PART 1

NEUROLOGIC AND PSYCHIATRIC EMERGENCES

1

1

Dystonic Drug Reaction

3

2

Heat Illness (Heat Edema, Heat Syncope, Heat Cramps, Heat Exhaustion)

6

3

Hyperventilation

10

4

Hysterical Coma or Pseudoseizure

13

5

Idiopathic Facial Paralysis (Bell’s Palsy)

16

6

Migraine Headache

20

7

Seizures (Convulsions, Fits), Adult

25

8

Seizures (Convulsions, Fits), Febrile and Pediatric

31

9

Tension-Type (Muscle Contraction) Headache

36

10

Trivial, Minimal, and Minor Head Trauma (Concussion)

40

11

Vasovagal or Neurocardiogenic or Neurally Mediated Syncope (Faint, Swoon)

45

12

Vertigo (Dizziness, Lightheadedness)

52

13

Weakness

60

PART 2

OPHTHALMOLOGIC EMERGENCIES

63

14

Conjunctivitis (Pink Eye)

65

15

Contact Lens Complications

71

16

Corneal Abrasion

74

17

Foreign Body, Conjunctival

78

18

Foreign Body, Corneal

81

19

Hordeolum (Sty)

85

20

Iritis (Acute Anterior Uveitis)

87

21

Periorbital and Conjunctival Edema

91

22

Periorbital Ecchymosis (Black Eye)

93

23

Removal of Dislocated Contact Lens

96

24

Subconjunctival Hemorrhage

98

25

Ultraviolet Keratoconjunctivitis (Welder’s or Tanning Bed Burn)

100

PART 3

EAR, NOSE, AND THROAT EMERGENCIES

103

26

Cerumen Impaction (Earwax Blockage)

105

27

Epistaxis (Nosebleed)

108

28

Foreign Body, Ear

116

29

Foreign Body, Nose

122

30

Foreign Body, Throat

127

31

Laryngotracheobronchitis (Croup)

131

32

Mononucleosis (Glandular Fever)

135

33

Nasal Fracture (Broken Nose)

138

34

Otitis Externa (Swimmer’s Ear), Acute

141

35

Otitis Media, Acute

146

36

Otitis Media with Effusion; Serous (Secretory) Otitis Media (Glue Ear)

151

37

Perforated Tympanic Membrane (Ruptured Eardrum)

154

38

Pharyngitis (Sore Throat)

156

39

Rhinitis, Acute (Runny Nose)

162

40

Rhinosinusitis (Sinusitis)

167

PART 4

ORAL AND DENTAL EMERGENCIES

173

41

Aphthous Ulcer (Canker Sore)

175

42

Avulsed Tooth, Dental Subluxation, Dental Luxation

179

43

Bleeding after Dental Surgery

184

44

Burning Mouth Syndrome, Burning Tongue (Glossodynia)

186

45

Dental Pain, Periapical Abscess (Tooth Abscess)

190

46

Dental Pain, Pericoronitis

193

47

Dental Pain, Postextraction Alveolar Osteitis (Dry Socket)

195

48

Dental Pain, Pulpitis

197

49

Dental Trauma (Fracture, Subluxation, and Displacement)

199

50

Gingivitis and Acute Necrotizing Ulcerative Gingivitis (Trench Mouth)

203

51

Lacerations of the Mouth

205

52

Mucocele (Mucous Cyst)

208

53

Oral Candidiasis (Thrush or Yeast Infection)

210

54

Oral Herpes Simplex (Cold Sore, Fever Blister)

212

55

Orthodontic Complications

215

56

Perlèche (Angular Cheilitis)

217

57

Sialolithiasis (Salivary Duct Stones)

219

58

Temporomandibular Disorder (TMD, TMJ Syndrome)

222

59

Temporomandibular Joint Dislocation (Jaw Dislocation)

226

60

Uvular Edema, Acute

229

PART 5

PULMONARY AND THORACIC EMERGENCIES

233

61

Bronchitis (Chest Cold), Acute

235

62

Costochondritis and Musculoskeletal Chest Pain

241

63

Inhalation Injury (Smoke Inhalation)

244

64

Irritant Incapacitant Exposure (Lacrimators. Riot Control Agents, Tear Gas)

249

65

Rib Fracture and Costochondral Separation (Broken Rib)

252

PART 6

GASTROINTESTINAL EMERGENCIES

257

66

Anal Fissure

259

67

Constipation, Irritable Bowel Syndrome, and Colic (Stomach Cramps)

263

68

Diarrhea (Acute Gastroenteritis)

270

69

Enterobiasis (Pinworm, Threadworm, Seatworm)

278

70

Esophageal Food Bolus Obstruction (Steakhouse or Café Coronary Syndrome)

281

71

Foreign Body, Rectal

285

72

Foreign Body, Swallowed

291

73

Hemorrhoids (Piles)

298

74

Innocuous Ingestions

303

75

Singultus (Hiccups)

305

76

Vomiting (Food Poisoning, Gastroenteritis)

308

PART 7

UROLOGIC EMERGENCIES

313

77

Blunt Scrotal Trauma

315

78

Colorful Urine

318

79

Epididymitis

320

80

Genital Herpes Simplex

325

81

Phimosis and Paraphimosis

329

82

Prostatitis, Acute Bacterial

332

83

Urethritis (Drip, Clap)

334

84

Urinary Retention, Acute

338

85

Urinary Tract Infection, Lower (Cystitis), Uncomplicated

342

86

Urinary Tract Infection, Upper (Pyelonephritis)

347

PART 8

GYNECOLOGIC EMERGENCIES

351

87

Bartholin Abscess

353

88

Condylomata Acuminata (Genital Warts)

356

89

Contact Vulvovaginitis

362

90

Dysmenorrhea (Menstrual Cramps)

364

91

Foreign Body, Vaginal

367

92

“Morning after” Emergency Contraception

369

93

Pelvic Inflammatory Disease (PID)

371

94

Vaginal Bleeding

376

95

Vaginitis

380

PART 9

MUSCULOSKELETAL EMERGENCIES

389

96

Acromioclavicular (Shoulder) Separation

391

97

Ankle Sprain (Twisted Ankle)

396

98

Annular Ligament Displacement, Radial Head Subluxation (Nursemaid’s Elbow)

404

99

Boutonnière Finger

408

100

Boxer’s Fifth Metacarpal Fracture

412

101

Bursitis

415

102

Carpal Tunnel Syndrome

419

103

Cervical Strain (Whiplash)

425

104

Cheiralgia Paresthetica (Handcuff Neuropathy)

430

105

Clavicle (Collarbone) Fracture

432

106

Coccyx Fracture (Tailbone Fracture)

436

107

De Quervain’s Paratenonitis (Thumb Tenosynovitis)

438

108

Extensor Tendon Avulsion—Distal Phalanx (Baseball or Mallet Finger)

441

109

Finger Dislocation (PIP Joint)

445

110

Finger Sprain (PIP Joint)

450

111

Fingertip (Tuft) Fractures

452

112

Flexor Digitorum Profundus Tendon Avulsion—Distal Phalanx (Splay Finger)

454

113

Ganglion Cysts

456

114

Gouty Arthritis, Acute

458

115

Knee Sprain

463

116

Lateral Epicondylitis and Medial Epicondylitis (Tennis Elbow, Golfer’s Elbow)

470

117

Ligament Sprains (Including Joint Capsule Injuries)

474

118

Locked Knee

476

119

Lumbar Strain, Acute (“Mechanical” Low Back Pain, Sacroiliac Dysfunction)

478

120

Monarticular Arthritis, Acute

486

121

Muscle Cramps (Charley Horse)

493

122

Muscle Strains and Tears

495

123

Myofascial Pain Syndrome, Fibromyalgia (Trigger Points)

499

124

Patellar Dislocation (Kneecap Dislocation)

509

125

Plantar Fasclitis (“Heel Spur”)

513

126

“Plantaris Tendon” Rupture, Gastrocnemius Muscle Tear (Calf Muscle Tear)

517

127

Polymyalgia Rheumatica

521

128

Radial Head Fracture

524

129

Radial Neuropathy (Saturday Night Palsy)

527

130

Scaphoid Fracture

530

131

Shoulder Dislocation

535

132

Tendinopathy: Tendinosis, Paratenonitis (Tendinitis)

541

133

Toe Fracture (Broken Toe)

545

134

Torticollis (Wryneck)

548

135

Ulnar Collateral Ligament Tear of the Thumb (Ski Pole or Gamekeeper’s Thumb)

551

PART 10

SOFT TISSUE EMERGENCIES

553

136

Bicycle Spoke Injury

555

137

Contusion (Bruise)

557

138

Fingernail or Toenail Avulsion

561

139

Fingertip Avulsion, Superficial

565

140

Fishhook Removal

568

141

Foreign Body Beneath Nail

572

142

Impalement Injuries, Minor

575

143

Laceration, Simple

578

144

Mammalian Bites

593

145

Marine Envenomations

600

146

Nail Bed Laceration

607

147

Nail Root Dislocation

610

148

Needle (Foreign Body) in Foot

613

149

Paronychia

617

150

Pencil Point Puncture

623

151

Puncture Wounds

625

152

Ring Removal

630

153

Sliver, Superficial (Splinter)

635

154

Subcutaneous Foreign Bodies (Metal, Dental Fragments, Glass, Gravel, and Hard Plastic)

640

155

Subungual Ecchymosis (Tennis Toe)

645

156

Subungual Hematoma

647

157

Torn/Split Earlobe

651

158

Traumatic Tattoos and Abrasions

656

159

Zipper Entrapment (Penis or Chin)

659

PART 11

DERMATOLOGIC EMERGENCIES

663

160

Allergic Contact Dermatitis

665

161

Arachnid Envenomation (Spider Bite)

672

162

Arthropod Bites (Bug Bites, Insect Bites)

677

163

Cutaneous Abscess or Pustule

682

164

Cutaneous Larva Migrans (Creeping Eruption)

688

165

Diaper Dermatitis (Diaper Rash)

691

166

Erysipelas, Cellulitis, Lymphangitis

694

167

Fire Ant Stings

699

168

Friction Blister

703

169

Frostnip, Frostbite, and Mild Hypothermia

705

170

Herpes Zoster (Shingles)

709

171

Hymenoptera (Bee, Wasp, Hornet) Envenomation (Bee Sting)

715

172

Impetigo

720

173

Partial-Thickness (Second-Degree) Burns and Tar Burns

723

174

Pediculosis (Lice, Crabs)

728

175

Pityriasis Rosea

733

176

Pyogenic Granuloma or Lobular Capillary Hemangioma (Proud Flesh)

736

177

Scabies (Human Itch Mite)

739

178

Sea Bather’s Eruption (Sea Lice)

744

179

Sunburn

747

180

Tick Bite, Tick Removal

751

181

Tinea Pedis, Tinea Cruris, Tinea Corporis (Athlete’s Foot, Jock Itch, Ringworm)

759

182

Toxicodendron (Rhus) Allergic Contact Dermatitis (Poison Ivy, Oak, or Sumac)

766

183

Urticaria (Hives), Acute

771

184

Warts (Common Wart, Plantar Wart)

777

APPENDICES

781

Appendix A

Complete Eye Examination

783

Appendix B

Digital Block

784

Appendix C

Fingertip Dressing, Simple

787

Appendix D

Oral Nerve Blocks

789

Appendix E

Procedural Sedation and Analgesia

791

Appendix F

Rabies Prophylaxis

795

Appendix G

Regional Poison Control Center Phone Numbers

798

Appendix H

Tetanus Prophylaxis

804

Index

809