Markovchick Vincent J., Pons Peter T., Bakes Katherine M.(ed.) Emergency medicine secrets. 5th ed
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INDEX738
Neurotmesis, of the radial nerve, 626
Neurotoxic shellfish poisoning, 356
Neutropenia
as oncologic emergency, 297t
febrile, 299b
NEXUS criteria, for cervical radiography, 62, 576-577, 578
Nicardipine, 226-227t
Nikolsky’s sign, 376
Nitrogen oxides, as smoke component, 507
Nitroglycerin, 226-227t
as acute coronary syndrome treatment, 206
as pulmonary edema treatment, 198
as reperfusion therapy adjuvant, 205
use in chest pain evaluation, 84
Nitroprusside, 226-227t
Nitrous oxide, 463t
Nodules
definition of, 375t
thyroid, 317, 322
Noninvasive intermittent ventilation (NIV), 178
Nonsteroidal anti-inflammatory drugs (NSAIDs)
as antipyretic agents, 76
as fever cause, 77t
as gout treatment, 373
as peptic ulcer cause, 236
as renal colic treatment, 258-259, 258t
Norepinephrine, as severe sepsis treatment, 328
Nose
foreign bodies in, 138-139
fractures of, 63-64, 570-571
Nosebleeds. See Epistaxis
nPEP, 544
Nuclear bombs, 702
Number needed to treat, 57
Nursemaid’s elbow, 630
Nystagmus, 108
induced, 133
psychogenic coma-related, 74
vertical, 107
O
Obesity, as gout risk factor, 373
Obstipation, 88
Occupational injuries, electrical injuries, 389
Ocular emergencies. See Ophthalmologic emergencies
Oculocephalitic testing, in comatose patients, 71
Oculovestibular testing, in comatose patients, 71, 72f
Odds ratio, 58
Odynophagia, esophageal causes of, 235-236
Olanzapine, as chemical restraint, 673, 674-675t
Oncologic emergencies, 296-300. See also specific
types of cancer
Ondansetron, 95-96t
“One pill can kill” list, 529-534
Open chest cardiac massage, 13
Open water wounds, 335
Ophthalmologic disorders
Graves’ disease-related, 317, 320
thyrotoxicosis-related, 317
Ophthalmologic emergencies
in AIDS patients, 345
nontraumatic, 129-134
traumatic, 587-590
Opiate, definition of, 511
Opiate syndrome, 477t
Opioid(s)
as mortality cause, 473
toxicology screen for, 514
Opioid abuse, 511
Opioid poisoning, 511-512, 513, 519-520
Opioid withdrawal, 513
Opium, 511
Oral cavity
bites to, 149
burns to, 148-149
Oral hypoglycemic agents, 314
Oral surgical emergencies, 146-154
Orbital floor, fractures of, 568, 569b
Orchitis, mumps-related, 448
Orogastric intubation, contraindication to, 238
Orthopedics. See also Fractures
pediatric, 628-631
Osmolal gap, 305-306
Osmolality, 305
in poisoning patients, 476
Osmolarity, determination of, 313
Osmolol gap, 485-486
Osmotic demyelinating syndrome, 305
Osteitis, alveolar, 152, 152b
Osteoarthritis, 368, 369t
hip dislocation-related, 627
Osteochondral fragments, 628
Osteomyelitis, 141
sickle cell disease-related, 294
Osteonecrosis. See also Necrosis, avascular
of the jaw, 152, 152b
Otitis externa, 142-143
malignant, 143-144, 315
Otitis media, measles-related, 447
Otolaryngology, nontraumatic emergencies in, 135-145
Outpatient treatment
for burn patients, 642-643
of congestive heart failure patients, 199
Overdose. See also Poisoning
of antipyretic agents, 489-495
asymptomatic, 474
of opioids, 511-512, 513, 519-520
of sedative-hypnotics, 516-517
Oversedation, in pediatric patients, 464-465
Oxygen delivery, definition of, 29
Oxygen delivery systems, fraction of inspired oxygen
(FiO
2
) in, 170-171
Oxygen demand, in sepsis, 328
Oxygen saturation levels
in chronic obstructive pulmonary disease, 177
in comatose patients, 71
measurement of, 170
venous, 30
Oxygen supply, in sepsis, 328
INDEX 739
Oxygen therapy
for seizures, 114
for smoke inhalation, 506
Oxygenation, 18
Oysters, raw, as Vibrio vectors, 356
P
Pacemaker syndrome, 215
Pacemakers, 212
DDD setting for, 214, 214t
external/transcutaneous, 213
magnet-mediated pacing, 215-216
malfunction of, 215, 216t, 217
permanent, 213-214, 215, 217
runaway, 216
temporary, 212-213
transthoracic, 213
transvenous, 213
Packing, nasal, 136-137, 136t, 137b
Pain
abdominal, 87-91
appendicitis-related, 240, 241t
in children, 90, 440-441
in elderly patients, 44, 88
of gastric or duodenal origin, 236
left lower quadrant, 65
in pediatric patients, 441t, 446t
renal colic-related, 255
right lower quadrant, 240, 241t
right upper quadrant, 65
alleviation of, 10
burn-related, 643
in chest, 80-86
chronic renal failure-related, 280
differential diagnosis of, 203-204
differentiated from pericarditis, 230
evaluation of, 80-81, 81f, 84
imaging-based evaluation of, 63
ischemic heart disease-related, 201-202
myocardial infarction-related, 201
pleuritic, 203
radiating, 81
compartment syndrome-related, 622-623
epigastric, 239
esophageal, 80, 82t, 83-84
in knee, hip disorders-related, 627
low back, 124-128
musculoskeletal, as chest pain cause, 80, 81-83,
82t, 84
as oncologic emergency, 297t
orofacial, nonodontogenic sources of, 149
relationship to vomiting, 87
scrotal, 66, 260
somatic (parietal), 87
visceral, 87
Pallor, compartment syndrome-related, 623
Palonosetron, 95-96t
Palpation, in chest trauma, 596
Pancreatic injury, amylase as indicator of, 603
Pancreatitis
as chest pain cause, 80
imaging of, 64
Pancuronium, for rapid-sequence intubation, 21-22t
Panencephalitis, subacute sclerosing, 447
Paper bag rebreathing treatment, of hyperventilation
syndrome, 309
Papilledema, 98t
differentiated from optic neuritis, 133, 134t
Paraldehyde, as elevated anion gap cause, 307
Paralysis
compartment syndrome-related, 623
hyperkalemic periodic, 303
lumbar puncture-related, 165
Paralytic drugs, for rapid-sequence intubation, 20,
21-22t, 23
Paralytic shellfish poisoning, 356
Paraplegia, 574
lightning, 386
Paresthesia, compartment syndrome-related, 623
Parkland formula, 392, 640-641, 642
Paronychia, 635
Partial thromboplastin time (PTT), 283-284
in coagulopathies, 288
in sepsis, 327
Parvovirus B19 virus infections, 376, 448
Pasteurella infections, 335, 624
Patella, dislocation of, 628
Patient Outcome Research Team (PORT), PSI score of,
183t, 184t, 186
Patients
agitated
alcoholic patients as, 482
management and restraint of, 670-676
evaluation of, 7
high-risk for malpractice lawsuits, 686
life-threatened, 7
psychotic, 658
refusal of care by, 688
violent
hypoglycemia in, 316
management of, 670-676
Peak expiratory flow rate (PEFR), in asthma,
174-175
Pediatric assessment triangle, 467
Pediatric Asthma Score, 438t
Pelvic C-clamp, 609
Pediatric drug ingestions, 529-534
Pelvic examination
in female dysuria patients, 271
in patients with abnormal vaginal discharge, 340
in pelvic fracture patients, 607
Pelvic inflammatory disease (PID), 535-539
Pelvic mass, palpable, 64-65
Pelvic packing, 610
Pelvis
fractures of, 626-628
stabilization of, 609
ultrasound evaluation of, 37
Pemphigus, 374
INDEX740
Penetrating trauma
to the chest, 596, 600, 605f
differentiated from blunt trauma, 602
to the liver, 603
to the neck, 592-593, 594
Penicillin, as fever cause, 76, 77t
Penis, fractures of, 612
Pentobarbital, 463t
Peptic ulcers, 236, 239
as chest pain cause, 80
perforated, 236-237
Periarticular diseases, 368, 369t
Pericardial effusion, 231, 233
malignant, as oncologic emergency, 297t
sonographic evaluation of, 34-35, 35f, 39t
Pericardial friction rubs, 26
Pericarditis, 229-232
acute
differentiated from musculoskeletal chest
pain, 230
differentiated from myocardial infarction, 230
causes of, 229-230, 229t
as chest pain cause, 80, 81-83, 82t, 84, 280
infectious mononucleosis-related, 449
as myocardial infarction mimic, 205
Pericardium, normal, 229
Pericholecystic fluid, 249
Peripheral nervous system, electrical injuries to, 391t
Peritoneal dialysis
as chronic renal failure treatment, 276
as peritonitis cause, 277-278, 278b
Peritoneal lavage. See Lavage, peritoneal
Peritonitis, 88
diffuse, 602
localized versus generalized, 87
peritoneal dialysis-related, 277-278, 278b
spontaneous bacterial, 252, 252b
Pernio, 405
Persistent conditions, evaluation of, 9
Personal protective equipment (PPE), 699-700
Perthes’ disease, 631
Pertussis (whooping cough), 451
Peyote, 520
Phenazopyridine, 272
Phentolamine, 226-227t
Phenylephrine, action mechanism of, 32
Phenytoin, as alcohol withdrawal-related seizure
treatment, 481
Pheochromocytoma, 322, 325-326
Phosgene, as smoke component, 507
Phosphorated carbohydrate, 95-96t
Phosphorus replacement therapy, for diabetic
ketoacidosis, 313
Physical abuse
of children, 453-454
of the elderly, 42
of pregnant patients, 613
Physical examination
of abdominal trauma patients, 602
for appendicitis diagnosis, 442
for arthritis diagnosis, 368-369
of chest pain patients, 83
of coagulopathy patients, 284
of headache patients, 99
of intimate partner violence victims, 678, 678b
of low back pain patients, 124
of patients with altered consciousness, 70
of patients with perforated peptic ulcers, 237
of pediatric seizure patients, 425
prior to pediatric sedation and analgesia,
462
of psychotic patients, 658
of seizure patients, 117
of sexual abuse victims, 458
of spinal trauma patients, 575
of syncope patients, 111
of urinary retention patients, 279
for vomiting evaluation, 93
of wound patients, 645-647
Physostigmine, as poisoning treatment, 478
Pilocarpine, 589
Placenta previa, 554
Placental abruption, 554, 605, 614
Plague, 348, 367
as biological weapon, 707, 709, 709t
Plaques, 375t
Plasmodium, as malaria causal agent, 360-361
Platelet transfusions, 285
Plethysmography, 169
impedance, 191
Pleural effusion, ultrasound evaluation of, 39t
Pneumatic antishock garment (PASG), 609
Pneumatosis intestinalis, 446t
Pneumocystis carinii, 56, 184, 344, 346
Pneumonia, 179-186
aspiration, 181t
as chest pain cause, 80, 81-84
community-acquired, 180, 181t, 182t, 185t
blood cultures in, 186
epidemiology of, 184
infectious mononucleosis-related, 449
measles-related, 447
Pneumocystis carinii, 56, 184, 344, 346
predisposing factors for, 179, 180t
risk stratification in, 182, 183t, 184t, 186
as serious bacterial infection component, 417
smoke inhalation-related, 506
in spinal cord injury patients, 575
treatment of, 182, 185t
“typical” differentiated from “atypical,”
179-180
Pneumonia-specific severity of illness (PSI) score,
183t, 184t, 186
Pneumothorax
as chest pain cause, 80, 81-84, 82t
simple, 596
tension, 596-597, 597b, 599
as cardiopulmonary arrest cause, 12-13
Poison ivy, 381
Physical examination (Continued)
INDEX 741
Poisoning
antidotes to, 478-479
general approach to, 473-479
mushroom-related, 355, 357, 519-520
Polyarticular diseases, 369t
Polymorphonuclear leukocytes, in pus formation,
331-332
Popliteal artery, knee dislocation-related injury to,
628
Positive end-expiratory pressure (PEEP), 172
Positive predictive value, 58
Postconcussive syndrome, 582
Posterior fossa herniation syndrome, 584
Posterior interosseous nerve, fracture-related injury to,
626
Posterior reversible leukoencephalopathy syndrome,
100, 105
Postpartum period, thyroiditis during, 317
Potassium
in acidosis and alkalosis, 309
intracellular movement of, 303-304
removal from body, 304
Potassium iodine (KI) tablets, 703
Potassium replacement therapy, for diabetic
ketoacidosis, 313
Power, statistical, 56
Pralidoxime, as poisoning treatment, 478
Pralidoxime chloride, as nerve agent toxicity treatment,
705-706
Pre-diabetes, 312
Predictive values, 58
Prednisone, as asthma treatment, 437
Preeclampsia, 222, 557
Pregnancy
abdominal trauma during, 605
appendicitis during, 240
asthma treatment during, 176
b-hCG in, 552
complications, 557-562
diarrhea treatment during, 358
ectopic, 240, 550-551
electrical injuries during, 391t
fever treatment during, 76
gestational diabetes mellitus of, 315
headaches during, 105
hypertension during, 222, 557
intrauterine, ultrasound evaluation of,
37, 39t
intravenous pyelography during, 256
perirectal abscesses during, 334
pelvic inflammatory disease during, 538
physiologic changes during, 613-614
pulmonary embolism diagnosis in, 192
sexual assault-related, 543
prophylaxis against, 543
in sickle cell disease patients, 294
tetanus vaccination during, 353
trauma in, 613-616
ultrasound evaluation of, 37
urinary tract infections during, 270
Pregnancy testing
for abdominal pain evaluation, 89
in sexual assault victims, 457
Preload, 196
Premature ventricular contraction, 210
Procainamide, 211t
as ventricular fibrillation treatment, 14
Procaine, 648t
Procedural problems, in safety management, 51
Prochlorperazine, 95-96t
as headache treatment, 103t
Proctitis, 341
Promethazine, 95-96t
Propofol, 23, 24t, 461, 463t
Propoxyphene, 514
adverse effects of, 515
Prostatitis, 274
acute bacterial, 274
chronic bacterial, 274
definition of, 270
Protected health information (PHI), 696-697
Protein C, activated, 288, 329
Proteus infections, 270, 334-335
Prothrombin time (PT), 283-284
in coagulopathies, 288
in sepsis, 327
Prothrombotics, new, 288
Protopam, as poisoning treatment, 478
Proximal interphalangeal joint, rheumatoid arthritis of,
368-369
Proximate cause, 686
Pruritus, AIDS-related, 344-345
Pseudoaneurysm, 224
Pseudogout, 368, 371t
differentiated from gout, 373
Pseudomonas infections
of bite wounds, 335
epididymitis, 262
necrotizing fasciitis, 334-335
otitis externa, 143-144
pneumonia, 180, 181t, 506
septic arthritis, 370, 372t
urinary tract, 270
Pseudoseizures, 119
Pseudotumor cerebri, as headache cause, 97, 98t, 104
Psilocybin, 520
Psoriasis, steroid therapy contraindication in, 381
Psychiatric disorders
lightning injury-related, 388t
as suicide risk factor, 666
Psychiatric patients, 47, 51t
Psychological abuse, of the elderly, 42
Psychology, as basis for safety management, 51, 54
Psychosis
acute, 657-662
depression-related, 664
organic differentiated from functional, 658-659,
659t
Pterygium, 131
Puffer fish poisoning, 356
INDEX742
Pulmonary function tests, 169
Pulseless electrical activity (PEA), as cardiopulmonary
arrest cause, 13, 15
Pulselessness, compartment syndrome-related, 623
Pulse oximetry, 18, 169-170, 170b, 307
in asthma, 174
in chronic obstructive pulmonary disease, 177
in smoke inhalation patients, 507
Pulse-temperature dissociation, 77
Pulsus paradoxus, 231
Pupils
Adie’s, 132
afferent defects of, 131, 132-133, 132b
Argyll-Robertson, 132
dilated, 131, 589
Marcus Gunn, 131, 132b
miotic, 132
reactivity of, in comatose patients, 71
Purpura
Schamberg’s, 381
solar, 381
systemic disease-related, mimics of, 381
thrombocytopenic
idiopathic, 284-285
thrombotic, 285
Purpuric gloves and socks syndrome, 376
Pus, 331-332
Pustules, 375t
p value, 57
Pyelonephritis, 273-274, 273b
acute, uncomplicated, 272-273
definition of, 270
emphysematous, 315
during pregnancy, 270
Pyloric stenosis, 443-444, 446t
Pylorus, enlarged, 446t
Pyoderma gangrenosum, 381
misdiagnosed as spider bite, 380
Pyuria, 271
Q
QRS complex, propoxyphene-related widening of, 515
Q-tip sign, 340
R
Rabies, 149, 501
postexposure prophylaxis against, 501
RACQITO, 48-49
Radial head, in nursemaid’s elbow, 630
Radial nerve
humeral shaft fracture-related injury to, 626
motor function testing of, 634
sensory distribution of, 633, 634f
Radiation
basic physics of, 700
of body heat, 401
shielding requirements for, 700, 701t
as thermoregulatory mechanism, 407
units of, 700, 700t
as weapon of mass destruction, 700-703, 700t,
707
Radiation burns, 638
Radiation exposure
fetal, 614
imaging-related, 61-62, 62b
Radiation injuries, types of, 701-702
Radiation syndromes, acute (ARS), 702-703, 703t
Radiation therapy, complications of, as oncologic
emergency, 297t
Radiation-contaminated patients, decontamination of,
711
Radicular pain, 125
Radio fibringen leg scanning, 191
Radioisotopes, 700
Radiological dispersal device (RDD), 702
Randomized controlled trials, 56-57
Ranitidine, as depression cause, 664
Rape, 540-546
drug facilitated, 542
Rapid-sequence intubation. See Intubation,
rapid-sequence
Rash
arthritis-related, 372b
erythema infectiosum-related, 448
heat rash, 408
measles-related, 447
toxic shock syndrome-related, 350
Reactive airway disease, as wheezing cause, 174
Rectal examination, for abdominal pain evaluation,
90
Rectal injuries, pelvic injuries-associated, 610
Rectal temperature, 75, 417
Recurrent conditions, evaluation of, 9
“Red eye,” 129, 130t
Referrals, 9
to otolaryngologists, 141
of sinusitis patients, 141
Referred pain, 125
Rehydration, in vomiting patients, 94
Reiter’s syndrome, 368, 369t, 370, 372
Relapsing fever, 363t, 365
Relative risk, 58
Renal disease, end-stage. See Renal failure, chronic
Renal failure
acute
ibuprofen overdose-related, 495
sepsis-related, 327
chronic, 276-282
as altered mental status cause, 281
as hyperkalemia cause, 303-304
as hypotension cause, 280
as elevated anion gap cause, 307
Renal pedicle injuries, 610-611
Renal stones, 255-257, 256b, 258-259, 258t
imaging of, 38, 63
removal of, 256
alternatives to, 259
Radiation (Continued)
INDEX 743
Renal system
electrical injuries to, 391t
lightning injuries to, 388t
Reperfusion therapy, for acute myocardial infarction,
204-205
Reporting
of child abuse, 454
of intimate partner violence, 679
of sexually-transmitted diseases, 341
Reproductive disorders, thyrotoxicosis-related, 317
Rescue airway devices, 18-27
Residency training, in emergency medicine, 689
Respiration, body heat loss through, 401
Respiratory depression
isopropyl alcohol-related, 487
opioid-related, 512
salicylate overdose-related, 490-491
Respiratory disorders
HIV infection-related, 344
hypothyroidism-related, 320
in pediatric patients, 431-439
Respiratory distress, in pediatric patients, 431,
432f
Respiratory failure
in pediatric patients, 431, 439
smoke inhalation-related, 509
Respiratory rate, 169
abnormal, 8
in comatose patients, 71
inaccuracte measurement of, 8
in pediatric patients, 431, 617
in systemic inflammatory response syndrome
(SIRS), 327
Respiratory syncytial virus, 434
Respiratory system
electrical injuries to, 391t
lightning injuries to, 388t
Restraint
of alcoholic patients, 482
of psychotic patients, 661
of violent patients, 671-672
Resuscitation
ABCs of, 11
exceptions to, 12
cardiopulmonary, 11-17
of elderly patients, 44
fetal, 613
maternal, 613
of near-drowning victims, 396-397, 398
of opioid overdose patients, 511
of pediatric patients, 619
neonates, 469-471, 471b
of pregnant patients, 614-615
of septic patients, 328
of shock patients, 28, 30-31, 32
termination of, 15-16
withholding of, 398
Retinal artery, central, occlusion of, 132-133, 133t, 587
Retinal vein, central, occlusion of, 132-133, 133t
Retinitis, cytomegalovirus, 345
Retropharyngeal space, infections of, 144, 433t, 434
Return of spontaneous circulation (ROSC), 12-13, 16
Rewarming
core, 403
following hypothermia, 403-404
of frostbitten tissues, 405-406
Reye’s syndrome, 76, 451
Reynold’s pentad, 248
Rh isoimmunization, prevention of, 615
Rheumatic fever, 369t, 370
Rheumatoid arthritis, 369t
as cervical spine subluxation risk factor, 575
juvenile, 631
synovial fluid analysis in, 371t
Rib, fractures of, 598, 603
in children, 620
Rickettsia rickettsia, as Rocky Mountain spotted fever
causal agent, 365
Rift Valley fever, 500
Ringer’s solution, lactated, as volume replacement
therapy, 302-303
Risk management, 685-689
Risperidone, as chemical restraint, 674-675t
Risus sardonicus, 352-353
Road rash, 649
Rocky Mountain spotted fever, 360, 363t, 365
skin findings in, 375
Rocuronium, 21-22t, 23
Roseola, 376, 448
Ross River virus, 500
Rotator cuff, tears of, 625
Rovsing’s sign, 442
Rubella, 447
Rule of 50, 531
“Rule of twos,” 445
Rumack-Matthew nomogram, 492
S
Sacral sparing, 579
SAD PERSONS Scale, 667, 668t
Safety management, in emergency medicine, 46-55
Salicylate intoxication, 307
Salicylate overdose, 489-491
Salicylate poisoning, 489-491
Salicylism, chronic, 491
Saline solutions
as increased intracranial pressure treatment, 585
as volume replacement therapy, 302-303
Salter-Harris classification, of epiphyseal fractures,
629, 629f, 631
Sample size, 56
Scabies, 498
Scalded skin syndrome, 451
Scaphoid bone, fractures of, 634, 637
Scarlet fever, 376
Scars, minimization of visibility of, 645, 646t
Schizophrenia, as suicide risk factor, 666
Sciatica, 125
Sciatic nerve, hip dislocation-related injury to, 626
INDEX744
SCIWORA (spinal cord injury without radiographic
abnormalities), 578, 619
Scombroid fish poisoning, 355-356
Scopolamine, 95-96t
Scopolamine patch, 587-588
Scorpion stings, 496-498
Scrotum, painful, 260, 260b
Seatbelt sign, 603
Secondary gain, 667
Secondary survey, 566
Second impact syndrome, 582
Secrets, Top 100, 1-6
Sedation
chemical restraint as, 673
contraindication in salicylate overdose, 490-491
levels of, 461
procedural
definition of, 648
in elderly patients, 43
in pediatric patients, 460-466
recurrent, opioid-related, 512
Sedative-hypnotics, 516-519
as depression cause, 664
as mortality cause, 473
overdose of, 477t
Seizures, 113-119
AIDS-related, 343-344
alcohol withdrawal-related, 480-481
as altered mental status cause, 72
causes of, 113, 115t
classification of, 113, 114t
COLD mnemonic for, 116-117
differential diagnosis of, 113
febrile, 418, 426-427
definition of, 426
as epilepsy risk factor, 427
in pediatric patients, 358, 424f, 425-426
grand mal, as lactic acidosis cause, 308
hyponatremia-related, 306
imaging studies of, 118, 119b
as lactic acidosis cause, 308
normeperidine-related, 514-515
as oncologic emergency, 297t
opioids-related, 514
in pediatric patients, 423-430
asymptomatic, 428
febrile, 358, 424f, 425-426
primary, 113
propoxyphene-related, 515
secondary (reactive), 113, 115t
tramadol-related, 515
Sellick maneuver, 11, 20, 23
Sensitivity, statistical, 58
Sensory nerve function testing, 633
Sentinel bleed, 102
Sentinel events, 695
Sepsis, 686
definition of, 31, 327
early goal-directed therapy for, 30-31
as fever cause, 77
severe, 327-328
in spinal cord injury patients, 575
ventilator settings in, 172t
Sepsis syndromes, 327-330
Serious bacterial infection (SBI), 417
Serotonin reuptake inhibitors, 664
Serotonin syndrome, 477t, 514-515
Serum sickness, 369t, 448-449
Severe acute respiratory syndrome (SARS), 184
Sexual abuse
of children, 453-454, 457-459, 458b
of pregnant patients, 613
Sexual assault, 540-546
Sexually-transmitted diseases, 339-347
in pediatric sexual abuse victims, 458, 543
reporting of, 341
sexual assault-related, 542
Sexual play, 457-458
Shaken baby syndrome, 456, 581, 619
Shark attacks, 502
Sheehan’s syndrome, 321
Shellfish poisoning, 355-356
Shigellosis
as pediatric febrile seizure cause, 358
Shivering, 401
Shock, 28-33
anaphylactic, 32
burn-related, 640
cardiac tamponade-related, 32
cardiogenic, 28, 31-32
compensated, 29
decompensated, 29
definition of, 28, 32
distributive, 28, 32
hypovolemic, 28-29, 32
as lactic acidosis cause, 308
neurogenic, 32, 575-576
obstructive, 28, 32
in pediatric patients, 618
pulmonary embolism-related, 32
septic, 31, 329
shock, 579
toxic/metabolic, 28, 32
Short bowel syndrome, 307
Shoulder, dislocations of, 625
Sickle cell disease/anemia, 290-295
aplastic crisis of, 292
as chest pain cause, 80
hemolytic crisis of, 292
sequestration crisis of, 291-292
vaso-occlusion (pain) crisis of, 291,
294-295
Sickle cell trait, 290, 291t
SIG E CAPS (mnemonic), for depression symptoms,
663-664
Silver nitrate, as epistaxis (nosebleed) treatment, 136,
136t
Silver sulfadiazine, 649
Sinus beat, 208
Sepsis (Continued)
INDEX 745
Sinusitis, 140-141
as headache cause, 102-104
infectious mononucleosis-related, 449
as toxic shock syndrome risk factor, 348-349
Skeletal survey, 456-457
Skier’s thumb, 636
Skin
child abuse-related injuries to, 455
electrical injuries to, 391t
lightning injuries to, 388t
Skin diseases. See Dermatologic disorders
Skin tension lines, 653, 653f, 654f
Skull fractures
basilar, 582
child abuse-related, 455
“Slapped cheeks” erythema, 376, 448
Slipped capital femoral epiphysis (SCFE), 630-631
Small intestine, obstruction of, 89, 244
imaging of, 65
Smallpox, as biological weapon, 707, 709, 709t
Smoke inhalation, , 506-510, 18, 638
Snakebites, 352, 499, 502-504
“Sniffing position,” 432, 617-618
Snow blindness, 589
Snuffbox, in wrist trauma, 625
Sodium bicarbonate
as cardiac arrest treatment, 16
contraindication in near-drowning victim resusci-
tation, 397
as hyperkalemia treatment, 279-280
Sodium channel blockade, drug-related, 524
Soft-tissue infections, 331-338
methicillin-resistant Staphylococcus aureus-
related, 380-381
Southern tick-associated rash illness (STARI), 363t, 365
Spasms, infantile, 427
Specificity, statistical, 58
Spectrophotometry, 169
Sphenopalatine artery, as epistaxis (nosebleed) source,
135
Spider bites, 380, 496, 497t, 498-499
Spinal cord
compression of
as oncologic emergency, 298, 298b
as stroke mimic, 155
traumatic injury to, 574-580
Spinal cord injury without radiographic abnormalities
(SCIWORA), 578, 619
Spine
disorders of, as low back pain cause, 124, 125t
fractures of, 124, 125t
Spleen
blunt trauma to, 603
infectious mononucleosis-related rupture of, 449
Splenic sequestration, 284
Spondylolisthesis, 125t, 126-127
Spondylolysis, 125t, 126-127
Sputum Gram stain, for pneumonia diagnosis, 184-186
Stab wounds, 605
Stabilization, of patients, 8, 10
Staphylococcal scalded skin syndrome, 376
Staphylococcus aureus infections
meningitis, 164t
methicillin-resistant, 348
community-associated, 332-333, 337t
cutaneous findings in, 380-381
misdiagnosed as spider bite, 380-381
septic arthritis, 370, 372t
soft-tissue infections associated with, 380-381
otitis externa, 143
pneumonia, 180, 181t, 185t, 186t, 506
retropharyngeal and peritonsillar abscesses, 144
septic arthritis, 370
soft-tissue, 337t
toxic shock syndrome, 348, 349-350
Staphylococcus infections
of bite wounds, 335
necrotizing fasciitis, 334-335
Staphylococcus saprophyticus infections, 270
Staples, surgical, 650
STARI (southern tick-associated rash illness), 363t, 365
Statistical terminology, 58, 58f
Status epilepticus, 116, 117t, 429
Stenson’s duct, injuries to, 572-573, 572f
Stereotypies, 423
Sternoclavicular joint, dislocations of, 626
Sternum, fractures of, 598
Steroids
as headache treatment, 103t
as meningitis treatment, 166
as spinal trauma treatment, 579
systemic, as dermatitis treatment, 381
Stevens-Johnson syndrome, 374, 378-379t
Stimulants, 520-523
Stings
from ants, 498
from bees and wasps, 498-499
from scorpions, 498
Straddle injury, 610
Straight leg raise test, 124-125, 126
Strangulation, smoke inhalation-related, 506
Streptococcus agalactiae infections, 370
Streptococcus infections
of bite wounds, 335
necrotizing fasciitis, 334-335
Streptococcus pneumoniae infections
meningitis, 164t, 167t
pneumonia, 179-180, 181t, 184, 185t
penicillin-resistant, 372t
septic arthritis, 370, 372t
sinusitis, 140
Streptococcus pyogenes infections, 144
Stress, as gout risk factor, 373
“String of pearls” sign, 244
Stroke, 686
blood pressure management in, 160
conditions which mimic, 161
definition of, 155
differentiated from transient ischemic attack (TIA),
155, 156t
INDEX746
Stroke (Continued)
as headache cause, 98t, 99-100
hemorrhagic, 155, 221
differentiated from ischemic, 160
treatment of, 160
high-risk patients for, 161
ischemic, 155-156, 221
differentiated from hemorrhagic, 160
treatment of, 160-161
mimics of, 155
severity assessment of, 157
sickle cell disease-related, 292
thrombolytic therapy for, 157
as vision loss cause, 133t
Stroke volume, in congestive heart failure, 195
Struvite renal stones, 255-256
Submersion incidents, 395-400
in cold water, 398
Succinylcholine
adverse effects of, 23
for rapid-sequence intubation, 21-22t, 23
use in burn patients, 639
Sudden infant death syndrome (SIDS), 457
Sudden unexplained death of infancy (SUDI), 457
Suicide, 397, 665-667
alcohol abuse-related, 664
depression-related, 665
intimate partner violence-related, 678
Sulfur dioxide, as smoke component, 507
Sumatriptan, 100-101, 103t
Superior vena cava oxygen saturation (ScVO
2
), 327
Superior vena cava syndrome, 296
as oncologic emergency, 297t
Supracondylar humeral fractures, in children, 629-630
Supraventricular rhythm, with aberrancy, 210, 211t
Surfactant therapy, 398
Sutures, 651t, 652t
Swan-neck deformity, 368
Swimmer’s ear. See Otitis externa
Sympathomimetic syndrome, 477t
Syncope, 107
of cardiac origin, 110
causes of, 110, 110b
definition of, 109
evaluation of, 110-111, 112
heat, 408-409
orthostatic, 423
Syndrome of inappropriate antidiuretic hormone
secretion (SIADH), 221, 305
Syndrome X, 315
Synovial fluid analysis, for arthritis diagnosis, 370, 371t
Synovitis
toxic, 370
transient, in pediatirc patients, 630-631
Syphilis, 339
chancre of, 341
latent, 341
primary, 341
secondary, 341
treatment of, 341
Systemic inflammatory response syndrome (SIRS),
31, 77, 327, 327b
Systemic lupus erythematosus
as arthritis cause, 372
joint involvement in, 369t
rash associated with, 368, 372
T
Tachyarrhythmias, 208-209
Tachycardia
narrow-complex, 208-209
pacemaker-mediated, 216
pericardial tamponade-related, 599
peritonitis-related, 88
relationship with fever, 77
tension pneumothorax-related, 597
wide-complex, 208-209, 210-211, 211t
Tachypnea, in children, 617
Tamponade, cardiac
as cardiopulmonary arrest cause, 12-13
as oncologic emergency, 296, 297t
pericardial, 231, 598-599, 599b
in chronic renal failure patients, 278, 280
as shock cause, 32
ultrasound evaluation of, 39t
Tampons, as toxic shock syndrome risk factor,
348-349
Tarantula bites, 496
Target lesion, 376-377
Target sign, of intussusception, 443
Tattooing, 649
as tetanus cause, 352
Teeth
avulsed, 146, 148
extraction, hemorrhage following, 151
fractures of, 146, 148, 148f
numbering system for, 146, 147t
reimplantation of, 148
Temporomandibular joint, dislocation of, 571
Tendinitis, 368, 369t
Tendon injuries, 686
partial lacerations, 633
Terbutaline, as asthma treatment, 176t
Terrorism/terrorist attacks, 699, 711
Testicular torsion, 260-261, 261b
Testicular trauma, 612
Testis, appendix, 261
Tetanus, 352-353
neonatal, 352
Tetanus booster, 336
Tetanus immunization/vaccine, 353
in burn patients, 643
in HIV-infected patients, 345
Tetanus immunoglobulin, 353
Tetraplegia, 574
b-Thalassemia, 290, 291t
Thawing, of frostbitten tissues, 405-406
Thermal burns, 638
to the airway, 639
INDEX 747
Thermoregulation, 407
impaired, 402
Thiamine, administration to alcoholic patients, 483
Thiamine deficiency, as metabolic acidosis cause,
308, 310
Thiazolidinediones, 314
Thiethylperazine, 95-96t
Thionamides, as thyroid storm treatment, 319
Thiopental, 20, 23, 24t
“30-30” rule, 387-388
Thoracic outlet syndrome, as chest pain cause, 80
Thoracic pump model, 12
Thoracotomy, emergent, 600, 600b
Thrombocytopenia, 284, 288
during blood transfusions, 285
heparin-related, 287
with thrombosis, 287
infectious mononucleosis-related, 449
malaria-related, 360-361
sepsis-related, 327
Thromboembolism, venous, 188-194
Thrombolytic therapy
for acute myocardial infarction, 204-205
complications of, 205
contraindications to, 204
for frostbite, 406
for stroke, 157, 160
Thrombosis
cavernous sinus, 130, 141, 334
cerebral venous sinus, 99-100, 101t, 105
deep venous, 38, 188
imaging of, 191
risk factors for, 189
Wells Criteria for, 189
Thumb, gamekeeper’s/skier’s, 636
Thumbprint sign, 142
Thunder, 383
Thunderstorms, 388. See also Lightning injuries
safety during, 384-385
Thyroid hormone therapy
adverse effects of, 317
for myxedema coma, 321
overdose in, 320
Thyroid nodules, 322
Thyroid storm, 317-318, 319t, 320b
Thyroiditis, 317
Thyrotoxicosis, 317
apathetic, 318
decompensated, 319t
factitia, 317
Tick bites, 364
Tick-borne diseases, 362, 363-364, 363t, 364b,
365-366, 367, 373
Tick paralysis, 363t, 366
Ticks, removal of, 366
Tics, 423
Tight glycemic control, in sepsis, 329
Tilt-chin lift maneuver, 11
Tinnitus
as oncologic emergency, 297t
TIPS-AEIOU (mnemonic), for coma evaluation, 69
Tissue adhesive, 650
Tissue plasminogen activator (tPA), 157-158, 158b
accidental administration of, 161
alternatives to, 161
contraindications to use of, 158, 159t
indications for use of, 158, 159t, 160
informed consent for use of, 158, 160
as intracerebral hemorrhage risk factor, 157-159,
160b
litigation risk associated with, 160
Tissue resistance, to electrical injuries, 390
Toads, hallucinogenic skin secretions of, 514
Todd’s palsy, postictal, 155
Tongue, lacerations to, 149
Tongue biting, during seizures, 423
Tongue blade test, 571
Top 100 Secrets, 1-6
Tophi, 369
Topographical anticipation, 632
TORCH infections, 425
Torsades de pointes, 14, 211t
Touching, of patients, 8
“Toxic appearance,” of children, 417, 417b
Toxic epidermal necrolysis (TEN), 374, 451
Toxic shock syndrome, 451
rash associated with, 350
skin disorders associated with, 350, 375,
378-379t
streptococcal, 350
Toxic syndromes, 477t
Toxicology, cardiovascular, 524-528
Toxicology screen, 476, 478
for acetaminophen, 493
for opioids, 514
Toxoplasmosis, as headache cause, 104, 106
Tracheitis, bacterial, in children, 432, 433t
Tracheobronchitis, as wheezing cause, 174
Tracheotomy, as rapid-sequence intubation alternative, 26
Tramadol, 515
Transfers, of patients, from hospitals, 692-693, 693b, 694
Transient ischemic attacks (TIAs), 155, 161
differentiated from stroke, 155
Transportation, of avulsed teeth, 146
Trauma
abdominal, 602-606
in pediatric patients, 620
as arthritis cause, 368, 369t
in burn patients, 642
as cardiac arrest cause, 12-13
child abuse-related, 455
in elderly trauma patients, 42-43
as epistaxis (nosebleed) cause, 135
as massive hemorrhage cause, 289
multiple, 563-567
to neck, 591-595
occult, 72
ophthalmologic, 587-590
in pediatric patients, 455, 617, 619
in pregnancy, 613-616