By Jeanmonod, Tomassi, Mayer, Rebecca Jeanmonod MD, Michelle Tomassi MD, Dan Mayer
A case-based e-book equipped via the head 10 universal court cases of sufferers providing to emergency departments. This procedure permits the reader to profit the pathophysiology of the main illnesses, and examine each one case in a manner that extra heavily approximates the scientific perform of drugs; no longer realizing which organ process is broken or compromised prior to analyzing the sufferer. The circumstances are in response to actual sufferers and the illnesses are both universal in emergency perform, or are risky diagnoses to not be neglected. The case descriptions contain questions in regards to the patient's presentation and uncomplicated information regarding the sickness, illustrating key components from the heritage, actual, and while helpful ancillary stories that aid result in a prognosis. every one bankruptcy ends with a move diagram exhibiting how ailments of other organ platforms can current with related preliminary proceedings. This e-book is a perfect source for clinical scholars, citizens and trainees in emergency drugs.
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Extra resources for Case Studies in Emergency Medicine
R General: the patient is awake, alert, and appropriate. He is resting in bed comfortably until waves of pain cause him to double over and clutch his abdomen. r Head and neck: the patient’s mucous membranes are moist. His neck is supple without jugular venous distension or bruit. The patient’s sclerae are non-icteric. r Cardiovascular: the patient’s heart is tachycardic without murmurs, rubs, or gallops. He has 2+ distal pulses in all four extremities. r Lungs: the patient’s breath sounds are equal and lungs are clear bilaterally without wheezes, rales, or rhonchi.
Heatstroke is severe dysfunction, with temperatures greater than 40◦ C with systemic inflammation and central nervous system (CNS) involvement. r Epidemiology: exact numbers are unknown, but it is estimated that thousands of patients seek treatment each year for heat illnesses in the United States. The Centers for Disease Control report 4780 heat-related deaths over a 20-year period. The incidence is directly related to ambient temperature. Patients who are very young, very old, medically debilitated, or who are taking medications which blunt compensatory mechanisms are more susceptible to heat illnesses.
Vital signs also reveal tachypnea and increased pulse pressure. Associated disseminated intravascular coagulation may result in purpura, conjunctival hemorrhages, gastrointestinal bleeding, or hematuria. Acute renal failure may result in oliguria or anuria. Decreased muscular tone distinguishes heatstroke from malignant hyperthermia or neuroleptic malignant syndrome. r Treatment: mainstays of treatment are immediate cooling and support of end-organ oxygenation, perfusion, and function. Prehospital care includes removing the patient from the hot environment and removing excessive clothing.