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Contents Contributors viii Preface XVI Acknowledgments xvii I. Common Procedures IV. Pulmonary Emergencies 1. Incision and Drainage 1 20. Dyspnea 84 2. Arterial Blood Gas 4 21. Asthma 89 3. Central Venous Access 8 22. Chronic Obstructive Pulmonary Disease 95 4. Procedural Sedation 13 23. Pneumonia 100 5. Lumbar Puncture 16 24. Pneumothorax 105 6. Laceration Repair 20 25. Pulmonary Embolism 108 7. Needle and Tube Thoracostomy 24 V. Abdominal Emergencies 8. Introduction to Emergency Ultrasonography 27 26. Acute Abdominal Pain 112 II. Resuscitation 27. Appendicitis 118 9. Emergency Medical Services 30 28. Acute Cholecystitis 121 1 o. Cardiopulmonary Arrest 33 29. Abdominal Aortic Aneurysm 125 11. Airway Management 37 30. Gastrointestinal Bleeding 128 12. Shock 42 31. Intestinal Obstruction 131 Ill. Cardiovascular Emergencies 32. Mesenteric Ischemia 135 13. Chest Pain 46 VI. Infectious Disease Emergencies 14. Acute Coronary Syndromes 50 33. Fever 138 15. Congestive Heart Failure 57 34. Sepsis 142 16. Dysrhythmias 63 35. Meningitis and Encephalitis 147 17. Aortic Dissection 70 36. Soft Tissue Infections 151 18. Hypertensive Emergencies 75 37. Human Immunodeficiency Virus 156 19. Syncope 80 38. Blood and Body Fluid Exposure 162 v CONTENTS VI I. Genitourinary Emergencies XI. Environmental Emergencies 39. Nephrolithiasis 166 61. Hypothermia 259 40. Urinary Tract Infections 170 62. Cold-Induced Tissue Injuries 263 41. Testicular Torsion 174 63. Heat-Related Illness 267 42. Penile Disorders 177 64. Drowning Incidents 270 VI II. Obstetrics/Gynecologic Emergencies 65. Envenomation 274 43. Vaginal Bleeding 181 XI I. Metabolic/Endocrine Emergencies 44. Vaginal Discharge 185 66. Diabetic Emergencies 280 45. Preeclampsia and Eclampsia 189 67. Potassium Disorders 284 46. Emergency Delivery 192 68. Thyroid Emergencies 288 IX. Pediatric Emergencies 69. Adrenal Emergencies 292 47. The Pediatric Patient 196 XI II. Hematologic/Oncologic Emergencies 48. Pediatric Fever 201 70. Oncologic Emergencies 295 49. Respiratory Distress 206 71. Sickle Cell Emergencies 299 50. Abdominal Pain 212 72. Transfusion Reactions 304 51. Dehydration 217 73. Anticoagulant Therapy and Its Complications 308 52. Otitis Media 221 XIV. HEENT Emergencies 53. Pharyngitis 225 7 4. Slit Lamp Examination 312 X. Toxicology 75. Red Eye 315 54. The Poisoned Patient 230 76. Acute Visual Loss 319 55. Toxic Alcohols 235 77. Epistaxis 324 56. Acetaminophen Toxicity 239 78. Dental Emergencies 327 57. Salicylate Toxicity 244 XV. Neurologic Emergencies 58. Carbon Monoxide Poisoning 247 79. Altered Mental Status 332 59. Digoxin 251 80. Headache 336 60. Cyclic Antidepressants 255 81. Dizziness 341 CONTENTS vii 82. Cerebrovascular Accident 347 92. Low Back Pain 403 83. Seizures and Status Epilepticus 353 93. Compartment Syndromes 407 XVI. Trauma 94. Septic Arthritis 410 84. Trauma Principles 358 95. Splinting 414 85. Head Injuries 363 XVI II. Dermatologic Emergencies 86. Cervical Spine Injuries 368 96. Life-Threatening Dermatoses 418 87. Thoracic Trauma 374 97. Allergic Reactions 423 88. Abdominal Trauma 381 XIX. Psychiatric Emergencies 89. Burns 387 98. Approach to the Psychiatric Patient 426 XVI I. Orthopedic Emergencies Index 429 90. Upper Extremity Injuries 391 91. Lower Extremity Injuries 397 Contributors Negean Afifi, DO Department of Emergency Medicine Cook County (Stroger) Hospital Chicago, Illinois Steven E. Aks, DO Director, The Toxikon Consortiwn Division of Toxicology, Department of Emergency Medicine Cook County (Stroger) Hospital Associate Professor Department of Emergency Medicine Rush Medical College Chicago, Illinois Amer Zia Aldeen, MD Assistant Professor Department of Emergency Medicine Northwestern University Feinberg School of Medicine Attending Physician Department of Emergency Medicine Northwestern Memorial Hospital Chicago, Illinois Kim L. Askew, MD Assistant Professor Department of Emergency Medicine Wake Forest University School of Medicine Winston-Salem, North Carolina John Bailitz, MD, RDMS Emergency Ultrasound Director Department of Emergency Medicine Cook County (Stroger) Hospital Assistant Professor of Emergency Medicine Department of Emergency Medicine Rush Medical College Chicago, Illinois Jeffery A. Baker, MD Attending Physician Department of Emergency Medicine Ochsner Health System Clinical Instructor University of Queensland, Ochsner Clinical School New Orleans, Louisiana viii Jonathan Bankoff, MD, FACEP Medical Director Emergency Department Middlesex Hospital Middletown, Connecticut Eric H. Beck, DO, NREMT-P Assistant Professor Section of Emergency Medicine The University of Chicago EMS Medical Director Chicago EMS Illinois EMS Region 1 1, Medical Directors Consortium Chicago, Illinois Lauren Emily Bence, MD Department of Emergency Medicine University of Chicago Hospital Chicago, Illinois Steven H. Bowman, MD, FACEP Assistant Professor Department of Emergency Medicine Rush Medical College Program Director Department of Emergency Medicine Cook County (Stroger) Hospital Chicago, Illinois Sean M. Bryant, MD Associate Professor Emergency Medicine Assistant Fellowship Director Toxikon Consortium Cook County (Stroger) Hospital Associate Medical Director Illinois Poison Center Chicago, Illinois Ann Buchanan, MD Assistant Director/Trauma Medical Director Department of Emergency Medicine St. David's Medical Center Austin, Texas Paul E. Casey, MD Instructor in Clinical Medicine Department of Emergency Medicine Rush University Medical Center Chicago, illinois Esther H. Chen, MD Associate Professor Emergency Medicine University of California, San Francisco General Hospital San Francisco, California George Chiampas, DO Assistant Professor, Department of Emergency Medicine Northwestern University Feinberg School of Medicine Team Physician, Northwestern University Medical Director, Bank of America Chicago Marathon Chicago, Illinois Kristine Cieslak, MD Assistant Professor Department of Pediatrics Northwestern University Feinberg School of Medicine Chicago, Illinois Director, Pediatric Emergency Medicine Department of Pediatric Emergency Medicine Children's Memorial at Central DuPage Hospital Winfield, Illinois Michael T. Cudnik, MD, MPH Assistant Professor Department of Emergency Medicine The Ohio State University Medical Center Columbus, Ohio Joanna Wieczorek Davidson, MD Department of Emergency Medicine Cook County (Stroger) Hospital Chicago, Illinois John Davis, MD, PhD Assistant Professor Department of Medicine The Ohio State University Attending Physician Department of Medicine Wexner Medical Center at The Ohio State University Columbus, Ohio Alex de la Fuente, MD Private Practice Everett, Washington Nicole M. Deiorio, MD Associate Professor Department of Emergency Medicine Director, Medical Student Education Oregon Health and Science University Portland, Oregon CONTRIBUTORS E. Paul DeKoning, MD, MS Assistant Professor Emergency Medicine Dartmouth-Hitchcock Medical Center Medical Student Education Director Emergency Medicine Dartmouth Medical School Lebanon, New Hampshire Bradley L. Demeter, MD EMS Physician Emergency Medicine University of Chicago Chicago, Illinois Vinodinee L. Dissanayake, MD Global Toxicology Fellow Emergency Medicine University of Illinois at Chicago and Cook County (Stroger) Hospital Clinical Instructor University of Illinois at Chicago Chicago, Illinois Marc Doucette, MD Associate Professor Emergency Medicine University of Colorado School of Medicine Attending Physician Emergency Medicine St. Anthony Hospital System Denver, Colorado Matthew T. Emery, MD Assistant Professor Emergency Medicine Michigan State University College of Human Medicine Attending Physician Department of Emergency Medicine Spectrum Health Hospital-Butterworth Campus Grand Rapids, Michigan Rakesh S. Engineer, MD Assistant Professor Emergency Medicine Case School of Medicine Attending Physician Emergency Services Institute Cleveland Clinic Cleveland, Ohio Jorge Fernandez, MD Assistant Professor of Clinical Emergency Medicine Department of Emergency Medicine University of Southern California Director of Medical Student Education Department of Emergency Medicine LA County + USC Medical Center Los Angeles, California CONTRIBUTORS Michael T. Fitch, MD, PhD, FACEP, FAAEM Associate Professor Department of Emergency Medicine Wake Forest School of Medicine Winston-Salem, North Carolina Alison R. Foster, MD Department of Emergency Medicine Northwestern University Chicago, illinois Douglas Franzen, MD, M.Ed, FACEP Assistant Professor Department of Emergency Medicine Virginia Commonwealth University Medical Center Richmond, Virginia Casey Glass, MD Assistant Professor Department of Emergency Medicine Wake Forest Health Sciences Winston-Salem, North Carolina David C. Gordon, MD Assistant Professor Division of Emergency Medicine, Department of Surgery Duke University Durham, North Carolina Nihja 0. Gordon, MD Department of Emergency Medicine Cook County (Stroger) Hospital Chicago, illinois Krista A. Grandey, DO Department of Emergencey Medicine Cook County (Stroger) Hospital Chicago, illinois Pilar Guerrero, MD Assistant Professor Department of Emergency Medicine Cook County (Stroger) Hospital Chicago, illinois Marianne Haughey, MD Associate Professor of Emergency Medicine Department of Emergency Medicine Jacobi Medical Center, Albert Einstein College of Medicine Bronx, New York Tarlan Hedayati, MD Assistant Program Director Department of Emergency Medicine Cook County (Stroger) Hospital Assistant Professor Department of Emergency Medicine Rush Medical College Chicago, illinois Corey R. Heitz, MD Assistant Professor Department of Emergency Medicine Virginia Tech Carilion School of Medicine Roanoke, Virginia Ross A. Heller, MD, MBA Associate Professor Department of Surgery/Division of Emergency Medicine Saint Louis University School of Medicine Saint Louis, Missouri Colleen N. Hickey, MD Assistant Professor Department of Emergency Medicine Northwestern University Feinberg School of Medicine Attending Physician Department of Emergency Medicine Northwestern Memorial Hospital Chicago, illinois Katherine M. Hiller, MD, MPH, FACEP Associate Professor Department of Emergency Medicine University of Arizona College of Medicine Tucson, Arizona Russ Horowitz, MD, RDMS Assistant Professor Department of Pediatrics Northwestern University Feinberg School of Medicine Attending Physician, Director Emergency Ultrasound Division of Emergency Medicine Children's Memorial Hospital Chicago, illinois Craig Huston, MD Emergency Physician Department of Emergency Medicine Blessing Hospital Quincy, illinois Harry C. Karydes, DO Assistant Professor Attending Physician Department of Emergency Medicine Rush Medical College Chicago, illinois Elizabeth W. Kelly, MD Assistant Professor Department of Emergency Medicine Wake Forest School of Medicine Winston-Salem, North Carolina Chad S. Kessler, MD Section Chief, Emergency Medicine Department of Medicine Jesse Brown VA Medical Center Chicago, illinois Sorabh Khandelwal, MD Associate Professor Department of Emergency Medicine Assistant Dean for Clinical Sciences College of Medicine The Ohio State University Columbus, Ohio Basem F. Khishfe, MD Department of Emergency Medicine Cook County (Stroger) Hospital Chicago, Illinois Brian C. Kitamura, MD Emergency Medicine Maricopa Integrated Health System Phoenix, Arizona Nicholas E. Kman, MD, FACEP Assistant Professor Department of Emergency Medicine The Ohio State University College of Medicine Columbus, Ohio Amy V. Kontrick, MD Assistant Professor Emergency Medicine Northwestern University Feinberg School of Medicine Chicago, Illinois Carl M. Kraemer, MD, FAAEM, FACEP Assistant Professor Department of Emergency Medicine Saint Louis University School of Medicine St. Louis, Missouri Brian Krieger, MD Department of Emergency Medicine Cook County (Stroger) Hospital Chicago, Illinois Rashid E. Kysia, MD, MPH Attending Physician Department of Emergency Medicine Cook County (Stroger) Hospital Assistant Professor Rush Medical College Chicago, Illinois Patrick M. Lank, MD Fellow Division of Medical Toxicology Toxikon Consortium Cook County (Stroger) Hospital Attending Physician Department of Emergency Medicine Northwestern Memorial Hospital Chicago, Illinois CONTRIBUTORS William B. Lauth, MD, FACEP Clinical Professor Department of Emergency Medicine Rosalind Franklin University, The Chicago Medical School Attending Physician Department of Emergency Medicine Captain James A. Lovell Federal Health Care Center North Chicago, Illinois Moses S. Lee, MD, FAAEM, FACEP Assistant Professor Emergency Medicine Rush Medical College Attending Physician Emergency Medicine Cook County (Stroger) Hospital Chicago, Illinois Trevor J. Lewis, MD Associate Professor Department of Emergency Medicine Rush Medical College Medical Director Emergency Department Cook County (Stroger) Hospital Chicago, Illinois Nathan Lewis, MD Assistant Professor Department of Emergency Medicine Virginia Commonwealth University School of Medicine Richmond, Virginia Chuang-yuan Lin, MD Department of Emergency Medicine Cook County (Stroger) Hospital Chicago, Illinois Jenny J. Lu, MD, MS Assistant Professor Department of Emergency Medicine, Division of Medical Toxicology Cook County (Stroger) Hospital Chicago, Illinois David E. Manthey, MD Professor Emergency Medicine Wake Forest School of Medicine Winston-Salem, North Carolina Anitha E. Mathew, MD Clinical Instructor Department of Emergency Medicine Emory University School of Medicine Attending Physician Department of Emergency Medicine Emory University Hospital and Grady Memorial Hospital Atlanta, Georgia xii Alisa A. McQueen, MD Assistant Professor CONTRIBUTORS Department of Pediatrics, Section of Pediatric Emergency Medicine University of Chicago Pritzker School of Medicine Attending Physician Pediatric Emergency Medicine University of Chicago Comer's Children Hospital Chicago, illinois Biswadev Mitra, MBBS, MHSM, PhD, FACEM Emergency & Trauma Centre The Alfred Hospital Melbourne, Australia Brooks L. Moore, MD Assistant Professor Department of Emergency Medicine Emory University School of Medicine Attending Physician Department of Emergency Medicine Emory University Hospital and Grady Memorial Hospital Atlanta, Georgia Tom Morrissey, MD, PhD Associate Professor Department Emergency Medicine University of Florida-Jacksonville Jacksonville, Florida Jordan B. Moskoff, MD Associate Medical Director Department of Emergency Medicine Cook County (Stroger) Hospital Assistant Professor Department of Emergency Medicine Rush Medical College Chicago, illinois Mark B. Mycyk, MD, FACEP, FACMT Associate Professor Department of Emergency Medicine Rush Medical College Northwestern University Feinberg School of Medicine Attending Physician Department of Emergency Medicine Cook County (Stroger) Hospital Chicago, illinois Isam F. Nasr, MD, FACEP Assistant Professor Department of Emergency Medicine Rush Medical College Attending Physician Department of Emergency Medicine Cook County (Stroger) Hospital Chicago, illinois Michael E. Nelson, MD, MS Attending Physician, Medical Toxicology Fellow Department of Emergency Medicine Cook County (Stroger) Hospital Chicago, illinois Attending Physician Department of Emergency Medicine Northshore University Health System Evanston, Illinois Erik K. Nordquist, MD Assistant Professor Department of Emergency Medicine Cook County (Stroger) Hospital Chicago, illinois Paula E. O ldeg, MD, FACEP Attending Physician Department of Emergency Medicine West Suburban Medical Center Oak Park, Illinois Adjunct Clinical Instructor Department of Emergency Medicine Rush Medical College Chicago, illinois S. Margaret Paik, MD Assistant Professor of Pediatrics Department of Pediatrics Associate Section Chief, Pediatric Emergency Medicine The University of Chicago Comer Children's Hospital Chicago, illinois Lisa R. Palivos, MD Assistant Professor Department of Emergency Medicine Rush Medical College Attending Physician Department of Emergency Medicine Cook County (Stroger) Hospital Chicago, illinois Jonathon D. Palmer, MD Assistant Professor Department of Emergency Medicine University of Arkansas for Medical Sciences Little Rock, Arkansas Matthew S. Patton, MD Department of Emergency Medicine Northwestern University Feinberg School of Medicine Chicago, illinois Rahul G. Patwari, MD Medical Student Clerkship Director Assistant Professor Attending Physician Department of Emergency Medicine Rush Medical College Chicago, illinois Monika Pitzele, MD, PhD Attending Physician Department of Emergency Medicine Mount Sinai Hospital Chicago, Illinois Henry Z. Pitzele, MD, FACEP Deputy Director Emergency Medicine Jesse Brown VA Medical Center Clinical Assistant Professor Department of Emergency Medicine University of Illinois at Chicago Chicago, Illinois Natalie Radford, MD Associate Professor Department of Clinical Medicine Florida State University Attending Physician Bixler Emergency Department Tallahassee Memorial Hospital Tallahassee, Florida Christopher Reverte, MD Chief Resident Department of Emergency Medicine LA County + USC Medical Center Los Angeles, California Attending Physician Department of Emergency Medicine St. Luke's-Roosevelt New York, New York Neil Rifenbark, MD Department of Emergency Medicine University of Southern California Department of Emergency Medicine LA County + USC Medical Center Los Angeles, California Rebecca R. Roberts, MD Director, Research Division Attending Physician Department of Emergency Medicine Cook County (Stroger) Hospital Chicago, Illinois Sarah E. Ronan-Bentle, MD, MS, FACEP Assistant Professor Department of Emergency Medicine University of Cincinnati College of Medicine Attending Physician Center for Emergency Care University Hospital Cincinnati, Ohio CONTRIBUTORS David H. Rosenbaum, MD, FAAEM Attending Physician Department of Emergency Medicine WakeMed Health and Hospitals Raleigh, North Carolina Adjunct Professor Department of Emergency Medicine xiii University of North Carolina School of Medicine Chapel Hill, North Carolina Christopher Ross, MD, FRCPC, FACEP, FAAEM Assistant Professor Department of Emergency Medicine Associate Chair Planning, Education, and Research Cook County (Stroger) Hospital Chicago, Illinois John Sarko, MD Attending Physician Department of Emergency Medicine Maricopa Medical Center Assistant Professor Department of Emergency Medicine University of Arizona Phoenix School of Medicine Phoenix, Arizona Shari Schabowski, MD Assistant Professor Department of Emergency Medicine Rush Medical College Attending Physician Department of Emergency Medicine Cook County (Stroger) Hospital Chicago, Illinois Conor D. Schaye, MD, MPH Department of Emergency Medicine Northwestern Memorial Hospital Chicago, Illinois Michael A. Schindlbeck, MD, FACEP Assistant Professor Department of Emergency Medicine Rush Medical College Assistant Residency Director Cook County (Stroger) Hospital Chicago, Illinois Suzanne M. Schmidt, MD, FAAP Clinical Instructor Department of Pediatrics Northwestern University Feinberg School of Medicine Attending Physician Department of Pediatrics Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, Illinois xiv T heresa M. Schwab, MD Attending Physician Department of Emergency Medicine Advocate Christ Medical Center Oak Lawn, Illinois Assistant Professor Department of Emergency Medicine University of Illinois at Chicago Chicago, Illinois Brian R. Sellers, MD Department of Emergency Medicine CONTRIBUTORS Northwestern University Feinberg School of Medicine Chicago, Illinois Emily L. Senecal, MD Clinical Instructor Department of Emergency Medicine Harvard Medical School Attending Physician Department of Emergency Medicine Massachusetts General Hospital Boston, Massachusetts Michelle Sergei, MD Assistant Professor Department of Emergency Medicine Rush Medical College Attending Physician Department of Emergency Medicine Cook County (Stroger) Hospital Chicago, Illinois Scott C. Sherman, MD Medical Student Clerkship Director PA Residency Director Associate Residency Director Department of Emergency Medicine Cook County (Stroger) Hospital Rush Medical College Chicago, Illinois Jeffrey N. Siegelman, MD Assistant Professor Department of Emergency Medicine Emory University Atlanta, Georgia Jessica Sime, MD Department of Emergency Medicine Union Memorial Hospital Baltimore, Maryland Lauren M. Smith, MD Assistant Professor Department of Emergency Medicine Rush Medical College Attending Physician Department of Emergency Medicine Cook County (Stroger) Hospital Chicago, Illinois William T homas Smith, MD Emergency Medicine Oregon Health and Sciences University Portland, Oregon Shannon E. Staley, MD Pediatric Emergency Medicine Fellow Department of Pediatrics University of Chicago Comer Children's Hospital Chicago, Illinois Christine R. Stehman, MD Clinical Fellow Department of Surgery, Division of Trauma, Burn, and Surgical Critical Care Associate Physician Department of Emergency Medicine Brigham and Women's Hospital, Harvard Medical School Boston, Massachusetts Harsh Sule, MD, FAAEM, FACEP Assistant Professor Department of Emergency Medicine Thomas Jefferson University & Hospitals Philadelphia, Pennsylvania Gim A. Tan, MBBS, FACEM Adjunct Lecturer Department of Emergency Medicine Monash University Senior Emergency Physician Emergency and Trauma Centre The Alfred Hospital Melbourne, Australia Katie L. Tataris, MD Department of Emergency Medicine Cook County (Stroger) Hospital Chicago, Illinois Matthew C. Tews, DO Associate Professor Department of Emergency Medicine Medical College of Wisconsin Milwaukee, Wisconsin CONTRIBUTORS S. Spencer Topp, MD Assistant Professor Department of Emergency Medicine University of Florida Health Science Center-Jacksonville Jacksonville, Florida Brandon C. Tudor, MD Private Practice Everett, Washington Katrina R. Wade, MD, FAAEM, FAAP Associate Professor Department of Surgery, Emergency Medicine Division Assistant Professor, Pediatrics Department of Pediatrics Saint Louis University School of Medicine St. Louis, Missouri David A. Wald, DO Professor of Emergency Medicine Medical Director, William Maul Measey Institute for Clinical Simulation and Patient Safety Temple University School of Medicine Philadelphia, Pennsylvania Joseph Walline, MD Assistant Professor Department of Surgery, Division of Emergency Medicine Saint Louis University School of Medicine Saint Louis, Missouri Joseph M. Weber, MD EMS Medical Director Department of Emergency Medicine Cook County (Stroger) Hospital Assistant Professor of Emergency Medicine Rush Medical College Chicago, Illinois Joanne C. Witsil, PharmD, RN, BCPS Adjunct Clinical Assistant Professor Department of Pharmacy Practice University of Illinois at Chicago Clinical Pharmacist Department of Emergency Medicine Cook County (Stroger) Hospital Chicago, Illinois Kathleen A. Wittels, MD Instructor in Medicine Department of Emergency Medicine Harvard Medical School Associate Clerkship Director Department of Emergency Medicine Brigham and Women's Hospital, Harvard Medical School Boston, Massachusetts Lynne M. Yancey, MD, FACEP Associate Professor Department of Emergency Medicine University of Colorado School of Medicine Denver, Colorado Attending Physician Department of Emergency Medicine University of Colorado Hospital Aurora, Colorado Leslie S. Zun, MD Professor Emergency Medicine Chicago Medical School Chair Emergency Medicine Mount Sinai Hospital Chicago, Illinois Preface We wrote this book because we remember our own experiences as medical students and junior residents working in the emergency department (ED). The ED is a unique environment that requires knowledge and skills often not covered in medical or physician assistant school. In this book, we attempt to create a resource for the medical student, physician assistant, nurse practitioner, and junior-level resident to use to get a grasp on the issues and scope of problems that they will confront while working in the ED. The book's length and format are designed to allow the student and practitioner to begin to digest the broad range of topics inherent to emergency medicine (EM). Each chapter begins with a section on Key Points, followed by an Introduction, Clinical Presentation (History and Physical Examination), Diagnostic Studies, Medical Decision Making, Treatment, and Disposition. Whenever possible, we tried to give practical information regarding drug dosing, medical decision-making thought processes, treatment plans, and dispositions that will actually allow you to function more comfortably in the clinical environment. The diagnostic algorithms are a unique feature that attempt to simplify the problem and point the clinician in the right direction. The book has 19 sections and 98 chapters that cover the entire contents of the EM clerkship curriculum (Acad Emerg Med. 201 0; 1 7:638-643). The authors are all practicing emergency physicians and EM educators from throughout the country. For medical student clerkship directors, we believe that this text is the perfect book for the student to pick up and digest during a 4-week rotation. In summary, we hope this book will enhance the emergency medicine experience of all its users. xvi Scott C. Sherman, MD Joseph M. Weber, MD Michael Schindlbeck, MD Rahul Patwari, MD Download pdf
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