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دانلود کتاب Geriatric Emergency Medicine: Principles and Practice
دانلود کتاب اورژانس سالمندان: اصول و عمل
مشخصات کتاب
Geriatric Emergency Medicine: Principles and Practice
دسته بندی: پزشکی ویرایش: 1 نویسندگان: Joseph H. Kahn, Brendan G. Magauran, Jr, Jonathan S. Olshaker سری: ISBN (شابک) : 9781107677647, 2013028335 ناشر: Cambridge University Press سال نشر: 2014 تعداد صفحات: 384 زبان: English فرمت فایل : PDF (درصورت درخواست کاربر به PDF، EPUB یا AZW3 تبدیل می شود) حجم فایل: 19 مگابایت
قیمت کتاب (تومان) : 54,000
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کلمات کلیدی مربوط به کتاب اورژانس سالمندان: اصول و عمل: سالمندان، اورژانس
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توجه داشته باشید کتاب اورژانس سالمندان: اصول و عمل نسخه زبان اصلی می باشد و کتاب ترجمه شده به فارسی نمی باشد. وبسایت اینترنشنال لایبرری ارائه دهنده کتاب های زبان اصلی می باشد و هیچ گونه کتاب ترجمه شده یا نوشته شده به فارسی را ارائه نمی دهد.
توضیحاتی در مورد کتاب اورژانس سالمندان: اصول و عمل
با ادامه رشد جمعیت جهانی سالمندان، نسبت فزاینده ای از افرادی که به بخش های اورژانس گزارش می دهند، سالمندان هستند. کار این بیماران نسبت به بیماران جوان‌تر از زمان و منابع بیشتری استفاده می‌کند و به دلیل این واقعیت که بیماری حاد اغلب به صورت ظریف‌تر و بدون تظاهرات بیرونی که معمولاً در بیماران جوان‌تر دیده می‌شود، پیچیده‌تر است. این جلد بر پاتوفیزیولوژی منحصر به فرد سالمندان تمرکز دارد و دستورالعمل هایی برای احیا، ارزیابی و مدیریت ارائه می دهد. بخش اول اصول کلی شامل جمعیت شناسی، فارماکولوژی و مدیریت درد را مورد بحث قرار می دهد. بخش‌های زیر شامل رئیس پرخطر ارائه شکایات و بررسی اورژانس‌های سالمندان می‌شود. در نهایت، موضوعات مربوط به ویژه در جمعیت سالمندان مورد بحث قرار می گیرد، از جمله ارزیابی عملکرد، مراقبت از پایان زندگی، ملاحظات مالی و سوء استفاده. این کتاب یک چارچوب جامع و عملی برای پزشکان اورژانس دانشگاهی و جامعه و همچنین مدیران بخش اورژانس فراهم می کند که در تلاش برای بهبود ارائه مراقبت به این جمعیت آسیب پذیر و در حال رشد هستند. هر فصل شامل مرواریدها و تله‌هایی است که بررسی سریع اجزای اصلی فصل را ارائه می‌کند فصل‌های اختصاصی درباره موضوعاتی بحث می‌کنند که در جمعیت سالمندان از اهمیت ویژه‌ای برخوردار هستند، مانند زمین خوردن، سوء استفاده از سالمندان و ملاحظات پایان زندگی. دستورالعمل های عملی به خوانندگان کمک می کند تا نظریه را به شیوه ای مرتبط بالینی به کار گیرند
توضیحاتی درمورد کتاب به خارجی
As the global geriatric population continues to grow, an increasing proportion of people reporting to emergency departments are elderly. The work-up of these patients uses more time and resources than that of younger patients, and is complicated by the fact that acute disease often presents more subtly, without the outward manifestations typically seen in younger patients. This volume focuses on the unique pathophysiology of the elderly, presenting guidelines for resuscitation, evaluation and management. The first section discusses general principles including demographics, pharmacology and pain management. The following sections cover high-risk chief presenting complaints and review geriatric emergencies. Finally, topics of particular relevance in the geriatric population are discussed, including functional assessment, end-of-life care, financial considerations and abuse. This book provides a comprehensive, practical framework for community and academic emergency medicine practitioners, as well as emergency department administrators striving to improve delivery of care to this vulnerable, growing population. Each chapter includes pearls and pitfalls, providing a rapid review of the key components of the chapter Dedicated chapters discuss topics that are of particular relevance in the geriatric population such as falls, elder abuse and end-of-life considerations Practical guidelines help readers to apply theory in a clinically relevant manner
فهرست مطالب
Cover Geriatric Emergency Medicine Title Copyright Contents Contributors Preface Section 1 General principles 1 Overview of geriatric emergency medicine Geriatric emergency medicine Population aging Health system aim Clinical challenge Complex patients Expensive care Chaotic environment Families Special challenges Palliative care in the ED Interfacing with PCPs and care facilities Geriatric emergency medicine education Summary Pearls and pitfalls Pearls Pitfalls References 2 The geriatric emergency department Introduction Where are we today? Barriers Defining the goal Considering a geriatric emergency department The geriatric emergency department Physical plant Quality initiatives Falls and fall assessment Medications Staff education Operations Advancing emergency severity index criteria for elderly Two-step geriatric program Coordination of hospital resources Coordination of community resources Staffing enhancements Patient satisfaction Observation and extended home observation Geriatric palliative care Summary Pearls and pitfalls Pearls Pitfalls References 3 General approach to the geriatric patient Introduction Principles of geriatric emergency medicine Healthy aging Physiologic changes with age Body composition Vital signs Skin/mucosa Cardiovascular Respiratory Gastrointestinal Genitourinary Musculoskeletal Neurologic Psychological Endocrine Immunologic Hematologic Polypharmacy and elders Diagnostic testing and age Atypical disease presentation Infections Acute coronary syndrome Acute abdomen Appendicitis Geriatric emergency care model Approach Pre-hospital care ED assessment Triage History Physical exam Preventive care Disposition Patient satisfaction Pearls and pitfalls Summary References 4 Resuscitation of the elderly Introduction Epidemiology and outcomes Pathophysiology Management of resuscitation Ethics of resuscitation and end-of-life care Advance directives Medical futility Family-witnessed resuscitation Summary Pearls and pitfalls Pearls Pitfalls References 5 Pharmacology in the elderly Introduction Epidemiology Definitions Pharmacokinetics Outcomes of adverse drug reactions Risk factors for adverse drug reactions Poisoning in the elderly Inappropriate medications in the elderly Preventability Conclusion Pearls and pitfalls Pearls Pitfalls References 6 Generalized weakness in the elderly Introduction Generalized weakness and fatigue Failure to thrive Sarcopenia Geriatric syndromes Falls Frailty Functional decline Summary Pearls and pitfalls Pearls Pitfalls References 7 Management of trauma in the elderly Background Epidemiology Mechanisms of injury Falls Motor vehicle collisions Pedestrians struck by automobiles Burns Elder abuse and neglect Physiology of aging and trauma Cardiovascular Pulmonary Gastrointestinal Renal Central nervous system Musculoskeletal Skin Endocrine Pre-existing medications Anticoagulants and antiplatelet agents Pre-hospital considerations Evaluation and management Initial evaluation Central nervous system Spine Thorax Abdomen Musculoskeletal Prognosis Disposition Pearls and pitfalls Pearls Pitfalls References 8 Pain management in the elderly Pitfalls Undertreatment Drug sensitivity and clearance in older adults Adverse drug events Beers Criteria and analgesic risks Analgesic options Non-opioids Acetaminophen NSAIDs Opioids Regional anesthesia Geriatric ED pain care quality indicators Goals of pain care management Pain assessment Pain scores Patient goals of pain care Summary Pearls References Section 2 Common high-risk presentations in the elderly 9 Chest pain in the elderly Introduction Cardiac causes of chest pain Acute coronary syndrome ST elevation myocardial infarction NSTEMI Demand ischemia Post-MI complications Pericarditis Pulmonary causes of chest pain Pneumonia Pulmonary embolism Pneumothorax Vascular causes Aortic dissection Aortic aneurysm Chest wall pathology Costochondritis Malignancy Chest trauma Herpes zoster Gastrointestinal causes of chest pain Esophageal rupture Abdominal etiologies Pearls and pitfalls References 10 Dyspnea in the elderly Introduction Respiratory system structural mechanics Effects on lung function Cardiovascular changes in the elderly Structural changes Physiological changes Vascular system changes Conditions causing dyspnea Congestive heart failure Pulmonary embolism Acute coronary syndrome COPD Asthma exacerbation Pneumonia Summary Pearls and pitfalls Pearls Pitfalls References 11 Abdominal pain in the elderly Background History Physical examination Diagnostic tests Imaging studies Plain radiographs Ultrasound Computed tomography Angiography Differential diagnoses Vascular catastrophes Ruptured abdominal aortic aneurysm Acute mesenteric ischemia Bowel obstructions Small bowel obstruction Large bowel obstruction Peptic ulcer disease Biliary tract disease Pancreatitis Appendicitis Diverticular disease Extra-abdominal causes Disposition Pearls and pitfalls Pearls Pitfalls References 12 Altered mental status in the elderly Introduction Acute disturbances in consciousness Coma and stupor Delirium Subtypes Epidemiology and outcomes Risk factors Chronic disturbances in cognition Dementia Assessment History Physical examination Assessing level of consciousness Assessing cognition Neurologic examination General physical examination Assessment of delirium Diagnostic testing Treatment Non-pharmacological treatment of delirium and agitation Pharmacological treatment of delirium Assessment of decision-making capacity Disposition Summary Pearls and pitfalls Pearls Pitfalls References 13 Syncope in the elderly Introduction Aging Epidemiology Causes Neurally mediated Vasovagal Situational CSH Cardiac Dysrhythmia Structural heart disease Vascular steal syndromes Orthostatic hypotension Unlikely causes of syncope History Sequence of events Specific data points Symptoms distinguishing seizure from syncope Symptoms suggestive of cardiac etiology Factors associated with autonomic failure Physical exam Ancillary studies Cardiovascular testing ECG Telemetry monitoring Echocardiography Autonomic nervous system testing Electrophysiologic testing Cardiac catheterization Ambulatory blood pressure recording Carotid sinus massage Laboratory testing Neurologic testing Head CT Electroencephalogram Systems of evaluation Determining risk Prognosis/risk stratification Driving and syncope Summary and recommendations Pearls and pitfalls Pearls Pitfalls References 14 Dizziness in the elderly Introduction and epidemiology Vestibular physiology Medication issues Falls Overarching diagnostic strategy Differential diagnosis History Physical examination Diagnostic tests Treatment Disposition Conclusions Pearls and pitfalls References 15 Headache in the elderly Background High-risk headache features Secondary headache disorders Cerebrovascular emergencies Subarachnoid hemorrhage Ischemic stroke and intracerebral hemorrhage Subdural hemorrhage Brain tumor CNS infection GCA Acute glaucoma Non-emergent secondary headache Primary headache disorders Conclusion Pearls and pitfalls References 16 Back pain in the elderly Background History Physical exam Diagnostic tests Laboratory testing Plain spinal radiographs CT MRI Differential diagnosis Mechanical causes Degenerative disk disease/unstable lumbar spine Lumbar spinal stenosis Disk displacement causing sciatica Osteoporotic causes Vertebral compression fractures Osteoporotic sacral fractures Systemic causes Primary or metastatic cancer Spinal infections Visceral diseases unrelated to the spine Abdominal aortic aneurysm or aortic dissection Other visceral causes Treatment Disposition Summary Pearls and pitfalls Pearls Pitfalls References Section 3 Systems 17 Eye, ear, nose, and throat emergencies in the elderly Introduction Eye Acute angle closure glaucoma Vitreous hemorrhage Retinal detachment Uveitis Conjunctivitis Central retinal artery occlusion Branch retinal artery occlusion Central retinal vein occlusion Branch retinal vein occlusion GCA Ears Otitis externa Malignant otitis externa Nose Epistaxis Throat Dental abscess Ludwig’s angina Peritonsillar abscess Epiglottitis Retropharyngeal abscess Angioedema due to angiotensin-converting enzyme inhibitors Summary Pearls and pitfalls References 18 Neurological emergencies in the elderly Introduction Ischemic stroke Acute ischemic stroke Transient ischemic attack Non-traumatic intracranial hemorrhage Intracerebral hemorrhage Aneurysmal subarachnoid hemorrhage Traumatic brain injury CNS infections Community-acquired bacterial meningitis Spinal epidural abscess Seizures New seizures Status epilepticus Conclusion Pearls and pitfalls Pearls Pitfalls References 19 Pulmonary emergencies in the elderly Introduction Pathophysiology History Physical Diagnostic tests Asthma/COPD Bronchiectasis Pneumonia Pulmonary embolism Pneumothorax Tuberculosis Pulmonary hypertension Restrictive lung disease Lung cancer Pearls and pitfalls Pearls Pitfalls References 20 Cardiovascular emergencies in the elderly Introduction Acute coronary syndrome Identification Treatment Dysrhythmias Identification Management Acute HF syndromes Identification Management Syncope Identification Management Acute thoracic aortic syndromes Identification Management Summary Pearls and pitfalls Pearls Pitfalls References 21 Gastrointestinal emergencies in the elderly Background History Physical examination Special considerations Diagnostic tests Laboratory studies Imaging studies Differential diagnosis Appendicitis Pancreatitis Diverticulitis Inflammatory and infectious colitis Gallbladder disease Peptic ulcer disease Esophageal obstruction and perforation Upper gastrointestinal bleed Lower gastrointestinal bleed Constipation Small bowel obstruction Large bowel obstruction Acute colonic pseudo-obstruction Mesenteric ischemia Ischemic colitis Disposition Pearls and pitfalls Summary References 22 Genitourinary and gynecologic emergencies in the elderly Age-related changes in the renal system Age-related changes in the genital system History Physical exam Genitourinary and gynecologic issues in the elderly Acute kidney injury Geriatric gynecological emergency presentations Vaginal discharge Vaginal bleeding Uterine prolapse Urinary retention/stricture Balanitis Male genital infections: prostatitis, epididymitis, orchitis Orchitis Epididymitis Prostatitis Antibiotic therapy in male genital system infections in the elderly Hematuria Phimosis/paraphimosis Fournier’s gangrene UTIs Summary Pearls and pitfalls Pearls Pitfalls References 23 Rheumatologic and orthopedic emergencies in the elderly Rheumatologic emergencies in the elderly Septic arthritis History Physical Diagnostic tests Differential Treatment Disposition Pearls and pitfalls Gout History Physical Diagnostic tests Differential Treatment Disposition Pearls and pitfalls Pseudogout History Physical Diagnostic tests Treatment Differential Disposition Pearls and pitfalls Rheumatoid arthritis History Physical Diagnostic tests Treatment Differential Disposition Pearls and pitfalls Osteoarthritis History Physical Diagnostic tests Differential Treatment Disposition Pearls and pitfalls Polymyalgia rheumatica and giant cell arteritis History Physical Diagnostic findings Treatment Disposition Pearls and pitfalls Back pain and spinal stenosis History Physical Diagnostic tests Differential Treatment Pearls and pitfalls Orthopedic injuries in the geriatric population Hip fractures History Physical Diagnostic findings Treatment Differential Disposition Pearls and pitfalls Hip dislocations History Physical Diagnostic findings Treatment Disposition Differential Pearls and pitfalls Pelvic fractures History Physical Diagnostic findings Treatment Differential Disposition Pearls and pitfalls Vertebral fractures History Physical Diagnostic findings Treatment Differential Disposition Pearls and pitfalls Proximal humeral fractures History Physical Diagnostic tests Treatment Differential Disposition Pearls and pitfalls Shoulder dislocations History Physical Diagnostic findings Treatment Disposition Pearls and pitfalls Distal radius fractures History Physical Diagnostic findings Differential Treatment Disposition Pearls and pitfalls References 24 Infectious diseases in the elderly Introduction Age-related impairment of defenses An onslaught of risks Altered clinical markers Approach to the elderly ED patient with suspected infection History Physical examination Differential diagnosis of fever in the elderly Pneumonia Urinary tract infection Community-dwelling elders Elders presenting to the ED from LTCF Elders presenting to the ED with indwelling catheters Abdominal infections Appendicitis Diverticulitis Acute cholecystitis Clostridium difficile-related diarrhea Central nervous system infections Skin and soft tissue infections Human immunodeficiency virus Infectious diseases in special geriatric populations Antibiotics and the elderly patient Conclusion Pearls and pitfalls References 25 Hematologic and oncologic emergencies in the elderly Introduction Overview of hematologic diseases Overview of oncologic diseases Specific disease conditions Fever and leukopenia Tumor lysis syndrome Hypercalcemia Superior vena cava syndrome Hyperviscosity syndrome Coagulopathy Anemia Thrombocytopenia Transfusion of blood components Administration of vitamin K Summary Pearls and pitfalls References 26 Psychiatric emergencies in the elderly Introduction Suicide Background and epidemiology Risk factors Evaluation Treatment Prevention Depression Background and epidemiology Risk factors Evaluation DSM IV-TR criteria for major depressive episode Treatment Substance abuse Background and epidemiology DSM IV-TR criteria for alcohol abuse DSM IV-TR criteria for alcohol dependence Risk factors Evaluation Treatment Geriatric psychoses Background and epidemiology Risk factors Evaluation Treatment Pearls and pitfalls Pitfalls Pearls References 27 Metabolic and endocrine emergencies in the elderly Diabetic ketoacidosis and hyperosmolar hyperglycemic state Background History Physical Diagnostic testing Differential diagnoses Treatment Disposition Thyroid disorder emergencies: myxedema coma and thyroid storm Background Myxedema coma History Physical Diagnostic testing Differential diagnoses Treatment Thyroid storm History Physical exam Diagnostic testing Differential diagnoses Treatment Disposition Rhabdomyolysis Background History Physical exam Diagnostic testing Management Disposition Adrenal crisis Background History Physical exam Diagnostic tests Treatment Differential diagnosis Disposition Pituitary apoplexy Background History Physical exam Diagnostic tests Differential diagnosis Treatment Disposition Potassium disorders Background Hyperkalemia Background History and physical exam Diagnostic tests Treatment Disposition Hypokalemia Background History and physical exam Diagnostic tests Treatment Disposition Sodium disorders Background Hyponatremia Background History and physical exam Diagnostic tests Treatment Disposition Hypernatremia Background History and physical exam Diagnostic tests Treatment Disposition Calcium disorders Background Hypercalcemia Background History and physical exam Diagnostic tests Differential diagnosis Treatment Disposition Hypocalcemia Background History and physical exam Diagnostic tests Differential diagnosis Treatment Disposition Acid–base disorders Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis Summary Pearls and pitfalls References Section 4 Special topics 28 Alternative geriatric care and quality metrics Introduction Input (reducing ED and hospital use) Avoiding ED presentation with primary care “Hospital at Home” Preventing hospital returns Telemedicine Throughput (care of patients within the ED) Output (safely transitioning patients out of the ED) “Transitional Care” Acute Care Elderly Unit/Mobile Acute Care Elderly Unit Quality indicators of care Summary Pearls and pitfalls References 29 Functional assessment of the elderly Comprehensive geriatric assessment Assessment tools for functional status Performance testing of function Prediction tools for post-ED functional decline ISAR BRIGHT SIGNET/TRST HARP SHERPA Inouye et al. Screening for common issues in elderly ED patients Visual impairment screening Hearing impairment Malnutrition Alcohol abuse Balance, gait, falls Summary and recommendations Pearls and pitfalls Pearls Pitfalls References 30 Palliative and end-of-life care in the emergency department Introduction Trajectories of illness and prognosis Cardiopulmonary resuscitation and prognosis in advanced illness Pre-hospital Family presence in resuscitation Rapid identification and assessment in the ED SPEED ABCD Advance directive Better symptom control Capacity Decision and disposition Ventilator discontinuation End of life The actively dying patient Hospice patients in the ED Hospice patients presenting to the ED Hospice referrals from the ED Summary References 31 Social services and case management Introduction Issues facing geriatric patients in the ED Case management Discharge planning Effectiveness of case management Assessing older driver safety Summary Pearls and pitfalls References 32 Falls and fall prevention in the elderly Epidemiology Morbidity and mortality Risk factors (identifying high-risk fallers) Pearls and pitfalls for fall prevention Recommendations and future directions Summary References 33 Financial issues in geriatric emergency care Background Demographics EMTALA Medicare Affordable Care Act Summary Pearls and pitfalls Pearls Pitfalls References 34 Elder mistreatment History Definitions Epidemiology Risk factors for abuse Suspicious presentations Physical abuse Sexual abuse Neglect Historical indicators Physical indicators Behavioral indicators Screening for elder abuse Documentation Legal/ethical considerations Preventive services Conclusion Pearls and pitfalls Pearls Pitfalls References Index
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