Rosen & Barkin's 5-Minute Emergency Medicine Consult

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Authors: Jeffrey J. Schaider,Adam Z. Barkin,Roger M. Barkin,Philip Shayne,Richard E. Wolfe,Stephen R. Hayden,Peter Rosen

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BOOK: Rosen & Barkin's 5-Minute Emergency Medicine Consult
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Rosen & Barkin’s
5-Minute
Emergency
Medicine
Consult
5TH EDITION

 

Jeffrey J. Schaider, MD

Professor, Department of Emergency Medicine

Rush Medical College

Chairman, Department of Emergency Medicine

Cook County Health and Hospital System

Chicago, Illinois

Roger M. Barkin, MD, MPH

Clinical Professor of Emergency Medicine and Pediatrics

University of Colorado School of Medicine

Attending Physician

Department of Emergency Medicine

Denver Health Medical Center

Denver, Colorado

Stephen R. Hayden, MD

Professor of Clinical Medicine

Program Director, Residency Program

Department of Emergency Medicine

University of California

Editor-in-Chief, Journal of Emergency Medicine

Medical Center

San Diego, California

Richard E. Wolfe, MD

Associate Professor

Division of Emergency Medicine

Harvard Medical School

Chief of Emergency Medicine

Beth Israel Deaconess Medical Center

Boston, Massachusetts

Adam Z. Barkin, MD, MPH

Assistant Clinical Professor

Department of Emergency Medicine

University of Colorado School of Medicine

Aurora, Colorado

Associate Medical Director

Emergency Medicine

Rose Medical Center

Denver, Colorado

Philip Shayne, MD

Professor of Emergency Medicine

Vice Chair for Education and Program Director

Department of Emergency Medicine

Emory University School of Medicine

Atlanta, Georgia

Peter Rosen, MD

Senior Lecturer on Medicine

Harvard Medical School

Attending Physician

Beth Israel Deaconess Medical Center

Boston, Massachusetts

Visiting Professor

University of Arizona

Tucson, Arizona

Rosen & Barkin’s
5-Minute
Emergency
Medicine
Consult
5TH EDITION

Jeffrey J. Schaider, MD

Roger M. Barkin, MD, MPH

Stephen R. Hayden, MD

Richard E. Wolfe, MD

Adam Z. Barkin, MD, MPH

Philip Shayne, MD

Peter Rosen, MD

Acquisitions Editor:
Jamie M. Elfrank
Product Development Editor:
Ashley Fischer
Production Product Manager:
Bridgett Dougherty
Manufacturing Manager:
Beth Welsh
Marketing Manager:
Stephanie Manzo
Design Coordinator:
Teresa Mallon
Production Service:
Aptara, Inc.

2015 by Wolters Kluwer Health
Two Commerce Square
2001 Market Street
Philadelphia, PA. 19103 USA
LWW.com

All rights reserved. This book is protected by copyright. No part of this book may be reproduced in any form by any means, including photocopying, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright.

Printed in China

Library of Congress Cataloging-in-Publication Data

Rosen & Barkin’s 5-minute emergency medicine consult / edited by Jeffrey J. Schaider,
Adam Z. Barkin, Roger M. Barkin, Philip Shayne, Richard E. Wolfe, Stephen R. Hayden,
Peter Rosen. – 5th edition.
      p. ; cm. – (5-minute consult series)
   Rosen & Barkin’s five-minute emergency medicine consult
   5-minute emergency medicine consult
   Rosen and Barkin’s 5-minute emergency medicine consult
   Includes bibliographical references and index.
   ISBN 978-1-4511-9067-0 (hardback)
   I. Schaider, Jeffrey, editor.   II. Title: Rosen & Barkin’s five-minute emergency medicine consult.
III. Title: 5-minute emergency medicine consult.  IV. Title: Rosen and Barkin’s 5-minute emergency medicine consult.   V. Series: 5-minute consult (Series)
   [DNLM: 1. Emergency Medicine–Handbooks.   2. Emergency Medical Services–Handbooks.
3. Emergency Treatment–Handbooks. WB 39]
   RC86.8
   616.02’5–dc23

2014017339

Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of the information in a particular situation remains the professional responsibility of the practitioner.

The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug.

Some drugs and medical devices presented in the publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice.

To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax orders to (301) 223-2320. International customers should call (301) 223-2300.

Visit Lippincott Williams & Wilkins on the Internet: at
LWW.com
. Lippincott Williams & Wilkins customer service representatives are available from 8:30 am to 6 pm, EST.

10  9  8  7  6  5  4  3  2  1

PREFACE

R
osen and Barkin’s 5-Minute Emergency Medicine Consult
continues to reflect the evolving nature of our clinical emergency medicine practices. Emergency medicine provides unique challenges to the clinician; the remarkable breadth of clinical conditions encountered, the time constraints of an acute illness, environmental considerations, and the logistical demands of busy emergency departments. Time is of the essence, and this book is truly designed to meet the needs of clinicians working in settings providing urgent and emergent care. To look for a diagnosis, one must think of it, and the very nature of the emergency department (ED) makes prolonged deliberation difficult. Nevertheless, it must become instinctive to think about the statistically rare, but clinically serious entity, rather than to just reach for the statistically probable but nonlife-threatening diagnosis.

R
osen
and Barkin’s 5-Minute Emergency Medicine Consult
provides concise formatted information allowing the busy clinician to respond to each patient appropriately. It is meant to be readily available in the ED, and frequently used in the trenches. Written and edited by practicing clinicians for their colleagues, the book is designed to synthesize a mountain of information into tightly formatted chapters that stimulate analysis and subsequent assessment.

We have attempted to integrate our authors’ expertise, experience, and knowledge base onto the pages of this book. The chapters are not meant to be a diagnostic engine, but rather a place to confirm a diagnosis supported by clinical judgment and the subjective and objective evidence of a patient’s presentation. Our authors attempt to provide a precise and clinically relevant summary useful in caring for the patient while also equipping students and residents with the structure needed to approach individual disease processes. We are indebted to our contributors for their commitment to this task.

The book is intended to be accurate, focused, and readily integrated into practice, rather than being definitive and all encompassing. As in the past, this new edition incorporates new information and approaches to management, while allowing us to modify topics that reflect some of the new challenges we face.

Our goal is to make
Rosen and Barkin’s 5-Minute Emergency Medicine Consult
useful to both novices in emergency medicine and experienced clinicians. The information and organization is designed to be easily used within the “chaos” that surrounds our clinical settings.

Clinical acumen, judgment, and experience are the foundations for our clinical practice. It is our hope that this book will serve students, nurses, emergency medical personnel, residents, and practicing emergency physicians as a readily used resource in excellent patient care and knowledge acquisition.

J
EFFREY
J. S
CHAIDER
R
OGER
M. B
ARKIN
S
TEPHEN
R. H
AYDEN
R
ICHARD
E. W
OLFE
A
DAM
Z. B
ARKIN
P
HILIP
S
HAYNE
P
ETER
R
OSEN

ACKNOWLEDGMENTS

T
he dedication of our authors and the input of our readers is appreciated and forms the foundation for this book. Ashley Fischer of Lippincott Williams & Wilkins held our hands throughout the production.

To my wife Anna and sons Jacob and Isaac—thank you for your continued support and inspiration. Thanks to the Cook County Emergency Medicine Attendings and Residents for their contributions to the book and to enhancing my knowledge and understanding of our unique field.

J.J.S.

I am most appreciative for my family’s support. Suzanne Barkin, MD is an exemplary clinician and has been a remarkable role model and teacher for the residents she has trained. Adam, Jill, Jacob, Eli, Michael, and Rachael remind us daily of the importance of our roles as clinicians and reaffirm our commitment to excellence.

It is also important to acknowledge and thank our colleagues nationally and internationally who continue to teach each of us on an ongoing basis and will hopefully find this book useful in their practices.

R.M.B.

To my wife Marina, and my children Connor, Maia, and Kenny; without your support and understanding, my involvement in academic emergency medicine and this book would be not possible. To my current residents and past graduates; I hope the information in this book helps guide your clinical decisions and prompts you to always maintain your intellectual curiosity.

S.R.H.

To my wife Alice whose unflagging support, patience, and humor provide the support for these efforts. To the faculty members at BIDMC who share the vision and high standards that this book strives to achieve. To Peter who has been a lifelong mentor and a role model.

R.E.W.

To Jill, Jacob, and Eli who provide so much joy, support, laughter, and love.

A.Z.B.

To my wife Helen for her unending patience, support, guidance, and understanding for her support in allowing me the freedom to work on this book. And to my sons Dylan and David for keeping me grounded to what really matters.

P.S.

CONTRIBUTORS

James G. Adams, MD

Department of Emergency Medicine

Feinberg School of Medicine

Northwestern University

Chair

Department of Emergency Medicine

Northwestern Memorial Hospital

Chicago, Illinois

Erik Adler, MD

Senior Resident

Emergency Medicine

Denver Health

Denver, Colorado

Rami A. Ahmed, DO

Assistant Professor

Department of Emergency Medicine

Northeastern Ohio Medical University

Rootstown, Ohio

Simulation Medical Director

Emergency Medicine

Summa Akron City Hospital

Akron, Ohio

Murtaza Akhter, MD

Senior Resident

Emergency Medicine

Grady Memorial Hospital

Atlanta, Georgia

Steven E. Aks, DO, FACMT, FACEP

Associate Professor

Department of Emergency Medicine

Rush University

Director

The Toxikon Consortium

Division of Toxicology

Department of Emergency Medicine

Cook County Hospital (Stroger)

Chicago, Illinois

Nadeem Alduaij, MD, MPH

Adjunct Assistant Professor

Institute of Public Health

UAE University

Abu Dhabi, UAE

Staff Physician

Department of Emergency Medicine

Adan Hospital

Riqqa, Kuwait

Paul J. Allegretti, DO, FACOEP, FACOI

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