Rosen & Barkin's 5-Minute Emergency Medicine Consult Standard Edition

4440 Pages·2014·14.12 MB·English

by  Jeffrey J. Schaider MD

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
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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
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Some drugs and medical devices presented in the publication have Food and Drug Administration (FDA) clearance for
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each drug or device planned for use in their clinical practice.
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10 9 8 7 6 5 4 3 2 1
PREFACE
osen and Barkin’s 5-Minute Emergency Medicine Consult continues to reflect the
R
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.
Rosen 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.
JEFFREY J. SCHAIDER
ROGER M. BARKIN
STEPHEN R. HAYDEN
RICHARD E. WOLFE
ADAM Z. BARKIN
PHILIP SHAYNE
PETER ROSEN
ACKNOWLEDGMENTS
he dedication of our authors and the input of our readers is appreciated and
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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.