BookJoseph R. Shiber, editor ; Scott D. Weingart, consulting editor.
Summary: This comprehensive book provides practical guidance on the care of the critical patient in the emergency department. It focuses on the ED physician or provider working in a community hospital where, absent the consulting specialists found in a large academic center, the provider must evaluate and stabilize critically ill and injured patients alone. Structured in an easily accessible format, chapters present fundamental information in tables, bullet points, and flow diagrams. Emergency medicine scenarios covered across 38 chapters include acute respiratory failure, spinal cord Injuries, seizures and status epilepticus, care of the newborn, and end-of-life care. Written by experts in the field, Emergency Department Critical Care is an essential resource for practicing emergency physicians and trainees, internists and family physicians, advance practice nurses, and physicians assistants who provide care in emergency departments and urgent care centers.
Contents:
Intro
Preface
Contents
Contributors
1: Shock Overview
Introduction
Pathophysiology and Monitoring
Classification of Shock
Hypovolemic Shock
Obstructive Shock
Cardiogenic Shock
Distributive Shock
Clinical Assessment
Physical Examination
Diagnostic Testing
Initial Stabilization
Intravascular Volume Resuscitation
Types of Fluid
Goals for Fluid Resuscitation
CVP
Fluid Responsiveness
Blood Products
Nonhemorrhagic Shock
Vasopressors
Cardiogenic Shock
Septic Shock
Airway Management
Protocol-Directed Therapy Mask Ventilation
Oropharyngeal Airway
Nasopharyngeal Airway
Direct Laryngoscopy
Bougie Stylet
Video Laryngoscopy
Glidescope
McGrath
C-MAC
Fiberoptic Intubation
Supraglottic Airway Devices
Laryngeal Mask Airway
Laryngeal Mask Airway-Fastrach
i-gel
Air-Q
Combitube
King Laryngeal Tube
Surgical Airway
Needle Cricothyrotomy
Surgical Cricothyrotomy
Endotracheal Tube Exchange
Conclusions
References
3: Acute Respiratory Failure
Introduction
Pathophysiology
Hypoxemic Respiratory Failure
Hypercapnic Respiratory Failure Patient Presentation
Diagnostics
Initial Stabilization and Treatment
Ventilatory Failure from COPD or Asthma
Hypoxemic Respiratory Failure
Respiratory Failure Secondary to Shock
References
4: Noninvasive and Mechanical Ventilation
Introduction
Physiologic Changes Due to Positive- Pressure Ventilation (PPV)
Indications for NIPPV
Indications for Invasive PPV
Oxygenation
Ventilation
Airway Protection
Anticipated Clinical Course
Ventilator Parameters and Modes
Parameters
Control
Trigger
Cycle
Limit
Modes Continuous Mandatory Ventilation (CMV) and Assist Control (AC)
Intermittent Mandatory Ventilation (IMV) and Synchronized Intermittent Mandatory Ventilation (SIMV)
Pressure Support Ventilation (PSV)
Airway Pressure Release Ventilation (APRV)
Dual-Mode Ventilation
Initial Ventilator Settings
Specific Clinical Situations and Ventilator Considerations
Airway Protection
Severe Hypoxemia and ARD (See Chap. 6 for Additional Discussion on ARDS)
Obstructive Lung Disease and Auto-PEEP (See Chap. 6 for Additional Discussion on COPD)
Troubleshooting the Ventilator
Auto-PEEP