Evidence–Based Emergency Care – Diagnostic Testing and Clinical Decision Rules 2e

Jesse M. Pines, MD, MBA; Director, Center for Health Care Quality, Associate Professor Emergency Medicine and Health Policy, George Washington University, Washington, D.C., USA

About the Authors xi Foreword xv Preface xvii Acknowledgments xix Section 1: The Science of Diagnostic Testing and Clinical Decision Rules 1 Diagnostic Testing in Emergency Care 3 2 Evidence-Based Medicine: The Process 11 3 The Epidemiology and Statistics of Diagnostic Testing 19 4 Clinical Decision Rules 36 5 Appropriate Testing in an Era of Limited Resources: Practice and Policy Considerations 44 6 Understanding Bias in Diagnostic Research 54 Section 2: Trauma 7 Cervical Spine Fractures 67 8 Cervical Spine Fractures in Children 80 9 Cervical Spine Fractures in Older Adults 86 10 Blunt Abdominal Trauma 92 11 Acute Knee Injuries 97 12 Acute Ankle and Foot Injuries 102 13 Blunt Head Injury in Children 107 14 Blunt Head Injury 117 15 Blunt Chest Trauma 128 16 Occult Hip Fracture 135 17 Blunt Soft Tissue Neck Trauma 141 18 Occult Scaphoid Fractures 147 19 Penetrating Abdominal Trauma 153 20 Penetrating Trauma to the Extremities and Vascular Injuries 162 Section 3: Cardiology 21 Heart Failure 173 22 Syncope 181 23 Acute Coronary Syndrome 189 24 Palpitations 205 Section 4: Infectious Disease 25 Bacterial Meningitis in Children 219 26 Serious Bacterial Infections in Children Aged 1 3 Months 223 27 Necrotizing Fasciitis 227 28 Infective Endocarditis 232 29 Pharyngitis 238 30 Rhinosinusitis 243 31 Pneumonia 248 32 Urinary Tract Infection 255 33 Sepsis 259 34 Septic Arthritis 270 35 Osteomyelitis 278 36 Sexually Transmitted Diseases (STDs) 288 37 Influenza 295 38 Pediatric Fever in Children Aged 3-36 Months 303 Section 5: Surgical and Abdominal Complaints 39 Acute Nonspecific Nontraumatic Abdominal Pain 309 40 Small Bowel Obstruction 317 41 Acute Pancreatitis 324 42 Acute Appendicitis 330 43 Acute Cholecystitis 340 44 Aortic Emergencies 347 45 Ovarian Torsion 351 Section 6: Urology 46 Nephrolithiasis 359 47 Testicular Torsion 365 Section 7: Neurology 48 Nontraumatic Subarachnoid Hemorrhage 375 49 Acute Stroke 381 50 Transient Ischemic Attack 387 51 Seizure 394 Section 8: Miscellaneous: Hematology Ophthalmology Pulmonology Rheumatology and Geriatrics 52 Venous Thromboembolism 403 53 Temporal Arteritis 415 54 Intraocular Pressure 421 55 Asthma 430 56 Nontraumatic Back Pain 441 57 Intravascular Volume Status 450 58 Geriatric Syndromes 457 Index 471