Algorithms for Emergency Medicine (Algorithms In)

Delivering Emergency Medicine involves constant challenges to the emergency clinician, reflectedby the wide breadth of conditions that are encountered, the necessity for the frequentneed to deal with multiple severely unwell patients, the time constraints of acute illnesses, andthe urgency needed in diagnosis and treatment.Algorithms for Emergency Medicine is designed to be a ‘straight to the point’ reference to helpface these challenges and allow the busy emergency clinician to respond and deliver appropriatecare in a timely fashion.The book is divided into ten sections (e.g. Practical procedures, Airway and breathing,Cardiovascular) and each section is comprised of a number of topics. Each topic is divided intoan information section, which provides essential knowledge, tips, and salient points on the topic,and an algorithm, which is aimed to guide the clinician in a step- by- step manner in managingthese conditions. These are based on the Royal College of Emergency Medicine curriculum forthose who would like to train or obtain experience in delivering Emergency Medicine whichcontains up- to- date evidence and knowledge.This book would have not been possible without the dedication and commitment by the authorsand the willingness to share their experience in delivering emergency care.We hope that this book will be useful for Emergency Nurse Practitioners, new doctorsstarting their placement in the Emergency Department, and trainee doctors working towardsspecializing in Emergency Medicine. Cover 1 Algorithms for Emergency Medicine 4 Copyright 5 Preface 6 Contents 8 Detailed Contents 10 Contributors 14 Abbreviations 16 SECTION 1 Practical procedures 20 1 Basic life support 21 2 Airway protection 23 3 Rapid sequence induction 25 4 Cricothyroidotomy 27 5 Needle thoracocentesis 29 6 Pleural aspiration—pneumothorax 31 7 Intercostal drain—​seldinger 33 8 Intercostal drain—​open 35 9 Arterial blood gas sampling 37 10 Peripheral venous cannulation 39 11 Central venous cannulation 41 12 Intraosseous access 43 13 Urinary catheterization 45 14 Nasogastric tube insertion 47 15 Arterial cannulation and arterial pressure monitoring 49 16 Lumbar puncture 51 17 Abdominal paracentesis/​ascetic tap 53 18 DC cardioversion 55 19 Temporary pacing (external) 57 20 Knee aspiration 59 21 Fracture manipulation 61 22 Procedural sedation 63 SECTION 2 Airway and breathing 66 1 Anaphylaxis 67 2 Apnoea, stridor and airway obstruction 69 3 Pneumothorax/​haemothorax 71 4 Asthma and chronic obstructive pulmonary disease (COPD) 73 5 Pulmonary embolism 75 6 Acute heart failure 77 7 Cough 79 8 Cyanosis 81 SECTION 3 Cardiovascular 84 1 Cardiorespiratory arrest—​adult life support (ALS) 85 2 Cardiorespiratory arrest—​advanced paediatric life support (APLS) 87 3 Chest pain 89 4 Palpitations 91 5 Tachyarrhythmias 93 6 Bradyarrhythmias 95 SECTION 4 Abdominal 98 1 Acute abdominal pain 99 2 Rectal bleeding 101 3 Dehydration in children 103 4 Diarrhoea 105 5 Dysuria 107 6 Ectopic pregnancy 109 7 Haematemesis and melaena 111 8 Jaundice 113 9 Nausea and vomiting 115 SECTION 5 Neurological 118 1 The unconscious patient 119 2 Aggressive/​disturbed behaviour 121 3 Alcohol and substance abuse 123 4 Acute confusion/​delirium 125 5 Dizziness and vertigo 127 6 Fits/​seizures 129 7 Headache 131 8 Syncope and pre-​syncope 133 9 Weakness and paralysis 135 10 Stroke 137 11 Subarachnoid haemorrhage 139 SECTION 6 Trauma 142 1 Primary survey 143 2 Secondary survey 145 3 Head injury 147 4 Major trauma—​chest injuries 149 5 Major trauma—​abdominal trauma 151 6 Major trauma—​spinal injuries 153 7 Major trauma—​maxillofacial 155 8 Major trauma—​burns 157 9 Traumatic limb and joint injuries 159 10 Wound assessment and management 161 11 Shoulder examination 163 12 Elbow examination 165 13 Hand examination 167 14 Hip examination 169 15 Knee examination 171 16 Ankle examination 173 SECTION 7 Environmental emergencies 176 1 Heat stroke and heat exhaustion 177 2 Drug-​related hyperthermias 179 3 Hypothermia and frostbite 181 4 Electrical burns/​electrocution 183 5 Drowning 185 SECTION 8 Other medical 188 1 The septic patient 189 2 The shocked patient 191 3 Abnormal blood glucose—​diabetic ketoacidosis (DKA) 193 4 Abnormal blood glucose—​hyperosmolar hyperglycaemic state (HHS) 195 5 Sickle cell crisis 197 6 Anaemia 199 7 Purpura and bruising in children 201 8 Leukaemia/​lymphoma in children 203 9 Bruising and spontaneous bleeding 205 10 Fever 207 11 The oliguric patient 209 12 Oncology emergencies 211 13 Poisoning/​self-​harm 213 14 Rashes 215 15 Acute red eye 217 16 Acute visual loss 219 17 Hyperkalaemia 221 18 Rhabdomyolysis 223 19 High INR 225 SECTION 9 Other surgical 228 1 Acute back pain 229 2 Epistaxis 231 3 Falls 233 4 Non-​traumatic limb pain and swelling 235 5 Acute neck pain 237 6 Painful ear (otalgia) 239 7 Sore throat 241 8 Scrotal pain 243 9 Acute urinary retention 245 10 Per-​vaginal bleeding 247 SECTION 10 Miscellaneous 250 1 Suicidal ideation 251 2 Needlestick injury 253 3 Pain management 255 Index 258 Delivering Emergency Medicine involves constant challenges to the emergency clinician, seen in the frequency of severely unwell patients, the wide breadth of conditions encountered, and the urgency required in diagnosis and treatment. Concise, and, critically, accessible, Algorithms for Emergency Medicine supports the key decision-making requirements of clinicians working in the Emergency Department. Designed to support rapid problem solving, this resource covers everything from common non-life-threatening emergencies such as headaches to life-threatening acute events such as major traumas. Each topic is divided into two; the left page provides essential knowledge, and on the right, an algorithm which guides the clinician in a step by step process in managing these conditions. Evidence based and up-to-date, this book follows the College of Emergency Medicine Curriculum, making it an invaluable resource for Emergency Nurse Practitioners, new doctors starting their placement in the Emergency Department, and trainee doctors working towards specialising in Emergency Medicine. Concise, and, critically, accessible, Algorithms for Emergency Medicine supports the key decision-making requirements of clinicians working in the Emergency Department, covering everything from common non-life-threatening emergencies like headaches to life-threatening acute events such as major traumas