BOOK
Respiratory Emergencies, An Issue of Emergency Medicine Clinics of North America, E-Book
Robert J. Vissers | Michael A. Gibbs
(2016)
Additional Information
Book Details
Abstract
This issue of Emergency Medicine Clinics, edited by Drs. Robert Vissers and Michael Gibbs, focuses on Pulmonary Emergencies. Articles include: Approach to the Adult Patient with Acute Dyspnea,Approach to the Pediatric Patient with Acute Dyspnea,Advances in Pulmonary Imaging,Respiratory Monitoring,Management of Acute Asthma and COPD,Diagnosis and Treatment of Acute Pulmonary Embolus,Pulmonary Manifestations Of Systemic Diseases,Pleural Disease,Management of Hemoptysis, and more!
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Respiratory Emergencies\r | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| CONSULTING EDITOR | iii | ||
| EDITORS | iii | ||
| AUTHORS | iii | ||
| Contents | v | ||
| Foreword: Pulmonary Emergencies\r | v | ||
| Preface: Respiratory Emergencies\r | v | ||
| Early Treatment of Severe Acute Respiratory Distress Syndrome\r | v | ||
| Management of Acute Exacerbation of Asthma and Chronic Obstructive Pulmonary Disease in the Emergency Department\r | v | ||
| Respiratory Emergencies in Geriatric Patients\r | v | ||
| Noninvasive Ventilation for the Emergency Physician\r | vi | ||
| Emergency Department Treatment of the Mechanically Ventilated Patient\r | vi | ||
| Pediatric Respiratory Emergencies\r | vi | ||
| Airway Management of Respiratory Failure\r | vi | ||
| Approach to Adult Patients with Acute Dyspnea\r | vii | ||
| Advances in Point-of-Care Thoracic Ultrasound\r | vii | ||
| EMERGENCY MEDICINE\rCLINICS OF NORTH AMERICA\r | viii | ||
| FORTHCOMING ISSUES | viii | ||
| May 2016 | viii | ||
| August 2016 | viii | ||
| November 2016 | viii | ||
| RECENT ISSUES | viii | ||
| November 2015 | viii | ||
| August 2015 | viii | ||
| May 2015 | viii | ||
| PROGRAM OBJECTIVE | ix | ||
| LEARNING OBJECTIVES | ix | ||
| ACCREDITATION | ix | ||
| DISCLOSURE OF CONFLICTS OF INTEREST | ix | ||
| UNAPPROVED/OFF-LABEL USE DISCLOSURE | ix | ||
| TO ENROLL | ix | ||
| METHOD OF PARTICIPATION | ix | ||
| CME INQUIRIES/SPECIAL NEEDS | x | ||
| Foreword: Pulmonary Emergencies \r | xi | ||
| Preface: Respiratory Emergencies \r | xiii | ||
| Erratum | xv | ||
| Early Treatment of Severe Acute Respiratory Distress Syndrome | 1 | ||
| Key points | 1 | ||
| INTRODUCTION | 1 | ||
| CLINICAL PRESENTATION AND ACUTE RESPIRATORY DISTRESS SYNDROME DEFINITION | 2 | ||
| PATIENT EVALUATION | 2 | ||
| EARLY MANAGEMENT | 3 | ||
| TREATMENT OF LIFE-THREATENING HYPOXIA | 5 | ||
| Fraction of Inspired Oxygen | 5 | ||
| Mean Airway Pressure | 6 | ||
| Recruitment | 7 | ||
| Diffusion | 8 | ||
| Redistribution of Blood Flow | 8 | ||
| Extracorporeal Membrane Oxygenation | 9 | ||
| MECHANICAL VENTILATION | 9 | ||
| MODES OF VENTILATION | 11 | ||
| MEDICATIONS | 11 | ||
| SUMMARY | 12 | ||
| ACKNOWLEDGMENTS | 12 | ||
| REFERENCES | 12 | ||
| Management of Acute Exacerbation of Asthma and Chronic Obstructive Pulmonary Disease in the Emergency Department | 15 | ||
| Key points | 15 | ||
| INTRODUCTION | 15 | ||
| DEFINITIONS | 16 | ||
| PATHOPHYSIOLOGY | 16 | ||
| RISK STRATIFICATION | 16 | ||
| ACUTE DECOMPENSATED HEART FAILURE | 17 | ||
| DIAGNOSIS | 17 | ||
| Spirometry | 17 | ||
| Laboratory Tests | 19 | ||
| Blood Gas Analysis | 19 | ||
| Capnography | 19 | ||
| Electrocardiogram | 19 | ||
| Radiography | 20 | ||
| Ultrasonography | 20 | ||
| TREATMENT | 21 | ||
| Oxygen | 21 | ||
| Bronchodilators | 21 | ||
| Short-acting β2-receptor agonists | 21 | ||
| Long-acting β2-receptor agonists | 21 | ||
| Anticholinergics | 22 | ||
| Delivery mode | 22 | ||
| Magnesium sulfate | 22 | ||
| Corticosteroids | 23 | ||
| Antibiotics | 24 | ||
| Noninvasive Ventilation | 24 | ||
| High-Flow Nasal Cannula Oxygen Therapy | 26 | ||
| Heliox | 26 | ||
| Ketamine | 26 | ||
| Epinephrine | 27 | ||
| Endotracheal Intubation | 27 | ||
| Post Endotracheal Intubation Documentation | 28 | ||
| Delayed sequence intubation | 29 | ||
| Mechanical Ventilation | 29 | ||
| Extracorporeal Membrane Oxygenation | 30 | ||
| Treatment Options Beyond the Emergency Department | 30 | ||
| MANAGEMENT BEYOND THE EMERGENCY DEPARTMENT | 30 | ||
| ACUTE EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ASTHMA CARE PLANS | 31 | ||
| REFERENCES | 31 | ||
| Noninvasive Ventilation for the Emergency Physician | 51 | ||
| Key points | 51 | ||
| INTRODUCTION | 51 | ||
| MODES OF NONINVASIVE VENTILATION | 52 | ||
| PHYSIOLOGIC CHANGES WITH NONINVASIVE VENTILATION | 52 | ||
| TRADITIONAL APPLICATIONS OF NONINVASIVE VENTILATION | 53 | ||
| Chronic Obstructive Pulmonary Disease | 53 | ||
| Acute Cardiogenic Pulmonary Edema | 54 | ||
| NOVEL APPLICATIONS OF NONINVASIVE VENTILATION | 54 | ||
| Asthma Exacerbations | 54 | ||
| Traumatic Respiratory Failure | 55 | ||
| Community-Acquired Pneumonia | 55 | ||
| Immunocompromised Patients | 56 | ||
| Delayed Sequence Intubation | 56 | ||
| CONTROVERSIAL USES OF NONINVASIVE VENTILATION | 56 | ||
| Altered Mental Status | 56 | ||
| Acute Respiratory Distress Syndrome | 57 | ||
| PRACTICAL CONSIDERATIONS FOR INITIATING NONINVASIVE VENTILATION | 57 | ||
| PREDICTING THE SUCCESS OR FAILURE OF NONINVASIVE VENTILATION | 58 | ||
| HIGH-FLOW NASAL CANNULA | 58 | ||
| SUMMARY | 59 | ||
| REFERENCES | 60 | ||
| Emergency Department Treatment of the Mechanically Ventilated Patient | 63 | ||
| Key points | 63 | ||
| HISTORY OF MECHANICAL VENTILATION | 63 | ||
| INTRODUCTION TO VARIABLES | 64 | ||
| Management of Ventilation | 64 | ||
| Trigger | 64 | ||
| Limit | 64 | ||
| Cycle | 65 | ||
| Management of Oxygenation | 65 | ||
| Fraction of inspired oxygen | 65 | ||
| Positive end-expiratory pressure | 65 | ||
| MODES OF VENTILATION | 66 | ||
| Volume-Controlled Ventilation | 66 | ||
| Volume Assist–Control Ventilation | 66 | ||
| Pressure Control Ventilation | 66 | ||
| Pressure Assist–Control Ventilation | 67 | ||
| Pressure-Regulated Volume Control | 68 | ||
| Synchronized Intermittent Mandatory Ventilation | 68 | ||
| Airway Pressure Release Ventilation | 69 | ||
| High-Frequency Oscillatory Ventilation | 69 | ||
| POSTINTUBATION GOALS AND TITRATING THE VENTILATOR | 69 | ||
| Titrating Oxygenation | 69 | ||
| Titrating Ventilation | 70 | ||
| Peak Pressures Versus Plateau Pressures | 70 | ||
| DAMAGE CONTROL VENTILATION | 71 | ||
| TROUBLESHOOTING THE VENTILATOR | 73 | ||
| SUMMARY | 74 | ||
| REFERENCES | 74 | ||
| Pediatric Respiratory Emergencies | 77 | ||
| Key points | 77 | ||
| NONINFECTIOUS EMERGENCIES | 77 | ||
| Foreign Body Aspiration | 77 | ||
| Epidemiology | 77 | ||
| Clinical presentation | 78 | ||
| Evaluation | 78 | ||
| Management | 79 | ||
| Asthma | 80 | ||
| Epidemiology | 80 | ||
| Clinical presentation | 80 | ||
| Evaluation | 82 | ||
| Management | 83 | ||
| INFECTIOUS EMERGENCIES | 84 | ||
| Epiglottitis | 84 | ||
| Epidemiology | 84 | ||
| Clinical presentation | 84 | ||
| Evaluation | 84 | ||
| Management | 85 | ||
| Bronchiolitis | 85 | ||
| Epidemiology | 85 | ||
| Clinical presentation | 86 | ||
| Evaluation | 86 | ||
| Management | 86 | ||
| Pneumonia | 87 | ||
| Epidemiology | 87 | ||
| Clinical presentation | 87 | ||
| Evaluation | 88 | ||
| Management | 89 | ||
| Pertussis | 90 | ||
| Epidemiology | 90 | ||
| Clinical Presentation | 90 | ||
| Evaluation | 91 | ||
| Management | 92 | ||
| SUMMARY | 92 | ||
| REFERENCES | 92 | ||
| Airway Management of Respiratory Failure | 97 | ||
| Key points | 97 | ||
| INTRODUCTION | 97 | ||
| THE DECISION TO INTUBATE | 98 | ||
| Is the Patient Able to Maintain the Airway? | 98 | ||
| Is Ventilation or Oxygenation Inadequate? | 99 | ||
| What Is the Anticipated Clinical Course? | 99 | ||
| What Is the Role of Arterial Blood Gas Values in the Decision to Intubate? | 99 | ||
| IMPORTANCE OF FIRST-PASS SUCCESS | 100 | ||
| What Can Be Done to Improve Success When Securing the Airway? | 101 | ||
| Evaluation of Airway Difficulty | 101 | ||
| Evaluation of Difficulty in Ventilating with Bag-Mask Ventilation | 101 | ||
| Technique of Bag-Mask Ventilation | 102 | ||
| Evaluation of Suitability for Extraglottic Device | 103 | ||
| Evaluation of Difficulty in Performing Cricothyrotomy | 103 | ||
| THE PROCESS OF RAPID SEQUENCE INTUBATION | 104 | ||
| Preparation | 104 | ||
| Preoxygenation | 105 | ||
| How is preoxygenation accomplished? | 105 | ||
| How long is the time to desaturation? | 105 | ||
| What is the physiologic basis for apneic oxygenation? | 106 | ||
| Pretreatment | 107 | ||
| Pretreatment agents in the critically ill patient | 107 | ||
| PARALYSIS WITH INDUCTION | 108 | ||
| Provide Ideal Intubating Conditions | 108 | ||
| Prevent Hemodynamic Instability | 108 | ||
| Promote Analgesia and Amnesia | 108 | ||
| Etomidate | 108 | ||
| Propofol | 109 | ||
| Ketamine | 109 | ||
| Barbiturates | 110 | ||
| Benzodiazepines | 110 | ||
| PARALYTICS | 110 | ||
| Depolarizing Neuromuscular Blockade | 110 | ||
| Nondepolarizing Neuromuscular Blockade | 111 | ||
| POSITIONING | 113 | ||
| What Role Does Cricoid Pressure Have in Rapid Sequence Intubation? | 113 | ||
| Pass the Tube with Verification | 113 | ||
| Verification of Endotracheal Tube Placement | 116 | ||
| POSTINTUBATION MANAGEMENT | 116 | ||
| What Are the Cardiovascular Responses to Intubation? | 116 | ||
| Hypotension | 116 | ||
| Hypertension | 117 | ||
| Tachycardia | 117 | ||
| What Factors Influence Sedation in the Immediate Postintubation Period? | 118 | ||
| MANAGEMENT OF THE FAILED AIRWAY | 119 | ||
| SUMMARY | 119 | ||
| SUPPLEMENTARY DATA | 119 | ||
| REFERENCES | 119 | ||
| Approach to Adult Patients with Acute Dyspnea | 129 | ||
| Key points | 129 | ||
| INTRODUCTION | 129 | ||
| PATIENT EVALUATION | 130 | ||
| History | 130 | ||
| Physical Examination | 130 | ||
| Testing | 131 | ||
| DIFFERENTIAL DIAGNOSIS FOR ACUTELY DYSPNEIC PATIENTS | 136 | ||
| Obstructive Dyspnea | 136 | ||
| Parenchymal Dyspnea | 142 | ||
| Circulatory Dyspnea | 143 | ||
| Compensatory Dyspnea | 146 | ||
| Diagnosis of Exclusion | 147 | ||
| SUMMARY | 147 | ||
| REFERENCES | 147 | ||
| Advances in Point-of-Care Thoracic Ultrasound | 151 | ||
| Key points | 151 | ||
| BASIC THORACIC EXAMINATION | 152 | ||
| Pneumothorax | 152 | ||
| Technique | 152 | ||
| Pleural Effusion | 154 | ||
| Technique | 154 | ||
| Parenchymal Evaluation | 154 | ||
| Lung Interstitial Syndrome | 155 | ||
| Lung Consolidation and Severe Contusion | 155 | ||
| Monitoring Pulmonary Function | 156 | ||
| SUMMARY | 156 | ||
| SUPPLEMENTARY DATA | 156 | ||
| REFERENCES | 156 | ||
| Index | 159 |