Contributing Authors

v

Preface

xvii

Acknowledgments

xviii

List of Algorithms

xxvii

SECTION I

LIFE-THREATENING EMERGENCIES

Chapter 1

Resuscitation—Pediatric Basic and Advanced Life Support   Stephen Ludwig, MD, and Jane M. Lavelle, MD

1

Chapter 2

Neonatal Resuscitation   Paul L. Aronson, MD, and Evaline A. Alessandrini, MD, MSCE

32

Chapter 3

Shock   Louis M. Bell, MD

46

Chapter 4

Sedation and Analgesia   Joel A. Fein, MD, MPH, and Steven M. Selbst, MD

58

Chapter 5

Emergency Airway Management—Rapid Sequence Intubation   Loren G. Yamamoto, MD, MPH, MBA, FAAP, FACEP

74

Chapter 6

Emergency Medical Services and Transport Medicine   George A. Woodward, MD, MBA, Andrew L. Garrett, MD, and MPH, Brent R. King, MD, MMM, and M. Douglas Baker, MD

85

Chapter 7

Emergency Department Recognition and Management of Victims of Biological and Chemical Terrorism   Richard J. Scarfone, MD, Fred M. Henretig, MD, Theodore J. Cieslak, MD, James M. Madsen, MD, MPH, FCAP, and FACOEM, COL, MC-FS, and Edward M. Eitzen Jr., MD, MPH

125

SECTION II

SIGNS AND SYMPTOMS

Chapter 8

Abdominal Distension   Jeffrey R. Avner, MD, FAAP

153

Chapter 9

Apnea   Susan B. Torrey, MD

160

Chapter 10

Ataxia   Janet H. Friday, MD

164

Chapter 11

Breast Lesion   Rakesh D. Mistry, MD, MS

168

Chapter 12

Coma and Altered Level of Consciousness   Douglas S. Nelson, MD

176

Chapter 13

Constipation   Rose C. Graham, MD, MSCE, and Stephen Ludwig, MD

187

Chapter 14

Cough   Richard G. Bachur, MD

194

Chapter 15

Cyanosis   Anne M. Stack, MD

198

Chapter 16

Crying and Colic in Early Infancy   Barbara B. Pawel, MD, and Fred M. Henretig, MD

203

Chapter 17

Dehydration   Kathy N. Shaw, MD, MSCE, and Philip R. Spandorfer, MD, MSCE

206

Chapter 18

Diarrhea   Gary R. Fleisher, MD

212

Chapter 19

Disturbed Child   Laura L. Chapman, MD, Emily R. Katz, MD, and Thomas H. Chun, MD

217

Chapter 20

Dizziness   Stephen J. Teach, MD, MPH

226

Chapter 21

Edema   Linda L. Brown, MD, MSCE

232

Chapter 22

Epistaxis   Fran Nadel, MD, MSCE, and Fred M. Henretig, MD

236

Chapter 23

Eye—Red   Alex V. Levin, MD, MHSc, FRCSC

240

Chapter 24

Eye—Strabismus   Alex V. Levin, MD, MHSc, FRCSC

245

Chapter 25

Eye—Unequal Pupils   Alex V. Levin, MD, MHSc, FRCSC

253

Chapter 26

Eye—Visual Disturbances   Karen Dull, MD

259

Chapter 27

Fever   Elizabeth R. Alpern, MD, MSCE, and Fred M. Henretig, MD

266

Chapter 28

Foreign Body—Ingestion/Aspiration   Jeff E. Schunk, MD

276

Chapter 29

Gastrointestinal Bleeding   Stephen J. Teach, MD, MPH

283

Chapter 30

Groin Masses   Deena Berkowitz, MD, MPH, and Bruce L. Klein, MD

291

Chapter 31

Hearing Loss   Robert J. Vinci, MD

295

Chapter 32

Patients With Heart Murmurs   Benjamin K. Silverman, MD

300

Chapter 33

Hematuria   Erica L. Liebelt, MD, FACMT

310

Chapter 34

Hypertension   Erika Constantine, MD

315

Chapter 35

Immobile Arm   Sara A. Schutzman, MD

324

Chapter 36

Injury—Ankle   Angela C. Anderson, MD, FAAP

328

Chapter 37

Injury—Head   Sara A. Schutzman, MD

337

Chapter 38

Injury—Knee   Marc N. Baskin, MD

345

Chapter 39

Injury—Shoulder   Marc N. Baskin, MD

353

Chapter 40

Jaundice—Unconjugated Hyperbilirubinemia   Kenneth D. Mandl, MD. MPH

359

Chapter 41

Jaundice—Conjugated Hyperbilirubinemia   Jonathan I. Singer, MD

367

Chapter 42

Limp   Susanne Kost, MD, PAAP, FACEP

372

Chapter 43

Lymphadenopathy   Richard Malley, MD

378

Chapter 44

Neck Mass   Carla Maria Pruden, MD, MPH, and Constance M. McAneney, MD, MS

385

Chapter 45

Neck Stiffness   Leah Tzimenatos, MD, Cheryl Vance, MD, and Nathan Kuppermann, MD, MPH

392

Chapter 46

Odor—Unusual   Alison Brent, MD

402

Chapter 47

Oligomenorrhea   Jan E. Paradise, MD

410

Chapter 48

Oral Lesions   Mark G. Roback, MD

415

Chapter 49

Pain—Abdomen   Mark I. Neuman, MD, MPH

421

Chapter 50

Pain—Back   Howard M. Corneli, MD

429

Chapter 51

Pain—Chest   Robyn L. Byer, MD

434

Chapter 52

Pain—Dysphagia   Ronald A. Furnival, MD, Vaishali Jha, MD, and George A. Woodward, MD, MBA

443

Chapter 53

Pain—Dysuria   Jacqueline Bryngil Corboy, MD

450

Chapter 54

Pain—Earache   Amy M. Arnett, MD

455

Chapter 55

Headache   Christopher King, MD, FACEP

461

Chapter 56

Pain—Joints   Richard J. Scarf one, MD

468

Chapter 57

Pain—Scrotal   Catherine E. Perron, MD

474

Chapter 58

Pallor   Sonal N. Shah, MD, MPH

483

Chapter 59

Palpitations   James F. Wiley II, MD, MPH

491

Chapter 60

Polydipsia   Ronald I. Paul, MD

496

Chapter 61

Rash—Eczematous   Todd A. Florin, MD, and James M. Callahan, MD

499

Chapter 62

Rash—Maculopapular   Karen D. Gruskin, MD

509

Chapter 63

Rash—Papular Lesions   Paul J. Honig, MD, Leslie Castelo-Soccio, MD, PhD, and Albert C. Yan, MD

520

Chapter 64

Rash—Papulosquamous Lesions   Paul J. Honig, MD, Leslie Castelo-Soccio, MD, PhD, and Albert C. Yan, MD

526

Chapter 65

Rash—Petechiae and Purpura   Rebecca L. Vieira, MD

532

Chapter 66

Rash—Urticaria   William J. Lewander, MD, and Emily A. Zajano, MD

540

Chapter 67

Rash—Vesicobullous   Paul J. Honig, MD, Leslie Castelo-Soccio, MD, PhD, and Albert C. Yan, MD

543

Chapter 68

Respiratory Distress   Debra L. Weiner, MD, PhD

551

Chapter 69

Seizures   Vincent W. Chiang, MD

564

Chapter 70

The Septic-Appearing Infant   Steven M. Selbst, MD

571

Chapter 71

Sore Throat   Gary R. Fleisher, MD

579

Chapter 72

Stridor   Holly E. Perry, MD

584

Chapter 73

Syncope   Carlos A. Delgado, MD, FAAP

589

Chapter 74

Tachycardia   James F. Wiley II, MD, MPH

596

Chapter 75

Urinary Frequency in Childhood   Robert G. Bolte, MD

601

Chapter 76

Vaginal Bleeding   Jan E. Paradise, MD

606

Chapter 77

Vaginal Discharge   Jan E. Paradise, MD

613

Chapter 78

Vomiting   Molly (Martha W.) Stevens, MD, MSCE, and Fred M. Henretig, MD

617

Chapter 79

Weakness   Nicholas Tsarouhas, MD, and Joanne M. Decker, MD

626

Chapter 80

Wheezing   Vincent J. Wang, MD

635

Chapter 81

Weight Loss   Cynthia R. Jacobstein, MD, MSE

643

SECTION III

MEDICAL EMERGENCIES

Chapter 82

Asthma and Allergic Emergencies   Michelle D. Stevenson, MD, MSE, and Richard M. Ruddy, MD

649

Chapter 83

Bites and Stings   Dee Hodge III, MD

671

Chapter 84

Cardiac Emergencies   Michael H. Gewitz, MD, and Paul K. Woolf, MD

690

Chapter 85

Dermatologic Urgencies and Emergencies   Paul J. Honig, MD, Leslie Castelo-Soccio, MD, PhD, and Albert C. Yan, MD

730

Chapter 86

Endocrine Emergencies   Michael S.D. Agus, MD

758

Chapter 87

Environmental Emergencies   Michele Burns Ewald, MD, and Carl R. Baum, MD

783

Chapter 88

Injuries Involving Radiation   Henry D. Royal, MD, Joanna R. Fair, MD, PhD, and David E. Drum, MD, PhD

805

Chapter 89

Gastrointestinal Emergencies   Dennis R. Durbin, MD, MSCE, Chris A. Liacouras, MD, and Jeffrey A. Seiden, MD

817

Chapter 90

Pediatric and Adolescent Gynecology   Joeli Hettler, MD

839

Chapter 91

Hematologic Emergencies   Colin A. Sieff, MD, and Jennifer C. Kesselheim, MD, M.Ed

862

Chapter 92

Infectious Disease Emergencies   Marvin B. Harper, MD, and Gary R. Fleisher, MD

887

Chapter 93

Infectious Disease Emergencies—Sexually Transmitted Diseases   Marvin B. Harper, MD

953

Chapter 94

Metabolic Emergencies   Debra L. Weiner, MD, PhD

972

Chapter 95

Problems in the Early Neonatal Period   Ameer P. Mody, MD, MPH, and Benjamin K. Silverman, MD

992

Chapter 96

Neurologic Emergencies   Marc H. Gorelick, MD, MSCE, and Charles D. Blackwell, MD

1011

Chapter 97

Oncologic Emergencies   Amy L. Billett, MD, and Jennifer C. Kesselheim, MD, M.Ed

1033

Chapter 98

Pulmonary Emergencies   Joshua Nagler, MD

1067

Chapter 99

Emergencies in Cystic Fibrosis   Eva Leder, MD, and Henry L. Dorkin, MD

1091

Chapter 100

Renal and Electrolyte Emergencies   Nancy M. Rodig, MD

1099

Chapter 101

Rheumatologic Emergencies   Amy L. Woodward, MD, MPH, and Robert P. Sundel, MD

1127

Chapter 102

Toxicologic Emergencies   Kevin C. Osterhoudt, MD, MS, Michele Burns Ewald, MD, Michael Shannon, MD, MPH, and Fred M. Henretig, MD

1171

Chapter 103

Evaluation of the Ill Returning Traveler   Mark L. Waltzman, MD, and Richard Malley, MD

1224

SECTION IV

TRAUMA

Chapter 104

An Approach to the Injured Child   Lois K. Lee, MD, MPH, and Gary R. Fleisher, MD

1233

Chapter 105

Major Trauma   Mark L. Waltzman, MD, and David P. Mooney, MD

1244

Chapter 106

Minor Trauma—Lacerations   Steven M. Selbst, MD, and Magdy W. Attia, MD

1256

Chapter 107

Abdominal Trauma   Richard A. Saladino, MD, and Dennis P. Lund, MD

1271

Chapter 108

Burns   Mark D. Joffe, MD

1281

Chapter 109

Dental Trauma   Linda P. Nelson, DMD, MSCD, Howard L. Needleman, DMD, and Bonnie L. Padwa, DMD, MD

1289

Chapter 110

Otolaryngologic Trauma   Ken Kazahaya, MD, MBA

1298

Chapter 111

Facial Trauma   Mark I. Neuman, MD, MPH

1307

Chapter 112

Genitourinary Trauma   Carmen Teresa Garcia, MD, and Valerie T. Thompson, MD

1316

Chapter 113

Hand Trauma   Michael Witt, MD, MPH, and Donald S. Bae, MD

1328

Chapter 114

Musculoskeletal Trauma   David Bachman, MD, and Stephen Santora, MD

1335

Chapter 115

Neck Trauma   George A. Woodward, MD, MBA

1376

Chapter 116

Neurotrauma   David S. Greenes, MD

1422

Chapter 117

Eye Trauma   Alex V. Levin, MD, MHSc, FRCSC

1448

Chapter 118

Thoracic Trauma   Howard A. Kadish, MD, MBA

1459

SECTION V

SURGICAL EMERGENCIES

Chapter 119

Minor Lesions and Injuries   Sarita Chung, MD

1478

Chapter 120

Approach to the Care of the Technology-Assisted Child   Joel A. Fein, MD, MPH, Kathleen M. Cronan, MD, and Jill C. Posner, MD, MSCE

1494

Chapter 121

Abdominal Emergencies   Richard G. Bachur, MD

1515

Chapter 122

Dental Emergencies   Linda P. Nelson, DMD, MSCD, and Stephen Shusterman, DMD

1538

Chapter 123

Otolaryngologic Emergencies   Lisa M. Elden, MD, CM, and William P. Potsic, MD, MMM

1545

Chapter 124

Urologic Emergencies   Howard M. Snyder III, MD

1560

Chapter 125

Orthopedic Emergencies   Mark D. Joffe, MD, and John M. Loiselle, MD

1568

Chapter 126

Neurosurgical Emergencies, Nontraumatic   Daniel S. Tsze, MD, MPH, and Dale W. Steele, MD

1587

Chapter 127

Ophthalmic Emergencies   Alex V. Levin, MD, MHSc, FRCSC

1595

Chapter 128

Thoracic Emergencies   Joy L. Collins, MD, FAAP, and Michael L. Nance, MD

1603

Chapter 129

Transplantation Emergencies   Heidi C. Werner, MD, Karan McBride Emerick, MD, Maryanne R.K. Chrisant, MD, and Elizabeth B. Rand, MD

1624

SECTION VI

PSYCHOSOCIAL EMERGENCIES

Chapter 130

Adolescent Emergencies   Monika Goyal, MD, Cynthia J. Mollen, MD, MSCE, and Jane M. Lavelle, MD

1634

Chapter 131

Behavioral Emergencies   Mirna M. Farah, MD, and Joseph Zorc, MD, MSCE

1650

Chapter 132

Child Abuse   Joanne N. Wood, MD, MSHP, and Stephen Ludwig, MD

1656

Chapter 133

Psychiatric Emergencies   Emily R. Katz, MD, Laura L. Chapman, MD, and Thomas H. Chun, MD

1701

SECTION VII

PROCEDURES

Chapter 134

Ultrasound   Jason Levy, MD

1729

Chapter 135

Illustrated Techniques of Pediatric Emergency Procedures   Lynn Babcock Cimpello, MD, Robert Jay Deutsch, MD, MPH, FAAP, Cinnamon Dixon, DO, Javier A. Gonzalez Del Rey, MD, Dee Hodge III, MD, David M. Jaffa, MD, Lisa L. Lewis, MD, Matthew Mittiga, MD, John M. Loiselle, MD, Constance M. McAneney, MD, MS, and Richard M. Ruddy, MD

1744

APPENDICES

Appendix A

Pediatric Emergency Medicine Equipment   Stephen Ludwig, MD

1843

Appendix B

Emergency Drug Compendium   Shannon F. Manzi, PharmD

1846

Appendix C

Practical Information   Joshua Nagler, MD

1881

Appendix D

Parental Instruction Sheets   Nanette C. Dudley, MD

1891

Appendix E

Clinical Pathways in Emergency Medicine   Jane M. Lavelle, MD, and Cynthia R. Jacobstein, MD, MSE

1907

Index

1933