Rosen & Barkin’s 5-Minute Emergency Medicine Consult 6TH EDITION
The sixth edition of this comprehensive yet concise Rosen & Barkin’s 5 Minute Emergency Medicine Consult pulls together up-to-date and evidence-based practice guidelines for easy use in a busy emergency department. In just two brief, bullet-friendly, clutter-free pages, you can quickly decipher the information you need to confirm your diagnosis, order tests, manage treatment and more!
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- Features new information—based on the latest practice guidelines and theoretical developments—and new approaches to diagnosis and management.
- Designed for integrating into your practice—in an urgent care setting with patients or during downtime between patients or meetings.
- Covers over 600 disease and condition topics, such as bleeding, orthopedic injuries, gastric conditions, domestic violence and more.
- Suitable for all practitioners, nurses and residents in an emergency room setting.
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content Rosen & Barkin’s 5-Minute Emergency Medicine Consult 6TH EDITION
Preface
Acknowledgements
Contributors
Abdominal Aortic Aneurysm
Abdominal Pain
Abdominal Trauma, Blunt
Abdominal Trauma, Imaging
Abdominal Trauma, Penetrating
Abortion, Spontaneous
Abscess, Skin/Soft Tissue
Abuse, Elder
Abuse, Pediatric (Nonaccidental Trauma [NAT]) Acetaminophen Poisoning
Acidosis
Acromioclavicular Joint Injury
Acute Coronary Syndrome: Angina
Acute Coronary Syndrome: Coronary Vasospasm
Acute Coronary Syndrome: Myocardial Infarction
Acute Coronary Syndrome: Non–Q-Wave (Non–ST-Elevation) MI Adrenal Insufficiency
Agitation
Airway Adjuncts
Airway Management
Alcohol Poisoning
Alcoholic Ketoacidosis
Alkalosis
Altered Mental Status
Amebiasis
Amenorrhea
Amphetamine Poisoning
Amyotrophic Lateral Sclerosis
Anal Fissure
Anaphylaxis
Anemia
Angioedema
Ankle Fracture/Dislocation
Ankle Sprain
Ankylosing Spondylitis
Anticholinergic Poisoning
Antidepressant Poisoning
Aortic Dissection, Thoracic
Aortic Rupture, Traumatic (TAI) Aphthous Ulcers
Apnea, Pediatric
Appendicitis
Arsenic Poisoning
Arterial Gas Embolism (AGE)
Arterial Occlusion
Arthritis, Degenerative
Arthritis, Juvenile Idiopathic
Arthritis, Monoarticular
Arthritis, Rheumatoid
Arthritis, Septic
Ascites
Asthma, Adult
Asthma, Pediatric
Asystole
Ataxia
Atrial Fibrillation
Atrial Flutter
Atrioventricular Blocks
Babesiosis
Back Pain
Bacterial Tracheitis
Barbiturates Poisoning
Barotrauma
Bartholin Abscess
Bath Salts–Synthetic Cathinones Poisoning Bell’s Palsy
Benzodiazepine Poisoning
Beta-Blocker Poisoning
Biologic Weapons
Bipolar Disorder
Bite, Animal
Bite, Human
Bladder Injury
Blast Injuries
Blow-Out Fracture
Boerhaave Syndrome
Botulism
Ankylosing Spondylitis
Anticholinergic Poisoning
Antidepressant Poisoning
Aortic Dissection, Thoracic
Aortic Rupture, Traumatic (TAI) Aphthous Ulcers
Apnea, Pediatric
Appendicitis
Arsenic Poisoning
Arterial Gas Embolism (AGE)
Arterial Occlusion
Arthritis, Degenerative
Arthritis, Juvenile Idiopathic
Arthritis, Monoarticular
Arthritis, Rheumatoid
Arthritis, Septic
Ascites
Asthma, Adult
Asthma, Pediatric
Asystole
Ataxia
Atrial Fibrillation
Atrial Flutter
Atrioventricular Blocks
Babesiosis
Back Pain
Bacterial Tracheitis
Barbiturates Poisoning
Barotrauma
Bartholin Abscess
Bath Salts–Synthetic Cathinones Poisoning Bell’s Palsy
Benzodiazepine Poisoning
Beta-Blocker Poisoning
Biologic Weapons
Bipolar Disorder
Bite, Animal
Bite, Human
Bladder Injury
Blast Injuries
Blow-Out Fracture
Boerhaave Syndrome
Botulism
Ankylosing Spondylitis
Anticholinergic Poisoning
Antidepressant Poisoning
Aortic Dissection, Thoracic
Aortic Rupture, Traumatic (TAI) Aphthous Ulcers
Apnea, Pediatric
Appendicitis
Arsenic Poisoning
Arterial Gas Embolism (AGE)
Arterial Occlusion
Arthritis, Degenerative
Arthritis, Juvenile Idiopathic
Arthritis, Monoarticular
Arthritis, Rheumatoid
Arthritis, Septic
Ascites
Asthma, Adult
Asthma, Pediatric
Asystole
Ataxia
Atrial Fibrillation
Atrial Flutter
Atrioventricular Blocks
Babesiosis
Back Pain
Bacterial Tracheitis
Barbiturates Poisoning
Barotrauma
Bartholin Abscess
Bath Salts–Synthetic Cathinones Poisoning Bell’s Palsy
Benzodiazepine Poisoning
Beta-Blocker Poisoning
Biologic Weapons
Bipolar Disorder
Bite, Animal
Bite, Human
Bladder Injury
Blast Injuries
Blow-Out Fracture
Boerhaave Syndrome
Botulism
Ankylosing Spondylitis
Anticholinergic Poisoning
Antidepressant Poisoning
Aortic Dissection, Thoracic
Aortic Rupture, Traumatic (TAI) Aphthous Ulcers
Apnea, Pediatric
Appendicitis
Arsenic Poisoning
Arterial Gas Embolism (AGE)
Arterial Occlusion
Arthritis, Degenerative
Arthritis, Juvenile Idiopathic
Arthritis, Monoarticular
Arthritis, Rheumatoid
Arthritis, Septic
Ascites
Asthma, Adult
Asthma, Pediatric
Asystole
Ataxia
Atrial Fibrillation
Atrial Flutter
Atrioventricular Blocks
Babesiosis
Back Pain
Bacterial Tracheitis
Barbiturates Poisoning
Barotrauma
Bartholin Abscess
Bath Salts–Synthetic Cathinones Poisoning Bell’s Palsy
Benzodiazepine Poisoning
Beta-Blocker Poisoning
Biologic Weapons
Bipolar Disorder
Bite, Animal
Bite, Human
Bladder Injury
Blast Injuries
Blow-Out Fracture
Boerhaave Syndrome
Botulism
Ankylosing Spondylitis
Anticholinergic Poisoning
Antidepressant Poisoning
Aortic Dissection, Thoracic
Aortic Rupture, Traumatic (TAI) Aphthous Ulcers
Apnea, Pediatric
Appendicitis
Arsenic Poisoning
Arterial Gas Embolism (AGE)
Arterial Occlusion
Arthritis, Degenerative
Arthritis, Juvenile Idiopathic
Arthritis, Monoarticular
Arthritis, Rheumatoid
Arthritis, Septic
Ascites
Asthma, Adult
Asthma, Pediatric
Asystole
Ataxia
Atrial Fibrillation
Atrial Flutter
Atrioventricular Blocks
Babesiosis
Back Pain
Bacterial Tracheitis
Barbiturates Poisoning
Barotrauma
Bartholin Abscess
Bath Salts–Synthetic Cathinones Poisoning Bell’s Palsy
Benzodiazepine Poisoning
Beta-Blocker Poisoning
Biologic Weapons
Bipolar Disorder
Bite, Animal
Bite, Human
Bladder Injury
Blast Injuries
Blow-Out Fracture
Boerhaave Syndrome
Botulism….
Rosen & Barkin’s 5-Minute Emergency Medicine Consult 6TH EDITION – ABDOMINAL AORTIC ANEURYSM
Adam S. Kaye • Carlo L. Rosen
BASICS
DESCRIPTION
Focal dilation of the aortic wall with an increase in diameter by at least 50% (>3 cm)
95% are infrarenal
Rapid expansion or rupture causes symptoms
Rupture can occur into the intraperitoneal or retroperitoneal spaces
Intraperitoneal rupture is usually immediately fatal (20% of ruptured AAA)
Average growth rate of 0.2–0.5 cm/yr
Of ruptures:
– 90% overall mortality
– 80% mortality for patients who reach the hospital
– 50% mortality for patients who undergo emergency repair
Of patients who have had endovascular aortic aneurysm repair (EVAR), persistent bloodflow into the aneurysm sac can lead to continued aneurysm growth and rupture
Geriatric Considerations
Risk increases with advanced age
Present in:
– 4–8% of all patients older than 65 yr
– 5–10% of men 65–79 yr old
– 12.5% of men 75–84 yr old
– 5.2% of women 75–84 yr old
ETIOLOGY
Risk factors are similar to other vascular diseases:
– Male gender
– Age >65 yr
– Family history
– Cigarette smoking
– Atherosclerosis
– HTN
– Diabetes mellitus
– Connective tissue disorders:
Ehlers–Danlos syndrome
Marfan syndrome
Uncommon causes:
– Blunt abdominal trauma
– Congenital aneurysm
– Infections of the aorta
– Mycotic aneurysm secondary to endocarditis
Rupture risk factors:
– Size (annual rupture rates):
Aneurysms 5–5.9 cm = 4%
Aneurysms 6–6.9 cm = 7%
…………………………………