Copyright Information The Atlas of Emergency Medicine, Third Edition Copyright © 2010, 2002, 1997, by The McGraw-Hill Companies, Inc. All rights reserved. Printed in China. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher. The views expressed in this work are those of the individual authors and do not reflect the official policy or position of the Departments of the Navy, Army or Air Force, the Department of Defense, or the U.S. Government. ISBN 978-0-07-149618-6 MHID 0-07-149618-1 Notice Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the information contained herein with other sources. For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs.
Preface We have a passion for improving patient care. Our journey with The Atlas of Emergency Medicine began with an aggressive goal of producing the most comprehensive source of highquality emergency department images available. The emergency department is, perhaps, the most diverse melting pot of patient conditions in the hospital. Diagnostic accuracy and prognostic prediction often rely heavily on visual clues. Our efforts are directed toward maximizing this skill. We also strongly believe the visual experience is critical to education in medicine, and that great images are the next best tool besides actual bedside exposure. Images often teach faster and with greater impact than many pages of text or hours of lecture. We continue our pursuit of these goals with a substantially updated, expanded, and improved third edition of The Atlas of Emergency Medicine. Nearly all of our changes and additions come from reader suggestions and criticisms, all of which we receive with sincere gratitude. First, we have changed the format to reduce text and allow for more images. Hence the text is more concise, providing only essential information. Each chapter item is now organized into: “Clinical Summary,” which includes pertinent differential diagnosis where appropriate, followed by “Emergency Department Treatment and Disposition” and, finally, “Pearls.” We have endeavored to provide “Pearls” that are more relevant and represent tips for diagnosis or unique aspects of a condition that are difficult to find in a typical text. Second, after extensive review and critique, hundreds of new and replacement images have been added.
Third, four new chapters grace the pages of this new edition: Tropical Medicine, Toxicology, Airway, and Electrocardiography. Our increased emphasis on worldwide delivery of healthcare and easier patient travel is represented with Tropical Medicine. Toxicology is one of our core skills and a welcome addition as a separate chapter. We have made a decision to expand beyond our main emphasis on pictorial presentations with the addition of the Airway and ECG chapters. We included these topics, beautifully displayed in an atlas format, as they represent critical areas of emergency medicine expertise and are extremely visual. We believe they significantly contribute to the Atlas' ability to provide important visual information in a single source. These new chapters also complement our greatly expanded and updated Emergency Department Ultrasound chapter. The primary audience for this text is emergency medicine clinicians, educators, residents, nurses, prehospital caregivers, and medical students who provide emergency and primary care. We hope it will aid them in making diagnoses and help take the student “to the bedside.” Many have found it extremely useful as a review for the ABEM written examination. Other healthcare workers, such as internists, family physicians, pediatricians, nurse practitioners, and physician assistants will find the Atlas a useful guide in identifying and treating the many conditions for which visual cues significantly guide, improve, and expedite diagnosis and treatment. We would also like to thank the many contributors and readers who have helped make this possible. Lastly, and most importantly, we express our gratitude to our patients who were willing to be a “great case” in the Atlas, thus ultimately paving the way for improved emergency care. Kevin J. Knoop, MD, MS Lawrence B. Stack, MD Alan B. Storrow, MD R. Jason Thurman, MD
Cover Preface Copyright Contributors Chapters Chapter 1. Head and Facial Trauma Chapter 2. Ophthalmologic Conditions Chapter 3. Funduscopic Findings Chapter 4. Opthalmic Trauma Chapter 5. Ear, Nose, and Throat Conditions Chapter 6. Mouth Chapter 7. Chest and Abdomen Chapter 8. Urologic Conditions Chapter 9. Sexually Transmitted Infections and Anorectal Conditions Chapter 10. Gynecologic and Obstetric Conditions Chapter 11. Extremity Trauma Chapter 12. Extremity Conditions Chapter 13. Cutaneous Conditions Chapter 14. Pediatric Conditions
Chapter 15. Child Abuse Chapter 16. Environmental Conditions Chapter 17. Toxicological Conditions Chapter 18. Wounds and Soft Tissue Injuries Chapter 19. Forensic Medicine Chapter 20. HIV Conditions Chapter 21. Tropical Medicine Chapter 22. Airway Procedures Chapter 23. ECG Abnormalities Chapter 24. Emergency Ultrasound Chapter 25. Microscopic Findings