Introduction

The Approach to the Emergency Department Patient   Robert L. Wears

1

SECTION I

RESUSCITATION   Jeffrey Scbaider, MD

1

Airway Management   Michael F. Murphy

5

2

Airway Procedures   Eric F. Reichman and Christopher J. Freeman

12

3

Cardiopulmonary Arrest   Christopher Ross and Theresa M. Schwab

28

4

Shock   Emanuel P. Rivers and David Amponsah

37

5

Vascular Access   Eric F. Reichman and Sara K. Miller

44

SECTION II

PAIN MANAGEMENT AND PROCEDURAL SEDATION   Carlo L. Rosen, MD

6

Acute Pain Management   Steven Rosenzweig, Bernard Lopez, and Eric Panzer

61

7

Chronic Pain Syndromes   Michael A. Turturro and Paul M. Paris

67

8

Procedural Sedation and Analgesia   Robert J. Vissers and James R. Miner

74

SECTION III

HIGH-RISK CHIEF COMPLAINTS   Carlo L. Rosen, MD

9

Chest Pain   Robert J. Zalenski and Sridevi R. Pitta

80

10

Abdominal Pain   Diane M. Birnbaumer and Michelle Charfen

84

11

Shortness of Breath   C. Keith Stone

91

12

Syncope   Shamai A. Grossman and Christopher M. Fischer

94

13

Fever   Elizabeth Hatfield-Keller and Harold A. Thomas, Jr.

97

14

Altered Mental Status and Coma   J. Stephen Huff and Marcus L. Martin

104

15

Headache   Jonathan A. Edlow

109

16

Weakness   Yasuharu Okuda and Andy Jagoda

115

17

Dizziness   Michele E. Krajicek and Wyatt W. Decker   

131

SECTION IV

TRAUMA   Carlo L. Rosen, MD

PART 1

GENERAL CONSIDERATIONS

18

General Principles of Trauma   Eric L. Legome and Peter Rosen

126

19

Trauma Airway Management   John H. Burton, Nestor B. Nestor, and Kevin R. Ward

134

20

Traumatic Shock   Christopher B. Colwell and Ernest E. Moore

142

31

Wound Management   Judd E. Hollander and Adam J. Singer

148

PART II

SPECIFIC INJURIES

22

Head Injuries    James F. Holmes and Cindy H. Chang

157

23

Maxillofacial Injuries   Danielle E. Turner-Lawrence and Stephen Colucciello

164

24

Dental Injuries   Kip Benko

172

25

Eye Trauma   Kevin J. Knoop and William R. Dennis

180

36

Blunt Neck Trauma   Edward Ullman

186

27

Penetrating Neck Trauma   John L. Kendall and Andrew L. Knaut

189

28

Cervical Spine Fractures   William R. Mower, Jerome R. Hoffman, and Swaminatha V. Mahadevan

194

29

Thoracolumbar Spine Fractures   Amy Kaji and Robert S. Hockberger

201

30

Spinal Cord Injuries    Brian D. Mahoney

207

31

Blunt Chest Trauma   Richard L. Byyny and Vincent J. Markovchick

213

32

Penetrating Chest Trauma   Seric S. Cusick

220

33

Blunt Abdominal Trauma   Eric L. Legome and William Goldberg

227

34

Penetrating Abdominal Trauma   Jennifer L. Isenhour and John A. Marx

232

35

Genitourinary Trauma   Carrie D. Tibbles

238

36

Peripheral Vascular Injuries   Peter T. Pons

243

PART III

ORTHOPAEDIC TRAUMA

37

Approach to Musculoskeletal Injuries   Andrew D. Perron and Carl A. Germann

246

38

Shoulder Injuries   Scott C. Sherman

256

39

Elbow Injuries   Andrew D. Perron and Carl A. Germann

264

40

Wrist and Forearm Injuries   Joel Kravitz and Carl R. Chudnofsky

272

41

Hand Injuries   Kenneth Jackimczyk

278

42

Pelvic Fractures   Carrie D. Tibbles and Michael Gibbs

286

43

Hip and Femur Injuries   Norberto Adame, Jr. and Timothy Seay

294

44

Knee Injuries   John E. Gough

298

45

Ankle and Foot Injuries   Kaushal Shah

304

PART IV

SPECIAL CONSIDERATIONS

46

Burns   Isabel Velasco, Luis H. Haro, and Wyatt W. Decker

310

47

Replantation   James L. Larson, Jr.

315

48

Acute Compartment Syndrome   Andrew D. Perron and Christopher T. Bowe

317

49

Ballistics   Jason Imperato and Leon D. Sanchez

321

50

Blast Injuries   David W. Callaway and Leon D. Sanchez

323

51

Hanging and Strangulation Injuries   Leon D. Sanchez and Richard E. Wolfe

327

52

Trauma in Pregnancy   Charles J. Gerardo and Susan B. Promes

329

53

Trauma in the Elderly   Phillip D. Levy   

332

SECTION V

EYE EMERGENCIES   Gregory W. Hendey, MD

54

The Eye Examination   Timothy F. Platts-Mills

337

55

Common Ophthalmic Medications   Kimberly Schertzer and Swaminatha V. Mahadevan

342

56

The Red Eye   Robert S. Porter

346

57

Corneal Abrasion and Foreign Bodies   Lori A. Weichenthal

349

58

Acute Vision Loss   Catherine A. Marco

358

59

Diplopia   James A. Comes

357

60

Acute Eye Infections   David A. Kramer, Michael A. Bohrn, and David D. Vega

361

61

Acute Angle-Closure Glaucoma   William Bozeman and R. Scott Everett

365

SECTION VI

ENTAND DENTAL EMERGENCIES   Gregory W. Hendey, MD

62

Dental Eemergencies   Gregory T. Guldner and Thomas Forney

372

63

Oral and Maxillofacial Disorders   Manon Kwon

375

64

Nontraumatic Upper Airway Obstruction   Jonathan Fisher

380

65

Sore Throat   Michael F. Murphy

383

66

Complications of Tracheostomies   Valerie Ann Dobiesz, Scott Andrew Miller, and Monika Jakacka Pitzele

388

67

Sinusitis and Rhinitis   Hagop M. Afarian

390

68

Ear Infections in Adults   Sukhjit S. Takhar

394

69

Epistaxis   Trevor J. Lewis

398

70

Vertigo   Eileen M. Raynor

402

71

Acute Hearing Loss and Tinnitus   Carolyn Cbooljian

407

SECTION VII

PULMONARY EMERGENCIES   Jeffrey Schaider, MD

72

Respiratory Failure   Micelle J. Hay Del and Peter M.C. DeBlieux

410

73

Pneumonia   Gregory J. Moran and David A. Talan

418

74

Pleural Effusion   Micelle Hay Del and Peter M.C. Deblieux

425

75

Asthma   Michelle J. Sergel and Rita K. Cydulka

432

76

Chronic Obstructive Pulmonary Disease   David S. Howes and Marc A. Bellazzini

439

77

Spontaneous Pneumothorax and Pneumomediastinum   Susan M. Dunmire

443

78

Pulmonary Embolism   Renee Y. Hsia and Jeffrey A. Tabas

445

79

Hemoptysis   Steven J. Parrillo

449

80

Sarcoidosis   Steven J. Parrillo

452

SECTION VIII

CARDIAC EMERGENCIES   Jeffrey Schaider, MD

81

Acute Coronary Syndrome   Christopher Ross and Theresa Schwab

456

82

Congestive Heart Failure and Cor Pulmonale   Shirley Beng Suat Ooi

469

83

Bradydysrhythmias   David Hartman and David T. Overton

475

84

Tachydysrhythmlas   Scott R. Votey and Mel Herbert

480

85

Pacemakers and Implantable Cardioverter-Defibrillators   Robert M. Rodriguez

492

86

Valvular Heart Disease   Joseph P. Ornato

496

87

Infectious Endocarditis   Ian D. Jones and Corey M. Slovis

501

88

Acute Pericarditis and Cardiac Tamponade   Howard A. Bessen and Richard Byyny

507

89

Hypertension   Philip Shayne and Edward Stettner

511

SECTION IX

VASCULAR EMERGENCIES   Gregory W. Hendey, MD

90

Nontraumatic Carotid and Vertebral Artery Disorders   Brian Chinnock

518

91

Peripheral Arterial Disease   Darren Braude

522

92

Deep Venous Thrombosis   Carolyn Chooljian, Edward A. Panacek, and J. Douglas Kirk

525

93

Vascular Graft Complications   Hoori Hovanessian

528

94

Thoracic Aortic Dissection   Shawna J. Perry

532

95

Abdominal Aortic Aneurysm   Alex J. Blau and Matthew R. Lewin

536

96

Mesenteric Ischemia   Kendall Ho and Shahin Shirzad

539

SECTION X

GASTROINTESTINAL EMERGENCIES   Gregory W. Hendey, MD

97

Esophageal Disorders   Charles M. Seamens and Jeremy J. Brywczynski

543

98

Upper Gastrointestinal Bleeding   Sukhjit S. Takhar

548

99

Lower Gastrointestinal Bleeding   Kenny V. Banh

551

100

Peptic Ulcer Disease   Dale S. Birenbaum

554

101

Jaundice   Tobias D. Barker and Gus M. Garmel

558

102

Biliary Tract Disease   Lance D. Wilson

563

103

Hepatitis   Mark J. Ault and Joel M. Geiderman

566

104

Hepatic Failure and Cirrhosis   David M. Cline

573

105

The Liver Transplant. Patient   Douglas W. Lowery-North, Scott R. Votey, and Eric A. Savitsky

576

106

Pancreatitis   Anuj A. Parikh and David C. Seaberg

581

107

Appendicitis   Brian K. Snyder

586

108

Bowel Obstruction   Philip L. Henneman and Susan P. Torrey

590

109

Hernias   Sharon E. Mace

592

110

Inflammatory Bowel Disease   Howard A. Werman

596

111

Diarrhea   Philip N. Salen

599

112

Diverticular Disease   Janak K. Acharya

606

113

Anorectal Disorders   Wendy C. Coates

608

114

Gastrointestinal Foreign Bodies   Valerie C. Norton

613

SECTION XI

RENAL AND UROLOGIC EMERGENCIES   Gregory W. Hendey, MD

115

Hematuria   H. Gene Hern, Jr. and Abigail R. Pease

617

116

Acute Renal Failure   Danielle D. Campagne

619

117

Chronic Kidney Disease and Dialysis-Related Emergencies   Allan B. Wolfson

623

118

The Renal Transplant Patient   Louis G. Graff, IV

628

119

Acute Scrota! Pain   Michael A. Silverman and Robert E. Schneider

632

120

Penile Disorders   Douglas L. McGee

637

121

Urinary Tract Infection   Lara Kulchycki

639

122

Prostatitis   Herbert G. Bivins

645

133

Fournier Gangrene   Gregory W. Hendey

647

124

Urolithiasis   Stephen R. Hayden

648

125

Urinary Incontinence and Retention   Stephen J. Wolf

651

126

Genitourinary Stents and Catheters   Paul E. Phrampus

655

SECTION XII

GYNECOLOGIC EMERGENCIES   Gregory W. Hendey, MD

127

Pelvic Pain   Joseph C. Schmidt

659

128

Pelvic Inflammatory Disease   Alfred Sacchetti

663

129

Vaginal Bleeding in the Nonpregnant Patient   Eric Anderson

666

130

Vaginitis   Ericka L. Powell and Alfred Sacchetti

669

131

Breast Masses and Infections   John M. Howell and Ellen M. Dugan

671

133

Sexual Assault   Carolyn Sachs

674

SECTION XIII

OBSTETRIC EMERGENCIES   Gregory W. Hendey, MD

133

First Trimester Vaginal Bleeding   Pamela L. Dyne

678

134

Ectopic Pregnancy   G. Richard Braen and Richard S. Krause

682

135

Hyperemesis Gravidarum   Lori Weichenthal

686

136

Post-Abortion Complications   Lynne McCullough

687

137

Hypertensive Disorders of Pregnancy   Jan Marie Shoenberger and Sean O. Henderson

690

138

Third Trimester Vaginal Bleeding   Moss H. Mendelson

693

139

Emergency Delivery   Michael D. Burg and Daan R.C.M. Biesbroeck

695

140

Postpartum Emergencies   Moss H. Mendelson and Joseph P. Lang

700

141

Drugs in Pregnancy and Lactation   Flavia Nobay and Daniel P. Hayes

705

SECTION XIV

MUSCULOSKELETAL EMERGENCIES   Gregory W. Hendey, MD

142

Hand and Wrist Pain   Gary M. Vilke

711

143

Bursitis and Tendinopathy   Ryan Friedberg

714

144

Hand Infections   Carl R. Chudnofsky and Paul B. Vanderbeek

719

145

Low Back Pain   David Della-Giustina

726

146

Foot Disorders   Valerie A. Dobiesz and Carissa Tyo

730

147

Monoarticular Arthritis   Alan C. Heffner

733

148

Polyarticular Arthritis   Richard S. Hartoch and Harold A. Thomas, Jr.

738

SECTION XV

NEUROLOGIC EMERGENCIES   Jeffrey Schaider, MD

149

Organic Brain Syndrome   Rebecca R. Roberts

743

150

Headache   Adrienne J. Birnbaum, Benjamin W. Friedman, and E. John Gallagher

747

151

Subaraehnoid Hemorrhage   Clifton W. Callaway

757

152

Cerebrovascular Disease   Phillip A. Scott

760

153

Seizures   Peter L. Shearer and Andy Jagoda

770

154

Transient Global Amnesia   Richard M. Kaplan

778

155

Peripheral Neuropathies   Phyllis A. Vallee and Christopher A. Lewandowski

779

156

Bell’s Palsy and Trigeminal Neuralgia   Ross P. Berkeley

784

157

Myopathies and Disorders of Neuromuscular Transmission   Sharad Pandit

788

158

Demyelinating Disease   Don W. Penney and Adrienne J. Birnbaum

794

159

Parkinsonism and Other Movement. Disorders   Brendan R. Furlong

798

SECTION XVI

PSYCHIATRIC EMERGENCIES   Jeffrey Schaider, MD

160

Medical Clearance   Kerry B. Broderick

801

161

Depression and Suicidal Ideation   Robert S. Hockberger and Uta Shimizu

803

163

Anxiety Disorders and Panic Attack   Radu V. Saveanu, Basheer Lotfi-Fard, and Douglas A. Rund

806

163

Schizophrenia and Bipolar Disorder   Radu V. Saveanu, Basheer Lotfi-Fard, and Douglas A. Rund

807

164

The Agitated or Violent Patient   Katherine Bakes and Vincent J. Markovchick

811

165

Factitious Illness, Malingering, and Conversion Disorder   Jeffrey S. Dubin and Mark Smith

814

166

Bereavement and Grief Reactions   Kenneth V. Iserson

817

SECTION XVII

DERMATOLOGIC EMERGENCIES   Jeffrey Schaider, MD

167

Life-Threatening Dermatoses   Alan T. forstater and Kenneth J. Neuburger

821

168

Papulosquamous Eruptions   Mark Spektor and John J. Kelly

830

169

Blistering DisorderS   Lisa R. Palivos

836

170

Purpuric Eruptions   Stephen C. Hartsell and Christian M. Neff

840

171

Urticaria   Theodore A. Christopher, C.H. Elijah Sadaphal, Richard Bruno, and Joseph D. Kim

844

SECTION XVIII

ALLERGIC AND IMMI7NOLOGIC EMERGENCIES   Jeffrey Schaider, MD

172

Anaphylaxis   David N. Zull

849

173

Angioedema   Aparajita Sohoni and Eric R. Snoey

854

174

Drug Allergy and Other Drug Reactions   Donna J. Kinser

859

175

Multisystem Autoimmune Disease   Theodore I. Benzer

862

SECTION XIX

INEECNOUS DISEASE EMERGENCIES   Jeffrey Schaider, MD

176

Bacteremia, Sepsis, and Septic Shock   Nathan I. Shapiro and Stephen Trzeciak

869

177

Skin and Soft-Tissue Infections   Alexander T. Trott and Seth Krupp

875

178

Tetanus   Daniel T. Wu

882

179

Meningitis and Encephalitis   Richard M. Kaplan

884

180

Brain Abscess and Other Suppurative CNS Infections   E. Bradshaw Bunney

888

181

Sexually Transmitted Diseases   Diane M. Birnbaumer

892

182

Lyme Disease   Edward B. Bolgiano and Robert A. Barish

898

183

Roeky Mountain Spotted Fever   Michael A. Gibbs

904

184

Other Tick-Borne Diseases   Ann P. Nguyen

908

185

Tuberculosis   Gregory J. Moran and David A. Talan

912

186

Infectious Mononucleosis   David A. Jerrard

917

187

Influenza   Jonathan S. Olshaker

920

188

Human Immunodeficiency Virus Infection and Related Disorders   Richard E. Rothman, Jonathan Scheele, Samuel Yang, and Catherine A. Marco

922

189

Toxic Shock Syndrome   Michelle J. Sergel and Frederick M. Schiavone

933

190

Parasitic Disease   Andrew P. Ross, Keith T. Borg, and Richard J. Ryan

935

191

Blood and Body Fluid Exposures in the Health Care Worker   Peter E. Sokolove

942

192

Food Poisoning   Marc C. Restuccia

946

SECTION XX

HEMATOLOGIC/ONCOLOGIC EMERGENCIES   Jeffrey Schaider, MD

193

Bleeding Disorders   Kathleen C. Hubbell

951

194

Complications of Antithrombotic Therapy   John Bailitz

959

195

Disseminated Intravascular Coagulation, Thrombotic Thrombocytopenic Purpura, and Hemolytic-Ureniic Svndrome   Kathleen C. Hubbell

967

196

Sickle Cell Disease   Michele L. Dorfsman and Donald M. Yealy

972

197

Anemia   Louis S. Binder and Melissa A. Tscheiner

977

198

Transfusion Reactions and Complications   Gregory W. Hendey

979

199

The Cancer Patient in the Emergency Department   Gwendolyn M. Lewis and Austen Chai

983

SECTION XXI

ENDOCRINE AND METABOLIC EMERGENCIES   Jeffrey Schaider, MD

200

Acid-Base Disturbances   Robert Shesser

990

201

Diabetes Mellitus   Scott R. Votey and Anne L. Peters

995

202

Diabetic Ketoacidosis   Scott R. Votey and Anne L. Peters

1002

203

Hyperosmolar Hyperglycemic State   Scott R. Votey and Anne L. Peters

1008

204

Hypoglycemia   Scott R. Votey and Anne L. Peters

1014

205

Alcoholic Ketoacidosis   Sage W. Wiener and Robert S. Hoffman

1019

206

Thyroid Emergencies   Scott >C. Sherman

1021

207

Adrenal and Pituitary Disorders   Adam G. Field

1030

208

Disorders of Sodium and Water Metabolism   Sandra A. Craig

1037

209

Disorders of Potassium Metabolism   Daniel J. Combs and Robert G. Buckley

1043

210

Disorders of Calcium, Phosphate, and Magnesium Metabolism   John W. Love and Robert G. Buckley

1048

211

Rhabdomyolysis   Mark T. Steele

1053

SECTION XXII

PEDIATRICS   Ghazala Q. Sharieff, MD

212

General Approach to the Pediatric Emergency Patient   Robert A. Wiebe

1059

PART I

RESUSCITATION

213

Newborn Resuscitation in the Emergency Department   Rodney B. Boychuk

1066

214

Pediatric Resuscitation   Stephanie J. Doniger

1074

215

Rapid-Sequence Intubation   Steven A. Godwin and Robert C. Luten

1078

216

Shock and Vascular Access   Tonia J. Brousseau

1083

PART II

PEDIATRIC TRAUMA

217

General Approach to Pediatric Trauma   Rick C. Place and Thorn A. Mayer

1089

218

Head Trauma   Dee Hodge III and Kimberly S. Quayle

1096

219

Evaluation of the Cervical Spine   Jeffrey R. Avner

1100

220

Chest and Abdominal Trauma   Christine E. Koerner and Brent R. King

1105

221

Pediatric Fractures   Greg Canty

1110

223

Pediatric Sports Injuries   Greg Canty

1114

PART III

CHIEF COMPLAINTS

223

Abdominal Pain   Loren G. Yamamoto

1117

234

Altered Mental Status   S. Margaret Paik and Mark A. Hostetler

1120

225

Apnea and Apparent Life-Threatening Events   Ghazala Q. Sharieff

1123

236

Ataxia   Peter S. Auerbach and Erin Eileen Endom

1138

237

Chest Pain   Steven M. Selbst

1130

228

Constipation   Le N. Lu and Dewesh Agrawal

1135

239

Crying, Fussy Infant   Naghma S. Khan

1137

230

Dehydration   Todd Wylie and Mark McIntosh

1139

231

Diarrhea   James E. Colletti, Jeahan H. Colletti, and Dale P. Woolridge

1143

332

Failure to Thrive   Robert E. Sapien

1147

233

Fever of Acute Onset   Maureen D. McCollough and David A. Talan

1149

234

Gastrointestinal Bleeding   Michael Gayle and Niranjan Kissoon

1156

235

Headache   Laurie J. Burton, M. Scott Perry, and Harold K. Simon

1160

236

Limp   Jonathan I. Singer

1164

237

Respiratory Distress   Richard Cantor

1167

238

Seizures   Craig R. Warden and Christopher S. Kennedy

1171

239

Pediatric Syncope   Sharon E. Mace

1175

240

Vomiting   Ronald A. Furnival

1179

PART IV

SPECIFIC DISEASES

241

Abuse: Sexual   Jamil Madati

1182

242

Abuse and Neglect: Physical   Seema Shah and Marilyn Kaufhold

1185

343

Appendicitis   Maureen D. McCollough

1189

244

Arrhythmias in Children   Syana Sarnaik, Ajit Sarnaik, and Robert W. Hickey

1192

245

Asthma   Jeffrey F. Linzer, Sr.

1394

246

Bronchiolitis   Esther M. Sampayo and Kathy N. Shaw

1200

247

Cardiac Murmurs   David G. Nelson

1203

248

Cellulitis   Christopher S. Kennedy and Mary E. Moffatt

1206

249

Congenital Heart Disease and CHF   Ann M. Dietrich, Dave Chan, and Leslie Mihalov

1311

250

Croup and Other Upper Airway Disorders   Cristina M. Estrada and Timothy G. Givens

1215

251

Diabetic Ketoacidosis   Cristina M. Estrada and Timothy G. Givens

1219

252

Ear Infections   Melissa A. Vitale and Noel S. Zuckerbraun

1221

253

Eye Disorders   Janet G. Alteveer and Kathryn McCans

1227

254

Foreign Bodies   Timothy P. Young and Lance Brown

1237

255

Genitourinary Disorders   Brianna K. Enriquez and Marianne Gausche-Hill

1339

256

Hematuria and Nephrotic Syndrome   Madeline M. Joseph and Cristina Zerctzke

1246

257

Human Immunodeficiency Virus   Joseph A. Church and Jeffrey F. Linzer, Sr.

1252

258

Immunizations   Maria J. Friedman and Sandra L. Grossman

1258

359

Intussusception   Jonathan I. Singer

1265

260

Kawasaki Disease   James A. Wilde

1266

261

Lymphadenitis and Neck Masses   Keri L. Carstairs

1268

262

Meningitis and Encephalitis   James A. Wilde

1273

263

Metabolic and Endocrine Disorders   Kenneth T. Kwon

1278

264

Newborn Problems   Robert D. Kregenow

1284

265

Nursemaid’s Elbow   Cynthia C. Hoecker

1296

266

Pertussis   Adam Z. Barkin and Roger M. Barkin

1297

267

Pharyngitis and Rheumatic Fever   Jerri A. Rose and Martha S. Wright

1299

268

Pneumonia   Ian McCaslin

1303

269

Psychosocial and Behavioral Emergencies   Cynthia J. Molten and Jill M. Baren

1306

270

Pyloric Stenosis   Ronald A. Furnival

1309

271

Hashes: Maculopapular Lesions and Infestations   Barry Gilmore, Sandip Godambe, and Rudy Kink

1310

272

Rashes: Vesicular, Pustular and Scaly Lesions   Martin I. Herman, W. Ricks Hanna, Jr., and Mindy Longjohn

1319

273

Sickle Cell Disease in Children   Nadeem Qureshi, Stephen Gletsu, and Mohammed Al-Mogbil

1332

274

Sinusitis   Kelli A. Petronis

1337

275

Torticollis   Gregory G. Gaar

1339

276

Urinary Tract Infections in Children   Kathleen Brown

1341

277

Ventricular Shunt Problems   Erin Doherty Phrampus and Christopher King

1345

PART V

ADMINISTRATIVE AND CLINICAL ISSUES

278

Pediatric Sedation and Pain Management   William F. Coombs

1348

279

Dealing with Death or Catastrophic Illness in Children   Phyllis L. Hendry and Mardi Steere

1351

SECTION XXIII

TOXICOLOGY   Louis J. Ling, MD

PART I

GENERAL CONSIDERATIONS

280

General Considerations: Recognition, Initial Approach, and Early Management of the Poisoned Patient   Joshua G. Schier and Robert S. Hoffman

1358

PART II

ALCOHOL-RELATED AGENTS AND CONDITIONS

281

Ethanol   Alexander D. Miller and Binh T. Ly

1364

282

Ethanol Withdrawal   Mark Su

1370

283

Ethylene Glycol   Michael Joseph Burns

1373

284

Methanol   Thomas C. Arnold

1377

285

Isopropanol, Acetone, and Other Glycols   Jeffrey R. Suchard

1379

PART III

ANALGESICS AND RELATED CONDITIONS

286

Acetaminophen   Jeffrey Brent and Robert B. Palmer

1381

287

Salicylates   Christopher H. Linden and Gerald E. Maloney, Jr.

1386

288

Nonsteroidal Anti-Inflammatory Drugs   Marco L.A. Sivilotti

1391

289

Opioids   Anna M. Arroyo Plasencia and R. Brent Furbee

1393

290

Complications of Injection Drug Use   James A. Feldman, Lauren M. Nentwich, and Geoffrey M. Gray

1398

PART IV

ANTICONVULSANTS AND SEDATIVE-HYPNOTICS

291

Barbiturates   Carson R. Harris

1402

292

Benzodiazepines   Matthew W. Morgan and Carson R. Harris

1405

293

Gamma Hydroxybutyrate   Stephen W. Smith

1409

294

Muscle Relaxants and Other Sedative-Hypnotic Agents   E. Martin Caravati and Barbara Insley Crouch

1412

295

Phenytoin   Ejaaz A. Kalimullah and Steven E. Aks

1415

296

Valproicacid Acid   Allan R. Mottram and Sean M. Bryant

1418

297

Carbamazepine   Marco L.A. Sivilotti

1419

298

Other Anticonvulsants   Jenny J. Lu and Mark B. Mycyk

1421

PART V

ANTI-INFECTIVE AGENTS AND BIOCIDES

299

Antimalarial Drugs   Timothy E. Albertson, Kathy A. Marquardt, and Judith A. Alsop

1428

300

Herbicides   Christopher H. Linden and William J. Lewander

1432

301

Isoniazid   Alan D. Woolf

1435

302

Organophosphate and Carbamate Insecticides   Jeanmarie Perrone

1437

303

Nicotine, Pyrethrins, and Organochlorine Pesticides   William K. Chiang and Richard Y. Wang

1440

304

Rodenticides   Richard D. Shih and Robert S. Hoffman

1443

PART VI

CARDIOVASCULAR DRUGS

305

Antidysrhythmic Drugs and Local Anesthetics   S. Rutherfoord Rose and James E. Cisek

1446

306

Centrally Acting Antihypertensive Agents   Susan E. Farrell

1450

307

Beta Blockers   Fermin Barrueto, Jr.

1452

308

Calcium Channel Antagonists   Matthew D. Sztajnkrycer and G. Randall Bond

1455

309

Cardiac Glycosides   John S. Kashani

1459

PART VII

CHEMICALS, GASES AND METALS

310

Arsenic and Mercury   Beth A. Baker

1462

311

Carbon Monoxide   Kent R. Olson

1464

312

Corrosives and Chemical Burns   Larissa I. Velez and Collin S. Goto

1466

313

Cyanide   Heather Long

1470

314

Fluoride and Hydrofluoric Acid   Kennon Heard

1473

315

Hydrocarbons   K. Sophia Dyer

1475