Textbook of Pediatric Emergency Medicine, 6th Edition

Textbook of Pediatric Emergency Medicine, Sixth Edition......Page 1
Half Title Page......Page 3
Title Page......Page 5
Copyright......Page 6
CONTRIBUTING AUTHORS......Page 7
PREFACE......Page 19
ACKNOWLEDGMENTS......Page 20
CONTENTS......Page 21
LIST OF ALGORITHMS......Page 29
BACKGROUND......Page 33
CLINICAL MANIFESTATIONS......Page 38
MANAGEMENT......Page 39
STABILIZATION AND TRANSPORT......Page 59
PARENTAL PRESENCE DURING CARDIOPULMONARY RESUSCITATION......Page 60
Suggested Readings......Page 61
EMERGENCY DEPARTMENT PREPAREDNESS......Page 64
PATHOPHYSIOLOGY......Page 65
MANAGEMENT......Page 67
SPECIAL SITUATIONS......Page 74
Suggested Readings......Page 77
PATHOPHYSIOLOGY......Page 78
CLINICAL MANIFESTATIONS......Page 81
TYPES OF SHOCK......Page 82
TREATMENT......Page 83
Suggested Readings......Page 89
ASSESSMENT OF PAIN IN CHILDREN......Page 90
NONPHARMACOLOGIC METHODS FOR PAIN CONTROL......Page 92
SPECIFIC AGENTS......Page 93
LOCAL ANESTHETIC AGENTS FOR WOUND REPAIR......Page 95
TOPICAL ANESTHETIC AGENTS FOR IV PLACEMENT AND VENIPUNCTURE......Page 96
PROCEDURAL SEDATION AND ANALGESIA (PSA)......Page 97
SEDATION PROTOCOLS......Page 98
CHOICE OF TECHNIQUES AND MEDICATIONS......Page 100
COMPLICATIONS AND ERRORS......Page 103
Suggested Readings......Page 104
RAPID SEQUENCE INTUBATION SEDATIVES......Page 106
SEDATIVE SELECTION......Page 108
MUSCLE RELAXANTS......Page 109
MUSCLE RELAXANT SELECTION......Page 110
RAPID SEQUENCE INTUBATION PROTOCOL......Page 111
MULTIPLE TRAUMA......Page 114
STATUS EPILEPTICUS......Page 115
Suggested Readings......Page 116
WHERE HAVE EMS SYSTEMS TRADITIONALLY FALLEN SHORT FOR CHILDREN?......Page 117
GOVERNANCE OF EMS SYSTEMS......Page 118
COMPONENTS OF PREHOSPITAL CARE SYSTEMS......Page 119
MEDICAL OVERSIGHT OF EMERGENCY MEDICAL SERVICES......Page 125
THE TIMELINE OF EMS CARE......Page 126
ISSUES AND CONTROVERSIES IN EMS CARE......Page 128
PEDIATRIC INTERFACILITY TRANSPORT......Page 131
STABILIZATION FOR TRANSPORT......Page 148
ALTITUDE PHYSIOLOGY AND THE AIR MEDICAL ENVIRONMENT......Page 150
MEDICAL–LEGAL ISSUES......Page 152
Suggested Readings......Page 153
BIOLOGICAL AND CHEMICAL WEAPONS......Page 157
BIOLOGICAL AGENTS......Page 158
THE SPECIFIC AGENTS......Page 164
CHEMICAL AGENTS......Page 168
EMERGENCY DEPARTMENT PREPAREDNESS......Page 181
Suggested Readings......Page 183
DIFFERENTIAL DIAGNOSIS......Page 185
EVALUATION AND DECISION......Page 188
Suggested Readings......Page 191
DIFFERENTIAL DIAGNOSIS......Page 192
EVALUATION AND DECISION......Page 193
Suggested Readings......Page 195
DIFFERENTIAL DIAGNOSIS......Page 196
EVALUATION AND DECISION......Page 197
Suggested Readings......Page 199
DIFFERENTIAL DIAGNOSIS......Page 200
EVALUATION AND DECISION......Page 204
Suggested Readings......Page 207
DIFFERENTIAL DIAGNOSIS......Page 208
EVALUATION AND DECISION......Page 213
Suggested Readings......Page 218
EVALUATION AND DECISION......Page 219
TREATMENT......Page 223
Suggested Readings......Page 225
EVALUATION AND DECISION......Page 226
Suggested Readings......Page 229
DIFFERENTIAL DIAGNOSIS......Page 230
EVALUATION AND DECISION......Page 233
Suggested Readings......Page 234
EVALUATION AND DECISION......Page 235
Suggested Readings......Page 237
EVALUATION AND DECISION......Page 238
Suggested Readings......Page 243
DIFFERENTIAL DIAGNOSIS......Page 244
EVALUATION AND DECISION......Page 245
Suggested Readings......Page 248
DIFFERENTIAL DIAGNOSIS......Page 249
EVALUATION AND DECISION......Page 253
Suggested Readings......Page 257
DIFFERENTIAL DIAGNOSIS......Page 258
EVALUATION AND DECISION......Page 260
Suggested Readings......Page 263
EVALUATION AND DECISION......Page 264
LOCALIZED EDEMA......Page 265
GENERALIZED EDEMA......Page 266
Suggested Readings......Page 267
EVALUATION AND DECISION......Page 268
Suggested Readings......Page 271
PATHOPHYSIOLOGY......Page 272
EVALUATION AND DECISION......Page 273
Suggested Readings......Page 276
PATHOPHYSIOLOGY......Page 277
EVALUATION AND DECISION......Page 279
Suggested Readings......Page 284
ANISOCORIA......Page 285
MIOSIS......Page 286
MYDRIASIS......Page 288
UNEQUAL PUPILLARY REACTIVITY......Page 289
Suggested Readings......Page 290
DIFFERENTIAL DIAGNOSIS......Page 291
EVALUATION AND DECISION......Page 294
Suggested Readings......Page 296
PATHOPHYSIOLOGY......Page 298
EVALUATION AND DECISION......Page 300
Suggested Readings......Page 306
DIFFERENTIAL DIAGNOSIS......Page 308
EVALUATION AND DECISION......Page 310
Suggested Readings......Page 314
INITIAL ASSESSMENT......Page 315
UPPER GASTROINTESTINAL BLEEDING......Page 316
LOWER GASTROINTESTINAL BLEEDING......Page 319
Suggested Readings......Page 322
DIFFERENTIAL DIAGNOSIS......Page 323
EVALUATION AND DECISION......Page 325
Suggested Readings......Page 326
DIFFERENTIAL DIAGNOSIS......Page 327
EVALUATION AND DECISION......Page 329
Suggested Readings......Page 331
DIFFERENTIAL DIAGNOSIS......Page 332
EVALUATION AND DECISION......Page 334
Suggested Readings......Page 340
DIFFERENTIAL DIAGNOSIS......Page 342
EVALUATION AND DECISION......Page 343
Suggested Readings......Page 346
EVALUATION AND DECISION......Page 347
MANAGEMENT (SEE CHAPTER 100)......Page 349
SPECIFIC THERAPY......Page 350
Suggested Readings......Page 354
DIFFERENTIAL DIAGNOSIS......Page 356
EVALUATION AND DECISION......Page 357
Suggested Readings......Page 359
DIFFERENTIAL DIAGNOSIS......Page 360
EVALUATION AND DECISION......Page 365
TREATMENT......Page 367
Suggested Readings......Page 368
DIFFERENTIAL DIAGNOSIS......Page 369
CLINICAL ASSESSMENT......Page 371
Suggested Readings......Page 376
DIFFERENTIAL DIAGNOSIS......Page 377
EVALUATION AND DECISION......Page 381
Suggested Readings......Page 384
DIFFERENTIAL DIAGNOSIS......Page 385
EVALUATION AND DECISION......Page 389
Suggested Readings......Page 390
DIFFERENTIAL DIAGNOSIS......Page 391
EVALUATION AND DECISION......Page 393
MANAGEMENT......Page 397
Suggested Readings......Page 398
EVALUATION AND DECISION......Page 399
Suggested Readings......Page 403
DIFFERENTIAL DIAGNOSIS......Page 404
EVALUATION AND DECISION......Page 408
Suggested Readings......Page 409
DIFFERENTIAL DIAGNOSIS......Page 410
EVALUATION AND DECISION......Page 414
Suggested Readings......Page 416
EVALUATION AND DECISION......Page 417
DIFFERENTIAL DIAGNOSIS......Page 419
Suggested Readings......Page 423
DIFFERENTIAL DIAGNOSIS......Page 424
EVALUATION AND DECISION......Page 429
Suggested Readings......Page 432
DIFFERENTIAL DIAGNOSIS......Page 434
EVALUATION AND DECISION......Page 439
Suggested Readings......Page 441
EVALUATION AND DECISION......Page 442
Suggested Readings......Page 446
DIFFERENTIAL DIAGNOSIS......Page 447
Suggested Readings......Page 451
DIFFERENTIAL DIAGNOSIS......Page 453
EVALUATION AND DECISION......Page 455
Suggested Readings......Page 460
DIFFERENTIAL DIAGNOSIS......Page 461
EVALUATION AND DECISION......Page 463
Suggested Readings......Page 465
DIFFERENTIAL DIAGNOSIS......Page 466
EVALUATION AND DECISION......Page 470
Suggested Readings......Page 474
DIFFERENTIAL DIAGNOSIS......Page 475
EVALUATION AND DECISION......Page 477
Suggested Readings......Page 481
DIFFERENTIAL DIAGNOSIS......Page 482
EVALUATION AND DECISION......Page 484
Suggested Readings......Page 485
DIFFERENTIAL DIAGNOSIS......Page 487
EXTERNAL EAR EXAMINATION......Page 491
Suggested Readings......Page 492
DIFFERENTIAL DIAGNOSIS......Page 493
EVALUATION AND DECISION......Page 495
Suggested Readings......Page 499
EVALUATION AND DECISION......Page 500
Suggested Readings......Page 505
DIFFERENTIAL DIAGNOSIS......Page 506
EVALUATION AND DECISION......Page 512
Suggested Readings......Page 514
DIFFERENTIAL DIAGNOSIS......Page 515
EVALUATION AND DECISION......Page 519
Suggested Readings......Page 522
DIFFERENTIAL DIAGNOSIS......Page 523
EVALUATION AND DECISION......Page 525
Suggested Readings......Page 527
EVALUATION AND DECISION......Page 528
Suggested Readings......Page 530
DIFFERENTIAL DIAGNOSIS......Page 531
EVALUATION AND DECISION......Page 537
Suggested Readings......Page 540
DIFFERENTIAL DIAGNOSIS......Page 541
EVALUATION AND DECISION......Page 549
Suggested Readings......Page 551
PAPULES WITH A CHARACTERISTIC CLINICAL APPEARANCE......Page 552
PAPULES WITH A NONCHARACTERISTIC CLINICAL APPEARANCE......Page 553
NONCHARACTERISTIC PAPULES......Page 556
Suggested Readings......Page 557
PAPULOSQUAMOUS ERUPTIONS......Page 558
Suggested Readings......Page 562
DIFFERENTIAL DIAGNOSIS......Page 564
EVALUATION AND DECISION......Page 569
Suggested Readings......Page 571
EVALUATION AND DECISION......Page 572
MANAGEMENT......Page 573
Suggested Readings......Page 574
DURATION......Page 575
CHILD YOUNGER THAN 3 YEARS......Page 579
ADOLESCENT OR OLDER......Page 580
BULLOUS IMPETIGO......Page 581
Suggested Readings......Page 582
PATHOPHYSIOLOGY......Page 583
DIFFERENTIAL DIAGNOSIS......Page 584
EVALUATION AND DECISION......Page 588
Suggested Readings......Page 595
DIFFERENTIAL DIAGNOSIS......Page 596
INITIAL STABILIZATION......Page 597
EVALUATION AND DECISION......Page 598
SPECIAL CONSIDERATIONS......Page 601
Suggested Readings......Page 602
DIFFERENTIAL DIAGNOSIS......Page 603
EVALUATION AND DECISION......Page 608
Suggested Readings......Page 610
DIFFERENTIAL DIAGNOSIS......Page 611
EVALUATION AND DECISION......Page 613
Suggested Readings......Page 615
DIFFERENTIAL DIAGNOSIS......Page 616
EVALUATION AND DECISION......Page 618
Suggested Readings......Page 620
DIFFERENTIAL DIAGNOSIS......Page 621
EVALUATION AND DECISION......Page 624
Suggested Readings......Page 626
DIFFERENTIAL DIAGNOSIS......Page 628
EVALUATION AND DECISION......Page 629
Suggested Readings......Page 632
PATHOPHYSIOLOGY......Page 633
DIFFERENTIAL DIAGNOSIS......Page 634
EVALUATION AND DECISION......Page 636
Suggested Readings......Page 637
VAGINAL BLEEDING BEFORE NORMAL MENARCHE (FIG. 76.1)......Page 638
VAGINAL BLEEDING WITHOUT SIGNS OF HORMONAL STIMULATION......Page 639
VAGINAL BLEEDING WITH SIGNS OF HORMONAL STIMULATION......Page 640
BLEEDING IN THE PREGNANT PATIENT (FIG. 76.3)......Page 641
BLEEDING IN THE NONPREGNANT ADOLESCENT PATIENT (FIG. 76.4)......Page 643
Suggested Readings......Page 644
EVALUATION AND DECISION......Page 645
Suggested Readings......Page 648
EVALUATION AND DECISION......Page 649
APPROACH TO CHILDREN BY AGE GROUPS......Page 651
Suggested Readings......Page 656
DIFFERENTIAL DIAGNOSIS......Page 658
EVALUATION AND DECISION......Page 663
Suggested Readings......Page 666
DIFFERENTIAL DIAGNOSIS......Page 667
EVALUATION AND DECISION......Page 670
DIAGNOSTIC TESTS......Page 672
CHILD 1 YEAR OR OLDER......Page 673
Suggested Reading......Page 674
DIFFERENTIAL DIAGNOSIS......Page 675
EVALUATION AND DECISION......Page 676
SUMMARY......Page 679
Suggested Readings......Page 680
ASTHMA......Page 681
ANAPHYLAXIS......Page 691
ANGIOEDEMA WITHOUT URTICARIA......Page 695
SERUM SICKNESS......Page 696
ALLERGIC RHINITIS......Page 699
Suggested Readings......Page 701
MARINE INVERTEBRATES......Page 703
MARINE VERTEBRATES......Page 704
TERRESTRIAL INVERTEBRATES......Page 706
TERRESTRIAL VERTEBRATES......Page 710
Suggested Readings......Page 719
CONGESTIVE HEART FAILURE......Page 722
NEWBORN WITH CHF-ASSOCIATED OBSTRUCTED SYSTEMIC OR PULMONARY BLOOD FLOW......Page 731
CARDIAC ARRHYTHMIAS......Page 733
PERICARDIAL DISEASE......Page 749
INFECTIVE ENDOCARDITIS......Page 753
HYPOXEMIC ATTACKS......Page 756
ACUTE RHEUMATIC FEVER......Page 758
Suggested Readings......Page 760
ATOPIC DERMATITIS......Page 762
SEBORRHEIC DERMATITIS......Page 767
ALLERGIC CONTACT DERMATITIS......Page 768
DIAPER DERMATITIS......Page 770
DRUG REACTIONS IN THE SKIN......Page 772
STAPHYLOCOCCAL SCALDED SKIN SYNDROME......Page 776
BITES AND INFESTATIONS (SEE ALSO CHAPTER 83)......Page 777
SUPERFICIAL FUNGAL INFECTIONS OF THE SKIN......Page 780
VASCULAR LESIONS......Page 783
PITYRIASIS ROSEA......Page 784
WARTS AND MOLLUSCUM CONTAGIOSUM......Page 785
DISORDERS OF PIGMENTATION......Page 787
Suggested Readings......Page 788
DIABETIC KETOACIDOSIS......Page 790
HYPERGLYCEMIA......Page 795
HYPOGLYCEMIA......Page 796
HYPOPITUITARISM......Page 798
ACUTE ADRENAL INSUFFICIENCY......Page 799
CONGENITAL ADRENAL HYPERPLASIA......Page 800
DIABETES INSIPIDUS......Page 803
SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE SECRETION......Page 805
HYPERPARATHYROIDISM......Page 806
RICKETS......Page 808
THYROID STORM......Page 809
NEONATAL THYROTOXICOSIS......Page 811
Suggested Readings......Page 812
DROWNING......Page 815
SMOKE INHALATION......Page 818
CARBON MONOXIDE POISONING......Page 821
ENVIRONMENTAL AND EXERTIONAL HEAT ILLNESS......Page 823
ACCIDENTAL HYPOTHERMIA......Page 826
ELECTRICAL INJURIES......Page 831
Suggested Readings......Page 835
PATHOPHYSIOLOGY......Page 837
RADIATION SAFETY......Page 838
CLINICAL MANIFESTATIONS AND EVALUATION......Page 839
MANAGEMENT OF RADIATION INJURIES......Page 846
Suggested Readings......Page 848
GASTROINTESTINAL BLEEDING......Page 849
UPPER GASTROINTESTINAL BLEEDING......Page 850
LOWER GASTROINTESTINAL BLEEDING......Page 853
INFLAMMATORY BOWEL DISEASE......Page 856
ULCER DISEASE......Page 858
REYE’S SYNDROME......Page 861
ACUTE BILIARY TRACT DISEASE......Page 862
ACUTE PANCREATITIS......Page 864
FULMINANT LIVER FAILURE......Page 866
ACUTE VIRAL HEPATITIS......Page 867
Suggested Readings......Page 869
INTRODUCTION......Page 871
GYNECOLOGIC DISORDERS OF CHILDHOOD......Page 873
GYNECOLOGIC DISORDERS OF ADOLESCENCE......Page 875
GENITAL TRACT INFECTIONS......Page 880
Suggested Readings......Page 892
DISORDERS OF RED BLOOD CELLS......Page 894
DISORDERS OF HEMOGLOBIN STRUCTURE AND PRODUCTION......Page 899
DIAGNOSING SICKLING DISORDERS IN THE EMERGENCY DEPARTMENT......Page 900
DISORDERS OF WHITE BLOOD CELLS......Page 906
DISORDERS OF PLATELETS......Page 907
DISORDERS OF COAGULATION......Page 910
OTHER HEMATOLOGIC EMERGENCIES......Page 917
Suggested Readings......Page 918
BACTEREMIA AND SEPSIS......Page 919
CENTRAL NERVOUS SYSTEM INFECTIONS......Page 924
UPPER RESPIRATORY TRACT INFECTIONS......Page 930
LOWER RESPIRATORY TRACT INFECTIONS......Page 944
GASTROINTESTINAL INFECTIONS......Page 951
SKIN, SOFT-TISSUE, AND BONE INFECTIONS......Page 956
GENITOURINARY INFECTIONS......Page 964
SPECIFIC INFECTIONS......Page 967
MISCELLANEOUS INFECTIONS......Page 972
Suggested Readings......Page 978
GONORRHEA......Page 985
SYPHILIS......Page 986
CHLAMYDIA......Page 988
HERPES SIMPLEX VIRUS......Page 989
HIV INFECTION......Page 990
Suggested Readings......Page 1002
UNKNOWN SUSPECTED IEM......Page 1004
KNOWN IEM......Page 1017
NEONATE WITH POSITIVE NBS......Page 1021
Suggested Readings......Page 1022
HISTORY......Page 1024
VITAL SIGNS......Page 1025
COLOR CHANGES......Page 1026
SKIN FINDINGS......Page 1030
HEAD AND NECK PROBLEMS......Page 1031
EYE PROBLEMS......Page 1032
CHEST AND BACK FINDINGS......Page 1033
ABDOMINAL AND PERINEAL FINDINGS......Page 1034
ORTHOPEDIC CONCERNS......Page 1035
NEUROLOGIC CONCERNS......Page 1036
CONGENITAL INFECTIONS......Page 1039
NEONATAL DRUG WITHDRAWAL......Page 1040
Suggested Readings......Page 1041
SEIZURES (SEE ALSO CHAPTER 69)......Page 1043
DISORDERS THAT PRESENT WITH ENCEPHALOPATHY (SEE ALSO CHAPTER 12)......Page 1050
DISORDERS THAT PRESENT WITH HEADACHE......Page 1051
DISORDERS OF MOTOR FUNCTION (SEE ALSO CHAPTER 79)......Page 1054
DISORDERS OF BALANCE (SEE CHAPTER 10)......Page 1059
MOVEMENT DISORDERS......Page 1060
DISORDERS OF CRANIAL NERVE FUNCTION......Page 1061
Suggested Readings......Page 1062
INITIAL CARE OF THE CHILD WITH NEW OR RECURRENT CANCER......Page 1065
COMPLICATIONS OF CANCER TREATMENT......Page 1084
RENAL COMPLICATIONS OF CANCER TREATMENT......Page 1094
COMPLICATIONS OF HEMATOPOIETIC STEM CELL TRANSPLANT......Page 1095
Suggested Readings......Page 1097
ACUTE RESPIRATORY FAILURE......Page 1099
BRONCHOPULMONARY DYSPLASIA......Page 1102
INTERSTITIAL LUNG DISEASE......Page 1103
ASPIRATION PNEUMONIA......Page 1105
PULMONARY EMBOLISM......Page 1107
PULMONARY EDEMA......Page 1111
PULMONARY HEMORRHAGE......Page 1113
PLEURITIS......Page 1114
OBSTRUCTIVE SLEEP APNEA......Page 1116
SARCOIDOSIS......Page 1119
Suggested Readings......Page 1120
RESPIRATORY/CHEST PRESENTATIONS......Page 1123
ABDOMINAL PRESENTATIONS......Page 1128
Suggested Readings......Page 1130
DEHYDRATION/HYPOVOLEMIA......Page 1131
ELECTROLYTE DISORDERS......Page 1135
ACUTE KIDNEY INJURY......Page 1145
GLOMERULAR DISEASES......Page 1148
CHRONIC KIDNEY DISEASE......Page 1155
Suggested Readings......Page 1157
JUVENILE RHEUMATOID ARTHRITIS......Page 1159
SYSTEMIC LUPUS ERYTHEMATOSUS......Page 1168
JUVENILE DERMATOMYOSITIS......Page 1177
SCLERODERMA......Page 1182
VASCULITIS......Page 1185
POLYARTERITIS NODOSA......Page 1186
KAWASAKI DISEASE......Page 1189
LYME DISEASE......Page 1196
Suggested Readings......Page 1199
GENERAL APPROACH TO THE POISONED CHILD......Page 1203
PEDIATRIC OVERDOSES......Page 1215
SUBSTANCE ABUSE......Page 1242
SPECIFIC DRUGS......Page 1246
Suggested Readings......Page 1253
FEVER......Page 1256
DIARRHEAL AND GASTROINTESTINAL COMPLAINTS......Page 1261
DERMATOLOGIC CONDITIONS......Page 1262
Suggested Readings......Page 1263
SPECTRUM OF TRAUMA AND INITIAL TRIAGE......Page 1265
GENERAL PRINCIPLES OF MANAGEMENT......Page 1266
MULTIPLE TRAUMA......Page 1267
LOCALIZED HEAD TRAUMA......Page 1268
LOCALIZED NECK TRAUMA......Page 1270
LOCALIZED THORACIC TRAUMA......Page 1271
LOCALIZED ABDOMINAL TRAUMA......Page 1272
EXTREMITY TRAUMA......Page 1273
Suggested Readings......Page 1274
CAUSES OF MAJOR TRAUMA......Page 1276
ASSESSMENT AND MANAGEMENT......Page 1277
SUMMARY......Page 1285
Suggested Readings......Page 1286
LACERATIONS......Page 1288
CARE FOR COMMON WOUNDS......Page 1299
Suggested Readings......Page 1301
APPROACH......Page 1303
INITIAL MANAGEMENT PRINCIPLES......Page 1304
BLUNT ABDOMINAL TRAUMA......Page 1307
LAP AND SHOULDER BELT AND AIR BAG INJURIES......Page 1310
Suggested Readings......Page 1311
PATHOPHYSIOLOGY......Page 1313
MAJOR BURNS......Page 1315
INFLICTED BURNS—CHILD ABUSE......Page 1319
Suggested Readings......Page 1320
ASSESSMENT OF TRAUMATIC DENTAL EMERGENCIES......Page 1321
OROFACIAL/DENTAL TRAUMA......Page 1323
Suggested Readings......Page 1329
EAR......Page 1330
NOSE AND PARANASAL SINUSES......Page 1332
ORAL CAVITY, PHARYNX, AND ESOPHAGUS......Page 1334
LARYNX AND TRACHEA......Page 1335
Suggested Readings......Page 1337
PHYSICAL EXAMINATION......Page 1339
IMAGING STUDIES......Page 1340
SPECIFIC INJURIES......Page 1341
Suggested Readings......Page 1346
KIDNEY......Page 1348
URETER......Page 1353
BLADDER......Page 1354
URETHRA......Page 1355
PENIS......Page 1357
SEXUAL ABUSE......Page 1358
Suggested Readings......Page 1359
EXAMINATION......Page 1360
CARPALS......Page 1361
METACARPALS......Page 1362
PHALANGES......Page 1363
FINGERTIP INJURIES......Page 1364
Suggested Readings......Page 1366
GENERAL PRINCIPLES OF PEDIATRIC ORTHOPEDICS......Page 1367
SPECIAL CONSIDERATIONS......Page 1372
INJURIES OF THE UPPER EXTREMITIES......Page 1374
FRACTURES OF THE PELVIS......Page 1390
INJURIES OF THE LOWER EXTREMITIES......Page 1392
INJURIES OF THE THORACOLUMBAR SPINE......Page 1404
Suggested Readings......Page 1406
PENETRATING TRAUMA......Page 1408
BLUNT TRAUMA......Page 1411
EVALUATION AND MANAGEMENT......Page 1420
CERVICAL SPINE EVALUATION......Page 1424
SPECIFIC INJURIES......Page 1436
Suggested Readings......Page 1451
HEAD TRAUMA......Page 1454
SPINAL CORD TRAUMA......Page 1473
PERIPHERAL NERVE INJURIES......Page 1477
Suggested Readings......Page 1478
EXAMINATION......Page 1480
RUPTURED GLOBE......Page 1484
BLOWOUT FRACTURE......Page 1485
CORNEAL AND CONJUNCTIVAL INJURY......Page 1486
HYPHEMA......Page 1488
CHILD ABUSE......Page 1489
Suggested Readings......Page 1490
PATHOPHYSIOLOGY......Page 1491
DIFFERENCES BETWEEN CHILDREN AND ADULTS......Page 1492
CLINICAL MANIFESTATIONS AND EVALUATION......Page 1494
INITIAL MANAGEMENT......Page 1495
Suggested Readings......Page 1508
HAND AND FOOT LESIONS......Page 1510
FACE AND SCALP LESIONS......Page 1512
NECK LESIONS......Page 1514
SURFACE LESIONS......Page 1518
Suggested Readings......Page 1524
APPROACH TO THE CARE OF THE TECHNOLOGY-ASSISTED CHILD......Page 1526
Suggested Readings......Page 1545
EVALUATION......Page 1547
DISEASES THAT PRODUCE PERITONEAL IRRITATION......Page 1549
ACUTE INTESTINAL OBSTRUCTION......Page 1552
CHRONIC PARTIAL INTESTINAL OBSTRUCTION......Page 1558
DISEASES THAT PRODUCE RECTAL BLEEDING......Page 1560
INTRAABDOMINAL MASSES......Page 1562
ABDOMINAL WALL DEFECTS......Page 1566
FOREIGN BODIES OF THE GASTROINTESTINAL TRACT......Page 1567
Suggested Readings......Page 1569
ORAL INFECTIONS......Page 1570
ORAL AND PERIORAL PATHOLOGY PRESENTING AS DENTAL EMERGENCIES......Page 1573
Suggested Readings......Page 1576
EAR......Page 1577
NOSE AND PARANASAL SINUSES......Page 1582
ORAL CAVITY, PHARYNX, AND ESOPHAGUS......Page 1585
LARYNX AND TRACHEA......Page 1587
NECK AND ASSOCIATED STRUCTURES......Page 1588
Suggested Readings......Page 1591
PENILE PROBLEMS......Page 1592
TESTICULAR PROBLEMS......Page 1595
URINARY TRACT INFECTIONS......Page 1596
ACUTE URINARY RETENTION......Page 1598
Suggested Readings......Page 1599
ORTHOPEDIC CONDITIONS......Page 1600
SPONDYLOLYSIS AND SPONDYLOLISTHESIS......Page 1610
OVERUSE SYNDROMES......Page 1611
COMPARTMENT SYNDROME......Page 1615
COMPLEX REGIONAL PAIN SYNDROME TYPE 1 (REFLEX SYMPATHETIC DYSTROPHY)......Page 1616
Suggested Readings......Page 1617
INCREASED INTRACRANIAL PRESSURE......Page 1619
HYDROCEPHALUS......Page 1620
STROKE......Page 1622
BRAIN TUMORS......Page 1624
Suggested Readings......Page 1625
EXAMINATION......Page 1627
COMMON EYE EMERGENCIES......Page 1629
Suggested Readings......Page 1634
INTRODUCTION......Page 1635
AIRWAY OBSTRUCTION......Page 1636
BRONCHIAL LESIONS......Page 1638
ESOPHAGUS-RELATED CAUSES OF AIRWAY DIFFICULTIES......Page 1639
CIRCULATORY IMPAIRMENT......Page 1641
PLEURAL DISEASES......Page 1642
LUNG LESIONS......Page 1645
MEDIASTINAL TUMORS......Page 1648
DIAPHRAGMATIC PROBLEMS......Page 1649
CHEST WALL TUMORS......Page 1652
Suggested Readings......Page 1653
HISTORY OF TRANSPLANTATION......Page 1656
IMMUNOSUPPRESSIVE MEDICATIONS......Page 1657
COMPLICATIONS RELATED TO IMMUNOSUPPRESSION......Page 1659
INFECTION PROPHYLAXIS......Page 1660
GENERAL PRINCIPLES OF MANAGEMENT......Page 1661
INFECTION......Page 1662
CONCLUSION......Page 1664
Suggested Readings......Page 1665
OVERVIEW......Page 1666
GENERAL CONSIDERATIONS FOR THE HISTORY AND PHYSICAL EXAMINATION......Page 1667
LEGAL ISSUES......Page 1668
SPECIFIC ISSUES......Page 1670
Suggested Readings......Page 1680
BREATH-HOLDING SPELLS......Page 1682
TICS AND MOVEMENT DISORDERS......Page 1683
HYPERVENTILATION SYNDROME......Page 1684
SLEEP DISTURBANCES......Page 1685
Suggested Readings......Page 1686
PHYSICAL ABUSE......Page 1688
SEXUAL ABUSE......Page 1707
NEGLECT......Page 1724
EMOTIONAL ABUSE......Page 1728
Suggested Readings......Page 1730
CRISIS AND CRISIS INTERVENTION......Page 1733
EVALUATION OF PSYCHIATRIC EMERGENCIES......Page 1734
AGITATED OR VIOLENT BEHAVIOR AND THE USE OF RESTRAINT......Page 1739
SUICIDE ATTEMPTS......Page 1742
DEPRESSION......Page 1746
PSYCHOSIS......Page 1748
MANIA/BIPOLAR DISORDER......Page 1751
AUTISM AND OTHER PERVASIVE DEVELOPMENTAL DISORDERS OF CHILDHOOD......Page 1753
DISSOCIATIVE DISORDERS......Page 1754
SCHOOL REFUSAL......Page 1755
CONDUCT DISORDERS......Page 1756
ATTENTION-DEFICIT/HYPERACTIVITY DISORDER......Page 1757
ATTACHMENT DISORDERS OF INFANCY......Page 1758
Suggested Readings......Page 1759
ADMINISTRATIVE ASPECTS......Page 1761
ULTRASOUND BASICS......Page 1762
DIAGNOSTIC EXAMINATIONS......Page 1763
PROCEDURAL APPLICATIONS......Page 1770
Suggested Readings......Page 1775
CHAPTER 135: ILLUSTRATED TECHNIQUES OF PEDIATRIC EMERGENCY PROCEDURES......Page 1776
1.1. RESTRAINTS......Page 1777
2.2. RADIAL ARTERIAL PUNCTURE......Page 1779
2.3. FEMORAL ARTERY/VEIN PUNCTURE......Page 1781
3.2. CENTRAL VENOUS CATHETER: PERCUTANEOUS SELDINGER TECHNIQUE—FEMORAL......Page 1782
3.3. JUGULAR VENOUS CANNULATION......Page 1784
COMPLICATIONS......Page 1786
PROCEDURE......Page 1787
3.7. RADIAL ARTERY CATHETERIZATION......Page 1791
3.9. AXILLARY VEIN CATHETERIZATION......Page 1793
3.10. ACCESSING CENTRAL VENOUS CATHETERS......Page 1795
4.1. LUMBAR PUNCTURE......Page 1796
4.2. EVALUATION OF VENTRICULOPERITONEAL SHUNT......Page 1797
4.4. SUBDURAL TAP......Page 1800
5.1. PNEUMATIC OTOSCOPIC EXAMINATION......Page 1801
5.3. REMOVAL OF A FOREIGN BODY FROM THE EAR......Page 1802
5.4. ASPIRATION OF AN AURICULAR HEMATOMA......Page 1803
6.3. EYELID RETRACTION......Page 1804
6.4. CONTACT LENS REMOVAL......Page 1806
7.1. NASAL CAUTERIZATION......Page 1807
7.2. NASAL PACKING—ANTERIOR AND POSTERIOR......Page 1808
7.3. REMOVAL OF A NASAL FOREIGN BODY......Page 1810
7.4. DRAINAGE OF SEPTAL HEMATOMA/ABSCESS......Page 1811
7.6. OROTRACHEAL INTUBATION......Page 1812
7.7. CRICOTHYROIDOTOMY/PERCUTANEOUS TRACHEOTOMY......Page 1814
7.8. REPLACEMENT OF A TRACHEOSTOMY CANNULA......Page 1817
8.1. INSERTION OF A CHEST TUBE......Page 1818
8.2. THORACENTESIS......Page 1819
8.3. RESUSCITATIVE THORACOTOMY......Page 1822
9.1. PERICARDIOCENTESIS......Page 1823
9.2. EMERGENCY TRANSVENOUS PACING......Page 1824
10.1. NASOGASTRIC TUBE PLACEMENT......Page 1826
10.2. PERITONEAL TAP......Page 1827
10.3. PERITONEAL LAVAGE......Page 1829
10.4. REPLACEMENT OF A GASTROSTOMY TUBE......Page 1831
10.5. REDUCTION OF AN INCARCERATED INGUINAL HERNIA......Page 1832
11.1. CATHETERIZATION OF THE BLADDER......Page 1834
11.2. SUPRAPUBIC BLADDER ASPIRATION......Page 1836
12.1. INCISION AND DRAINAGE OF AN ABSCESS......Page 1837
12.2. CLOSED REDUCTION OF DISLOCATIONS......Page 1838
12.3. DRAINAGE OF A SUBUNGUAL HEMATOMA......Page 1842
12.4. INCISION AND DRAINAGE OF A FELON......Page 1843
12.6. REMOVAL OF A SUBUNGUAL SPLINTER OR FOREIGN BODY......Page 1844
12.7. REMOVAL OF RINGS......Page 1845
12.8. REMOVAL OF FISH HOOKS......Page 1846
12.9. HAIR TOURNIQUET REMOVAL (FIG. 12.9)......Page 1847
12.10. ARTHROCENTESIS—GENERAL CONSIDERATIONS......Page 1849
12.11. TOPICAL ANESTHESIA AND DIRECT WOUND INFILTRATION......Page 1851
12.12. FIELD BLOCK......Page 1852
12.13. PERIPHERAL NERVE BLOCKS—GENERAL PRINCIPLES......Page 1854
12.14. SPLINTING OF MUSCULOSKELETAL INJURIES......Page 1859
12.15. REDUCTION OF NURSEMAID’S ELBOW......Page 1864
12.16. APPLICATION OF A FIGURE-OF-EIGHT HARNESS......Page 1865
13.2. FOCUSED ABDOMINAL SONOGRAPHY FOR TRAUMA......Page 1866
13.3. URINARY BLADDER ULTRASOUND......Page 1868
Suggested Readings......Page 1872
A-1 EMERGENCY DEPARTMENT......Page 1875
A-2 OFFICE OR CLINIC......Page 1877
RESUSCITATION DRUG LIST......Page 1878
MEDICATIONS......Page 1882
ABBREVIATIONS......Page 1912
VITAL SIGNS......Page 1913
BEDSIDE LABORATORY TESTING......Page 1914
ELECTROCARDIOGRAPHIC CAVEATS......Page 1916
SENSORY NERVE DERMATOMES......Page 1917
PROPHYLAXIS AFTER EXPOSURE TO SERIOUS DISEASE......Page 1918
SCORES......Page 1921
ANIMAL BITES......Page 1923
BRONCHIOLITIS......Page 1924
CAST OR SPLINT CARE......Page 1925
CONCUSSION......Page 1926
CONSTIPATION......Page 1927
DIAPER RASH......Page 1928
ECZEMA (ATOPIC DERMATITIS)......Page 1929
FEVER......Page 1930
FEVER LESS THAN 2 MONTHS......Page 1931
IMPETIGO......Page 1932
RINGWORM......Page 1933
SEDATION......Page 1934
SPRAINS AND STRAINS......Page 1935
URINARY TRACT INFECTION......Page 1936
VOMITING AND/OR DIARRHEA......Page 1937
WOUND CARE......Page 1938
APPENDIX E: CLINICAL PATHWAYS IN EMERGENCY MEDICINE......Page 1939
References......Page 1964
INDEX......Page 1965