CONTENTS Chapter 1 Approach To the Emergency Department Patient 1 1.1 What Is Emergency Medicine? 1 1.2 Unique Aspects Of Emergency Medicine Practice 1 1.3 Principles of Emergency Medicine 1 1.4 Conclusion 2 Chapter 2 Pre-hospita Eerency Services 3 2.1 Components of an Emergency Medical Services System 3 2.2 EMS Delivery During Natural Disasters and Terrorist Attacks 9 . Future of EMS 10 Chapter 3 Disaster Medicine 11 3.1 Overview of Disaster Medicine 11 3.2 Disaster Cycle 11 3.3 Categories of Disaster And Mass Casualty Events 12 3.4 Oraioal Issues in Disasters 14 3.5 Disaster Preparedness in The United States 15 3.6 Disaster Preparedness in China 18 3.7 Prehospital Disaster Planning 19 3.8 Hospital and Emergency Department Disaster Management 20 3.9 The Specialty Management of Hazardous Materials and Radiation 21 Chapter 4 Emergency Bedside Ultrasound 4.1 Emergency Bedside Ultrasound Basic 4.2 Primary Indication 26 Chapter 5 Emergency Procedures 39 5.1 Transcutaneous Cardiac Pacing 39 5.2 Orotracheal Intubation, and Nasotracheal Intubation 39 5.3 Cricothyrotomy 41 5.4 Central Venous Catheterization 42 5.5 Radial Artery Puncture: For Blood Gas and pH Analysis 47 5.6 Nasogastric Intubation: for Gastric Evacuation or Lavage 47 5.7 Thoracentesis 48 5.8 Tube Thoracostomy: Insertion of a Chest Tube 49 5.9 Abdominal Paracentesis 50 5.10 Insertion of Indwelling (Foley) Urinary Catheter 51 5.11 Focused Assessment with Sonography for Trauma 52 Chapter 6 Procedural Sedation and Analgesia 55 6.1 Basics of Procedural-Sedation and Analgesia 55 6.2 Agents For Proceda 5 6.3 Reversal Agents 58 Chapter 7 Basic and Advanced Cardiac Life Support 60 7.1 Overview of Cardiac Arrest 60 7.2 Adult Basic Life Support 60 7.3 Adult Advanced Life Support 64 7.4 Cardiopulmonary Resuscitation in Infants and Children 69 Chapter 8 Cormied Airway 71 8.1 Immediate Management of the Cormied Airway 71 8.2 Principles of Intubation 75 8.3 Nonsurgical Devices and Techniques for Managing the Difficult Airway 75 Chapter 9 Shock 78 9.1 Introduction 78 9.2 Pathophysiology 78 9.3 Etiology 78 9.4 Initial evaluation 79 9.5 Therapy 79 9.6 Specific Shock 79 Chapter 10 The Multiply Injured Patient 83 10.1 Immediate Management of Life-Threatening Problems 83 10.2 Initial Assessment 83 10.3 Hemorrhagic Shock 86 Chapter 11 Respiratory Distress 88 11.1 Immediate Management of Life-Threatening Problems 88 11.2 Cardiac Arrest 88 11.3 Severe Upper Airway Obstruction 88 11.4 Altered Mental Status with Shallow Breathing 90 11.5 Tension Pneumothorax 90 11.6 Massive Aspiration 90 11.7 Severe Pulmonary Edema 91 11.8 Severe Asthma, Chronic Obstructive Pulmonary Disease 91 11.9 Further Diagnostic Evaluation 92 Chapter 12 Chest Pain 95 12.1 Immediate Management of Life-Threatening Problems 95 12.2 Management of Specific Disorders Causing Chest Pain 101 Chapter 13 Abdominal Pain 105 13.1 Immediate Management of Life-Threatening Problems 105 13.2 Further Evaluation of the Patient with Abdominal Pain 105 13.3 Management of Specific Disorders Causing Abdominal Pain 113 13.4 Conditions Causing Acute Abdominal Pain That Are Not Amenable to Surgery 120 Chapter 14 Gastrointestinal Bleeding 121 14.1 Immediate Management of Life-Threatening Bleeding 121 14.2 Further Evaluation of Gastrointestinal Bleeding 124 14.3 Emergency Treatment of Specific Disorders Causing Upper Gastrointestinal Bleeding 125 14.4 Emergency Treatment of Specific Disorders Causing Lower Gastrointestinal Bleeding 127 Chapter 15 Coma 130 15.1 Immediate Management of Life-Threatening Problems 130 15.2 Further Evaluation of the Comatose Patient 131 15.3 Emergency Treatment of Specific Disorders Causing Coma (Structural Lesions) 132 15.4 Metabolic Encephalopathies 133 15.5 Other Disorders Causing Coma 135 Chapter 16 Syncope 136 16.1 Immediate Management of Life-Threatening Problems Causing Syncope 136 16.2 Valuation of The Conscious Patient with a History of Syncope 136 16.3 Energency Evaluation of Specific Disorders Causing Syncope 137 Chapter 17 Seizures 140 17.1 Life-Threatening Problems 140 17.2 Evaluation of The Conscious 142 Chapter 18 Headache 144 Definition 144 18.1 Etiology 144 18.2 Pathogenesis 144 18.3 Signs and Sytm 144 18.4 Diagnosis 146 18.5 Treatments 148 Chapter 19 Arthritis and Back Pain 151 19.1 Evaluation of the Patient With Acute Arthritis 151 19.2 Emergency Treatment of Specific Conditions Causing Acute Arthritis 151 19.3 Evaluation of The Patient With Acute Back Pain 155 19.4 Emergency Treatment of Specific Conditions Causing Back Pain 157 Chapter 20 Head Injuries 160 20.1 Immediate Management of Life-Threatening Problems 160 20.2 Management