Tintinalli's Emergency Medicine Manual

David Cline, MD Associate Professor and Research Director Department of Emergency Medicine Wake Forest University Baptist Medical Center Winston-Salem, NC O. John Ma, MD Professor and Chair Department of Emergency Medicine Oregon Health Sciences University Portland, OR

Section 1 Resuscitative Problems and Techniques


1 Advanced Airway Support


2 Arrhythmia Management


3 Resuscitation of Children and Neonates


4 Fluids, Electrolytes, and Acid-Base Disorders


5 Therapeutic Approach to the Hypotensive Patient


6 Anaphylaxis, Acute Allergic Reactions, and Angioedema



Section 2 Analgesia, Anesthesia, and Sedation 55


7 Acute Pain Management and Procedural Sedation


8 Management of Patients With Chronic Pain



Section 3 Emergency Wound Management


9 Evaluating and Preparing Wounds


10 Methods for Wound Closure


11 Lacerations to the Face and Scalp


12 Injuries of the Arm, Hand, Fingertip, and Nail


13 Lacerations to the Leg and Foot


14 Soft Tissue Foreign Bodies


15 Puncture Wounds and Mammalian Bites

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16 Post Repair Wound Care



Section 4 Cardiovascular Diseases


17 Chest Pain: Cardiac or Not


18 Acute Coronary Syndromes: Management of Myocardial Infarction and Unstable Angina Jim


19 Cardiogenic Shock


20 Low Probability Acute Coronary Syndromes


21 Syncope


22 Congestive Heart Failure and Acute Pulmonary Edema


23 Valvular Emergencies


24 The Cardiomyopathies, Myocarditis, and Pericardial Disease


25 Thromboembolism


26 Systemic and Pulmonary Hypertension


27 Aortic Dissection and Aneurysms


28 Occlusive Arterial Disease



Section 5 Pulmonary Emergencies


29 Respiratory Distress


30 Bronchitis, Pneumonia, and SARS


31 Tuberculosis


32 Spontaneous and Iatrogenic Pneumothorax


33 Hemoptysis


34 Asthma and Chronic Obstructive Pulmonary Disease



Section 6 Gastrointestinal Emergencies


35 Acute Abdominal Pain


36 Nausea and Vomiting


37 Disorders Presenting Primarily With Diarrhea


38 Acute and Chronic Constipation


39 Gastrointestinal Bleeding


40 Esophageal Emergencies


41 Peptic Ulcer Disease and Gastritis


42 Pancreatitis and Cholecystitis


43 Acute Appendicitis


44 Diverticulitis


45 Intestinal Obstruction and Volvulus


46 Hernia in Adults and Children


47 Anorectal Disorders


48 Jaundice, Hepatic Disorders, and Hepatic Failure


49 Complications of General Surgical Procedures



Section 7 Renal and Genitourinary Disorders


50 Acute Renal Failure


51 Rhabdomyolysis


52 Emergencies in Renal Failure and Dialysis Patients


53 Urinary Tract Infections and Hematuria


54 Acute Urinary Retention


55 Male Genital Problems


56 Urologic Stone Disease


57 Complications of Urologic Devices



Section 8 Gynecology and Obstetrics


58 Vaginal Bleeding and Pelvic Pain in the Nonpregnant Patient


59 Ectopic Pregnancy and Emergencies in the First 20 Weeks of Pregnancy


60 Comorbid Diseases in Pregnancy


61 Emergencies After 20 Weeks of Pregnancy and the Postpartum Period

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62 Emergency Delivery


63 Vulvovaginitis


64 Pelvic Infl ammatory Disease and Tubo-Ovarian Abscess


65 Complications of Gynecologic Procedures



Section 9 Pediatrics



66 Fever and Serious Bacterial Illness in Children


67 Common Neonatal Problems


68 Common Infections of the Ears, Nose, Neck, and Throat


69 Upper Respiratory Emergencies—Stridor and Drooling


70 Wheezing in Infants and Children


71 Pneumonia in Infants and Children


72 Pediatric Heart Disease


73 Vomiting and Diarrhea in Infants and Children


74 Pediatric Abdominal Emergencies


75 Pediatric Urinary Tract Infections


76 Seizures and Status Epilepticus in Children


77 Headache and Altered Mental Status in Children


78 Syncope and Sudden Death in Children and Adolescents


79 Hypoglycemia and Metabolic Emergencies in Infants and Children


80 The Diabetic Child


81 Fluid and Electrolyte Therapy


82 Musculoskeletal Disorders in Children


83 Rashes in Infants and Children


84 Sickle Cell Anemia in Children


85 Hematologic-Oncologic Emergencies in Children


86 Renal Emergencies in Infants and Children



Section 10 Infectious and Immunologic Diseases


87 Sexually Transmitted Diseases


88 Toxic Shock


89 Septic Shock


90 Soft Tissue Infections


91 Disseminated Viral Infections


92 HIV Infections and AIDS


93 Infective Endocarditis


94 Tetanus and Rabies


95 Malaria


96 Foodborne and Waterborne Diseases


97 Zoonotic Infections


98 World Travelers


99 The Transplant Patient



Section 11 Toxicology and Pharmacology


100 General Management of the Poisoned Patient


101 Anticholinergic Toxicity


102 Psychopharmacologic Agents


103 Sedatives and Hypnotics


104 Alcohols


105 Drugs of Abuse


106 Analgesics


107 Xanthines and Nicotine


108 Cardiac Medications


109 Anticonvulsants


110 Iron


111 Hydrocarbons and Volatile Substances


112 Caustics


113 Pesticides


114 Metals and Metalloids


115 Industrial Toxins and Cyanide


116 Herbals and Vitamins


117 Dyshemoglobinemias



Section 12 Environmental Injuries


118 Frostbite and Hypothermia


119 Heat Emergencies


120 Bites and Stings


121 Trauma and Envenomation from Marine Fauna


122 High-Altitude Medical Problems


123 Dysbarism and Complications of Diving


124 Near Drowning


125 Thermal and Chemical Burns


126 Electrical and Lightning Injuries


127 Carbon Monoxide


128 Mushroom and Plant Poisoning



Section 13 Endocrine Emergencies


129 Diabetic Emergencies


130 Alcoholic Ketoacidosis


131 Thyroid Disease Emergencies


132 Adrenal Insuffi ciency and Adrenal Crisis



Section 14 Hematologic and Oncologic Emergencies


133 Evaluation of Anemia and the Bleeding Patient


134 Acquired Bleeding Disorders


135 Hemophilias and von Willebrand Disease


136 Sickle Cell Disease and Other Hereditary Hemolytic Anemias


137 Transfusion Therapy


138 Anticoagulants, Antiplatelet Agents, and Fibrinolytics


139 Emergency Complications of Malignancy



Section 15 Neurology


140 Headache and Facial Pain


141 Stroke, Transient Ischemic Attack, and Subarachnoid Hemorrhage


142 Altered Mental Status and Coma


143 Ataxia and Gait Disturbances


144 Vertigo and Dizziness


145 Seizures and Status Epilepticus in Adults


146 Acute Peripheral Neurological Lesions


147 Chronic Neurologic Disorders


148 Central Nervous System and Spinal Infections



Section 16 Eye, Ear, Nose, Throat, and Oral Emergencies


149 Ocular Emergencies


150 Face and Jaw Emergencies


151 Ear, Nose, and Sinus Emergencies


152 Oral and Dental Emergencies


153 Neck and Upper Airway Disorders



Section 17 Disorders of the Skin


154 Dermatologic Emergencies


155 Other Dermatologic Disorders


Section 18 Trauma


156 Trauma in Adults


157 Trauma in Children


158 Trauma in the Elderly


159 Trauma in Pregnancy


160 Head Trauma in Adults and Children


161 Spine and Spinal Cord Injuries in Adults and Children


162 Facial Injuries


163 Trauma to the Neck


164 Cardiothoracic Trauma


165 Abdominal Injuries


166 Penetrating Trauma to the Flank and Buttocks


167 Genitourinary Injuries Matthew


168 Penetrating Trauma to the Extremities



Section 19 Injuries to the Bones, Joints, and Soft Tissue


169 Initial Evaluation and Management of Orthopedic Injuries


170 Hand and Wrist Injuries


171 Forearm and Elbow Injuries


172 Shoulder and Humerus Injuries


173 Pelvis, Hip, and Femur Injuries


174 Knee and Leg Injuries


175 Ankle and Foot Injuries


176 Compartment Syndromes



Section 20 Nontraumatic Musculoskeletal Disorders



177 Neck and Thoracolumbar Pain


178 Shoulder Pain


179 Hip and Knee Pain


180 Acute Disorders of the Joints and Bursae


181 Emergencies in Systemic Rheumatic Diseases


182 Infectious and Noninfectious Disorders of the Hand

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183 Soft Tissue Problems of the Foot



Section 21 Psychosocial Disorders



184 Clinical Features of Behavioral Disorders


185 Emergency Assessment and Stabilization of Behavioral Disorders


186 Panic and Conversion Disorders


Section 22 Abuse and Assault


187 Child and Elderly Abuse


188 Sexual Assault and Intimate Partner Violence and Abuse


Index