | ||
| References | 945 | ||
| Chapter 48.\rA guide for interns working in emergency medicine | 946 | ||
| Introduction | 946 | ||
| Day 1—getting started | 946 | ||
| Working up a patient | 947 | ||
| Further into the term/learning opportunities | 953 | ||
| Miscellaneous | 955 | ||
| Quick/general tips | 961 | ||
| Chapter 49.\rStudents’ guide to the emergency department | 963 | ||
| Advantages of the ED | 963 | ||
| Use it as a light at the end of the tunnel | 965 | ||
| How do you get the most out of it? | 966 | ||
| Summary | 968 | ||
| Index | 970 | ||
| Quick reference | QR1 | ||
| 1 Cardiorespiratory arrest algorithms | QR2 | ||
| 2 Cardiac arrest drugs | QR5 | ||
| 3 Miscellaneous drugs—adults | QR7 | ||
| 4 Miscellaneous drugs—paediatrics | QR11 | ||
| 5 Cardiology | QR14 | ||
| 6 ECGs | QR19 | ||
| 7 Respiratory | QR26 | ||
| 8 Trauma | QR30 | ||
| 9 Metabolic equations and electrolytes | QR39 | ||
| 10 Thromboembolism and coagulopathy | QR51 | ||
| 11 Neurology | QR58 | ||
| 12 Important procedures | QR61 | ||
| 13 Toxicology | QR64 | ||
| 14 Drug infusions | QR70 | ||
| 15 Paediatrics | QR75 | ||
| 16 Pathology | QR79 | ||
| 17 Orthopaedics | QR82 | ||
| 18 Obstetrics and gynaecology | QR87 | ||
| 19 Dental | QR89 | ||
| 20 Common conversions | QR92 | ||
| 21 Antibiotic prescribing | QR94 | ||
| 22 Normal values | QR106 | ||
| Abbreviations | A1 |