BOOK
Emergency Medicine, An Issue of Physician Assistant Clinics, E-Book
(2017)
Additional Information
Book Details
Abstract
This issue of Physician Assistant Clinics, guest edited by Fred Wu and Dr. Michael E. Winters, is devoted to Emergency Medicine. Articles in this outstanding issue include: Anaphylaxis; Back Pain Emergencies; Lethal Rashes; Pregnancy Disasters in the First Trimester; Current Concepts in the Evaluation of the Febrile Child; Skin and Soft Tissue Infections; Pitfalls in Wound Management; Ocular Emergencies; Deadly Drug Ingestions; Low Risk Chest Pain; Headache Mistakes You Don't Want to Make; Asymptomatic Hypertension in the Emergency Department; Orthopedic Pearls and Pitfalls; and Antibiotic Stewardship: Choosing Wisely.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Emergency Medicine | i | ||
| Copyright\r | ii | ||
| CME Accreditation Page | iii | ||
| PROGRAM OBJECTIVE | iii | ||
| TARGET AUDIENCE | iii | ||
| LEARNING OBJECTIVES | iii | ||
| ACCREDITATION | iii | ||
| DISCLOSURE OF CONFLICTS OF INTEREST | iii | ||
| UNAPPROVED/OFF-LABEL USE DISCLOSURE | iii | ||
| TO ENROLL | iii | ||
| METHOD OF PARTICIPATION | iv | ||
| CME INQUIRIES/SPECIAL NEEDS | iv | ||
| Contributors | v | ||
| CONSULTING EDITOR | v | ||
| EDITORS | v | ||
| AUTHORS | v | ||
| Contents | ix | ||
| Foreword: Emergency Medicine | ix | ||
| Preface: High-Risk Emergency Medicine | ix | ||
| Anaphylaxis | ix | ||
| Back Pain Emergencies: Easily Missed Diagnoses | ix | ||
| Lethal Rashes | ix | ||
| Pregnancy Disasters in the First Trimester | x | ||
| Current Concepts in the Evaluation of the Febrile Child | x | ||
| Skin and Soft Tissue Infections: Causes and Treatments | x | ||
| Pitfalls in Wound Management | x | ||
| Deadly Drug Ingestions | xi | ||
| Asymptomatic Hypertension in the Emergency Department | xi | ||
| Orthopedic Pearls and Pitfalls | xi | ||
| Antibiotic Stewardship Choosing Wisely | xi | ||
| Headache Mistakes You Do Not Want to Make | xii | ||
| Ocular Emergencies | xii | ||
| Low-Risk Chest Pain: What Is the Evidence? | xii | ||
| PHYSICIAN ASSISTANT CLINICS\r | xiii | ||
| FORTHCOMING ISSUES | xiii | ||
| October 2017 | xiii | ||
| January 2018 | xiii | ||
| April 2018 | xiii | ||
| RECENT ISSUES | xiii | ||
| April 2017 | xiii | ||
| January 2017 | xiii | ||
| October 2016 | xiii | ||
| Foreword: Emergency Medicine\r | xv | ||
| Preface:\rHigh-Risk Emergency Medicine | xvii | ||
| Anaphylaxis | 345 | ||
| Key points | 345 | ||
| INTRODUCTION | 345 | ||
| Clinical Features | 347 | ||
| MANAGEMENT | 350 | ||
| Epinephrine | 350 | ||
| Second-Line Medications | 351 | ||
| Intravenous Fluids | 352 | ||
| Vasopressors | 352 | ||
| DISPOSITION | 353 | ||
| SUMMARY | 353 | ||
| REFERENCES | 354 | ||
| Back Pain Emergencies | 357 | ||
| Key points | 357 | ||
| INTRODUCTION | 357 | ||
| HISTORY AND PHYSICAL EXAMINATION | 358 | ||
| History of Present Illness | 358 | ||
| Red Flags for Back Pain | 358 | ||
| Physical Examination | 359 | ||
| CAUDA EQUINA SYNDROME | 360 | ||
| SPINAL EPIDURAL ABSCESS | 362 | ||
| AORTIC CATASTROPHES | 363 | ||
| Aortic Dissection | 363 | ||
| Abdominal Aortic Aneurysm | 366 | ||
| SUMMARY | 367 | ||
| REFERENCES | 368 | ||
| Lethal Rashes | 371 | ||
| Key points | 371 | ||
| STAPHYLOCOCCAL TOXIC SHOCK SYNDROME | 371 | ||
| Diagnosis | 372 | ||
| Treatment | 373 | ||
| MENINGOCOCCEMIA | 374 | ||
| Diagnosis | 375 | ||
| Treatment | 376 | ||
| ERYTHEMA MULTIFORME | 377 | ||
| Clinical Manifestations | 378 | ||
| Diagnosis | 378 | ||
| Treatment | 378 | ||
| STEVENS–JOHNSON SYNDROME/TOXIC EPIDERMAL NECROLYSIS | 379 | ||
| Risk Factors | 379 | ||
| Clinical Features | 380 | ||
| Diagnosis | 380 | ||
| Treatment | 380 | ||
| SUMMARY | 381 | ||
| REFERENCES | 382 | ||
| Pregnancy Disasters in the First Trimester | 385 | ||
| Key points | 385 | ||
| INTRODUCTION | 385 | ||
| THE BASICS | 386 | ||
| PHYSIOLOGIC CHANGES IN PREGNANCY | 386 | ||
| EMERGENCY DEPARTMENT EVALUATION OF PREGNANT PATIENTS | 386 | ||
| Triage and Initial Management | 386 | ||
| History of Present Illness | 387 | ||
| Review of Systems | 388 | ||
| Past Medical History | 388 | ||
| Physical Examination | 389 | ||
| DIFFERENTIAL DIAGNOSIS | 389 | ||
| Ectopic Pregnancy | 389 | ||
| Spontaneous Abortion | 392 | ||
| Appendicitis | 392 | ||
| THE EVALUATION | 392 | ||
| Laboratory Evaluation | 392 | ||
| Ultrasonography | 393 | ||
| SPECIAL CIRCUMSTANCES OF EARLY PREGNANCY | 395 | ||
| Hyperemesis Gravidarum | 395 | ||
| SUMMARY | 398 | ||
| REFERENCES | 398 | ||
| Current Concepts in the Evaluation of the Febrile Child | 401 | ||
| Key points | 401 | ||
| INTRODUCTION | 401 | ||
| FEVER | 402 | ||
| EVALUATION OF THE FEBRILE CHILD | 402 | ||
| Method of Fever Measurement | 402 | ||
| Collection of the Clinical History | 403 | ||
| Physical Examination | 404 | ||
| Diagnostic Evaluation | 404 | ||
| Complete Blood Cell Count | 406 | ||
| C-Reactive Protein | 406 | ||
| Procalcitonin | 406 | ||
| Blood Culture | 406 | ||
| Urinalysis and Urine Culture | 406 | ||
| Chest Radiograph | 406 | ||
| Cerebral Spinal Fluid Analysis | 407 | ||
| Respiratory Virus Testing | 407 | ||
| BIOSIGNATURE ANALYSIS | 407 | ||
| FEVER BY AGE | 408 | ||
| 0 to 28 Days Old | 408 | ||
| 29 to 90 Days Old | 408 | ||
| 90 Days to 36 Months Old | 409 | ||
| IMMUNIZATIONS | 409 | ||
| CLINICAL DECISION GUIDES | 410 | ||
| Philadelphia Protocol | 411 | ||
| Rochester Criteria | 413 | ||
| Boston Criteria | 413 | ||
| “Step by Step” Approach | 413 | ||
| TREATMENT, DISPOSITION, AND FOLLOW-UP OF THE FEBRILE CHILD | 414 | ||
| Treatment 0 to 28 Days Old | 414 | ||
| Treatment 29 to 90 Days Old | 415 | ||
| Treatment 90 Days to 36 Months of Age | 416 | ||
| SUMMARY | 418 | ||
| REFERENCES | 419 | ||
| Skin and Soft Tissue Infections | 421 | ||
| Key points | 421 | ||
| INTRODUCTION | 421 | ||
| MICROBIOLOGY | 422 | ||
| CELLULITIS AND ERYSIPELAS (NONPURULENT SKIN AND SOFT TISSUE INFECTIONS) | 422 | ||
| Clinical Presentation | 422 | ||
| Diagnosis | 422 | ||
| Treatment and Disposition | 423 | ||
| ABSCESS (PURULENT SKIN AND SOFT TISSUE INFECTIONS) | 425 | ||
| Clinical Presentation | 425 | ||
| Diagnosis | 425 | ||
| Treatment and Disposition | 426 | ||
| NECROTIZING INFECTION | 427 | ||
| Clinical Presentation | 427 | ||
| Diagnosis | 428 | ||
| Treatment and Disposition | 428 | ||
| SUMMARY | 428 | ||
| REFERENCES | 429 | ||
| Pitfalls in Wound Management | 435 | ||
| Key points | 435 | ||
| INTRODUCTION | 435 | ||
| METHODS TO PREVENT WOUND INFECTION | 435 | ||
| ANTIBIOTIC PROPHYLAXIS | 438 | ||
| SELECTING AN AGENT | 440 | ||
| TETANUS PROPHYLAXIS | 440 | ||
| EVALUATION AND MANAGEMENT OF ANIMAL BITES | 441 | ||
| THERMAL BURNS | 442 | ||
| CLASSIFYING DEPTH OF BURNS | 442 | ||
| TREATMENT OF BURNS | 444 | ||
| REFERENCES | 447 | ||
| Deadly Drug Ingestions | 449 | ||
| Key points | 449 | ||
| INITIAL MANAGEMENT | 449 | ||
| DIAGNOSIS OF DEADLY DRUGS | 451 | ||
| PHYSICAL EXAMINATION TOXIDROMES | 452 | ||
| Anticholinergic Toxidrome | 452 | ||
| Cholinergic Toxidrome | 453 | ||
| Opioid Toxidrome | 453 | ||
| Sympathomimetic Toxidrome | 454 | ||
| Hyperthermic Toxidromes | 454 | ||
| Sedative Hypnotic Toxidrome | 455 | ||
| LABORATORY TESTING CONSIDERATIONS | 455 | ||
| Toxins Inducing Osmolar Gap | 456 | ||
| Toxins Inducing Anion Gap Metabolic Acidosis | 456 | ||
| ELECTROCARDIOGRAPHIC TOXIC EFFECTS | 456 | ||
| QT Prolongation | 456 | ||
| QRS Prolongation | 457 | ||
| Bradycardia | 457 | ||
| ONE PILL CAN KILL | 457 | ||
| DECONTAMINATION | 457 | ||
| Gastrointestinal Decontamination | 457 | ||
| Gastric lavage | 458 | ||
| Activated charcoal | 458 | ||
| Whole-bowel irrigation | 459 | ||
| Enhanced Elimination | 459 | ||
| DISPOSITION | 459 | ||
| SUMMARY | 460 | ||
| REFERENCES | 460 | ||
| Asymptomatic Hypertension in the Emergency Department | 465 | ||
| Key points | 465 | ||
| INTRODUCTION | 465 | ||
| DEFINITIONS | 466 | ||
| CLASSIFICATIONS OF HYPERTENSION | 466 | ||
| Chronic Hypertension | 467 | ||
| Hypertensive Emergency | 467 | ||
| Signs and Symptoms | 467 | ||
| Diagnostic Evaluation | 468 | ||
| Indications for Initiation of Antihypertensive Medications in the Emergency Department | 470 | ||
| SUMMARY | 470 | ||
| REFERENCES | 471 | ||
| Orthopedic Pearls and Pitfalls | 473 | ||
| Key points | 473 | ||
| INTRODUCTION | 473 | ||
| EVALUATION CONSIDERATIONS | 474 | ||
| History | 474 | ||
| Physical Examination | 474 | ||
| Inspection | 474 | ||
| Neurovascular function | 474 | ||
| Palpation | 474 | ||
| Range of motion | 474 | ||
| CONSULTATION CONSIDERATIONS | 474 | ||
| Open Fracture | 475 | ||
| Irreducible Fracture/Dislocation | 475 | ||
| Neurovascular Compromise | 475 | ||
| Compartment Syndrome | 475 | ||
| Need for Surgical Intervention | 475 | ||
| CRITICAL UPPER EXTREMITY ORTHOPEDIC EMERGENCIES | 476 | ||
| Sternoclavicular Dislocation | 476 | ||
| Posterior Shoulder Dislocations | 476 | ||
| Elbow Fracture/Dislocation: The “Terrible Triad” | 477 | ||
| Scaphoid Fractures | 477 | ||
| CRITICAL LOWER EXTREMITY ORTHOPEDIC EMERGENCIES | 478 | ||
| Hip Fracture Radiographic Considerations | 478 | ||
| Knee Dislocation | 478 | ||
| Maisonneuve Fracture | 479 | ||
| Lisfranc Injury | 479 | ||
| COMPARTMENT SYNDROME | 480 | ||
| Clinical Features | 480 | ||
| Diagnosis | 481 | ||
| Management | 482 | ||
| SEPTIC ARTHRITIS | 482 | ||
| Clinical Presentation | 482 | ||
| Diagnosis | 483 | ||
| Management | 483 | ||
| PEDIATRIC ORTHOPEDIC CONSIDERATIONS | 484 | ||
| SUMMARY | 485 | ||
| REFERENCES | 485 | ||
| Antibiotic Stewardship Choosing Wisely | 489 | ||
| Key points | 489 | ||
| INTRODUCTION | 489 | ||
| ACUTE OTITIS MEDIA | 490 | ||
| Diagnosis | 490 | ||
| Antibiotic Therapy Versus Observation | 490 | ||
| Duration of Therapy | 491 | ||
| PHARYNGITIS | 491 | ||
| Epidemiology and Diagnosis | 491 | ||
| Antibiotic Therapy | 491 | ||
| ACUTE BRONCHITIS | 492 | ||
| Diagnosis | 493 | ||
| Treatment | 493 | ||
| SINUSITIS | 493 | ||
| Epidemiology and Diagnosis | 493 | ||
| Therapy | 494 | ||
| SEPSIS | 494 | ||
| Definition | 494 | ||
| Diagnosis and Antibiotic Therapy | 495 | ||
| SUMMARY | 498 | ||
| REFERENCES | 498 | ||
| Headache Mistakes You Do Not Want to Make | 503 | ||
| Key points | 503 | ||
| OBJECTIVES | 503 | ||
| SUBARACHNOID HEMORRHAGE | 504 | ||
| Epidemiology | 505 | ||
| Clinical Presentation | 506 | ||
| Treatment | 507 | ||
| CEREBRAL VENOUS SINUS THROMBOSIS OR CEREBRAL VENOUS THROMBOSIS | 508 | ||
| Epidemiology | 508 | ||
| Clinical Presentation | 508 | ||
| Diagnostic Studies | 508 | ||
| Treatment | 509 | ||
| GIANT CELL ARTERITIS OR TEMPORAL ARTERITIS/CRANIAL ARTERITIS | 509 | ||
| Background | 509 | ||
| Epidemiology | 510 | ||
| Clinical Presentation | 510 | ||
| Diagnostic Studies | 510 | ||
| Treatment | 510 | ||
| MENINGITIS/ENCEPHALITIS | 511 | ||
| Epidemiology | 511 | ||
| Clinical Presentation | 511 | ||
| Diagnostic Studies | 512 | ||
| Treatment | 512 | ||
| SUMMARY | 515 | ||
| REFERENCES | 516 | ||
| Ocular Emergencies | 519 | ||
| Key points | 519 | ||
| INTRODUCTION | 519 | ||
| INITIAL EMERGENCY DEPARTMENT EVALUATION | 519 | ||
| ACUTE MONOCULAR VISION LOSS | 522 | ||
| Amaurosis Fugax | 523 | ||
| Retinal Artery Occlusion | 523 | ||
| Central Retinal Vein Occlusion | 524 | ||
| Giant Cell Arteritis | 525 | ||
| Retinal Detachment | 526 | ||
| Optic Neuritis | 526 | ||
| INFECTIOUS CONDITIONS | 527 | ||
| Endophthalmitis | 527 | ||
| Herpes Simplex Keratitis | 529 | ||
| CORNEAL INJURIES | 530 | ||
| Corneal Abrasion | 530 | ||
| Corneal Ulcer | 530 | ||
| ADDITIONAL OCULAR EMERGENCIES | 531 | ||
| Acute Angle Closure Glaucoma | 531 | ||
| Globe Rupture | 532 | ||
| SUMMARY | 533 | ||
| REFERENCES | 533 | ||
| Low-Risk Chest Pain | 537 | ||
| Key points | 537 | ||
| INTRODUCTION | 537 | ||
| CAUSES OF CHEST PAIN | 538 | ||
| ACUTE CORONARY SYNDROME | 540 | ||
| PATHOPHYSIOLOGY OF ACUTE CORONARY SYNDROME | 540 | ||
| LOW-RISK CHEST PAIN | 541 | ||
| EVALUATION | 542 | ||
| History | 542 | ||
| Physical Examination | 542 | ||
| Risk Factors | 542 | ||
| DIAGNOSIS | 544 | ||
| Cardiac Enzymes | 544 | ||
| Electrocardiography | 545 | ||
| Imaging | 546 | ||
| PATIENT DISPOSITION AND SCORING SYSTEMS | 546 | ||
| The History, Electrocardiogram, Age, Risk Factors, Troponin Score | 549 | ||
| SUMMARY | 553 | ||
| REFERENCES | 553 |