E. Contents

PART 1 Neurologic Emergencies

Phil~p Buttaravoli and Mar~oTrabulsy

1 Dystonic Drug Reaction 1 2 Heat Illness (Heat Edema, Heat Syncope, Heat Cramps, Heat Exhaustion) 4 3 Hyperventilation 8 4 Hysterical Coma or Pseudoseizure 11 5 Idiopathic Facial Paralysis (Bell's Palsy) 14 6 Migraine Headache 18 7 Seizures (Convulsions, Fits), Adult 23 8 Seizures (Convulsions, Fits), Febrile and Pediatric 29 9 Tension-Type (Muscle Contraction) Headache 33

10 Trivial, Minimal, and Minor HeadTrauma (Concussion) 37 11 Vasovagal or Neurocardiogenic or Neurally Mediated Syncope (Faint, Swoon) 42 12 Vertigo (Dizziness, Lightheadedness) 48 13 Weakness 56

P A R T 2 Ophthalmologic Emergencies

Philip Buttaravoli and Ray Keller

14 Conjunctivitis (Pink Eye) 59 15 Contact Lens Complications 65

16 Corneal Abrasion 68 17 Foreign Body, Conjunctival 72 18 Foreign Body, Corneal 75 19 Hordeolum (Stye) 79 20 Iritis (Acute Anterior Uveitis) 81 21 Periorbital and Conjunctival Edema 85 22 Periorbital Ecchymosis (Black Eye) 87 23 Removal of Dislocated Contact Lens 90 24 Subconjunctival Hemorrhage 92 25 Ultraviolet Keratoconjunctivitis (Welder's orTanning Bed Burn) 94

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P A R T 3 Ear, Nose, and Throat Emergencies

Philip Buttaravoli and Steve Hulsey

26 Cerumen Impaction (Earwax Blockage) 97 27 Epistaxis (Nosebleed) 100 28 Foreign Body, Ear 108 29 Foreign Body, Nose 113 30 Foreign Body, Throat 118 31 Laryngotracheobronchitis (Croup) 122 32 Mononucleosis (Glandular Fever) 126 33 Nasal Fracture (Broken Nose) 129 34 Otitis Externa (Swimmer's Ear), Acute 132 35 Otitis Media, Acute 137 36 Otitis Media with Effusion; Serous (Secretory) Otitis Media (Glue Ear) 142 37 Perforated Tympanic Membrane (Ruptured Eardrum) 145 38 Pharyngitis (SoreThroat) 147 39 Rhinitis, Acute (Runny Nose) 152 40 Rhinosinusitis (Sinusitis) 157

P A R T 4 Oral and Dental Emergencies

Philip Buttaravoli and Dan~el Wolfson

41 Aphthous Ulcer (Canker Sore) 161 42 AvulsedTooth, Dental Subluxation, Dental Luxation 166 43 Bleeding after Dental Surgery 172 44 Burning Mouth Syndrome, Burning Tongue (Glossodynia) 174 45 Dental Pain, Periapical Abscess (Tooth Abscess) 178 46 Dental Pain, Pericoronitis 181 47 Dental Pain, Postextraction Alveolar Osteitis (Dry Socket) 183 48 Dental Pain, Pulpitis 185 49 DentalTrauma (Fracture, Subluxation, and Displacement) 187 50 Gingivitis and Acute Necrotizing Ulcerative Gingivitis (Trench Mouth) 191 51 Lacerations of the Mouth 193 52 Mucocele (Mucous Cyst) 196 53 Oral Candidiasis (Thrust or Yeast Infection) 198 54 Oral Herpes Simplex (Cold Sore, Fever Blister) 200 55 Orthodontic Complications 203 56 Perleche (Angular Cheilitis) 205 57 Sialolithiasis (Salivary Duct Stones) 207 58 Temporomandibular Disorder (TMD,TMJ Syndrome) 210 59 Temporomandibular Joint Dislocation (Jaw Dislocation) 214 60 Uvular Edema, Acute 21 7

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P A R T 5 Pulmonary and Thoracic Emergencies

Philip Buttaravoli and Katherine Walsh

61 Bronchitis (Chest Cold), Acute 221 62 Costochondritis and Musculoskeletal Chest Pain 226 63 Inhalation Injury (Smoke Inhalation) 229 64 Irritant Incapacitant Exposure (Lacrimators, Riot Control Agents,Tear Gas) 233 65 Rib Fracture and Costochondral Separation (Broken Rib) 236

PART 6 Gastrointestinal Emergencies 241

Phll~p Buttaravoll and Maj Els~nger

66 Anal Fissure 24 1 67 Constipation, Irritable Bowel Syndrome, and Colic (Stomach Cramps) 245 68 Diarrhea (Acute Gastroenteritis) 253 69 Enterobiasis (Pinworm,Threadworm, Seatworm) 260 70 Esophageal Food Bolus Obstruction (Steakhouse or Cafe Coronary Syndrome) 263 71 Foreign Body, Rectal 267 72 Foreign Body, Swallowed 273 73 Hemorrhoids (Piles) 280 74 Innocuous Ingestions 285 75 Singultus (Hiccups) 287 76 Vomiting (Food Poisoning, Gastroenteritis) 290

PART 7 Urologic Emergencies

Philip Buttaravoli and Andrew Bushnell

Blunt Scrotal Trauma Colorful Urine Epididymitis Genital Herpes Simplex Phimosis and Paraphimosis Prostatitis, Acute Bacterial Urethritis (Drip, Clap) Urinary Retention, Acute Urinary Tract Infection, Lower (Cystitis), Uncomplicated Urinary Tract Infection, Upper (Pyelonephritis)

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Gynecologic Emergencies Philip Buttaravoli and Wendy James

87 Bartholin Abscess 88 Condylomata Acuminata (Genital Warts) 89 ContactVulvovaginitis 90 Dysmenorrhea (Menstrual Cramps) 91 Foreign Body, Vaginal 92 "Morning After" Emergency Contraception 93 Pelvic Inflammatory Disease (PID) 94 Vaginal Bleeding 95 Vaginitis

P A R T 9 Musculoskeletal Emergencies

Ph~l~p Buttaravoli, Laurel Plante, and Wayne Misselbeck

96 Acromioclavicular (Shoulder) Separation 97 Ankle Sprain (Twisted Ankle) 98 Annular Ligament Displacement, Radial Head Subluxation (Nursemaid's Elbow) 99 Boutonniere Finger

100 Boxer's Fifth Metacarpal Fracture 101 Bursitis 102 Carpal Tunnel Syndrome 103 Cervical Strain (Whiplash) 104 Cheiralgia Paresthetica (Handcuff Neuropathy) 105 Clavicle (Collarbone) Fracture 106 Coccyx Fracture (Tailbone Fracture) 107 De Quervain Paratenonitis (ThumbTenosynovitis) 108 ExtensorTendon Avulsion - Distal Phalanx (Baseball or Mallet Finger) 109 Finger Dislocation (PIP Joint) 11 0 Finger Sprain (PIP Joint) 11 1 Fingertip (Tuft) Fractures 112 Flexor Digitorum ProfundusTendon Avulsion-Distal Phalanx (Splay Finger) 11 3 Ganglion Cysts 114 Gouty Arthritis, Acute 11 5 Knee Sprain 116 Lateral Epicondylitis and Medial Epicondylitis (Tennis Elbow, Golfer's Elbow) 117 Ligament Sprains (Including Joint Capsule Injuries) 1 18 Locked Knee 119 Lumbar Strain, Acute ("Mechanical"Low Back Pain, Sacroiliac Dysfunction) 120 Monarticular Arthritis, Acute 121 Muscle Cramps (Charley Horse) 122 Muscle Strains and Tears

123 Myofascial Pain Syndrome, Fibromyalgia (Trigger Points) 124 Patellar Dislocation (Kneecap Dislocation) 125 Plantar Fasciltis ("Heel Spur") 126 "PlantarisTendon" Rupture, Gastrocnemius Muscle Tear (Calf MuscleTear) 127 Polymyalgia Rheumatica 128 Radial Head Fracture 129 Radial Neuropathy (Saturday Night Palsy) 130 Scaphoid Fracture 131 Shoulder Dislocation 132 Tendinopathy:Tendinosis, Paratenonitis (Tendinitis) 133 Toe Fracture (Broken Toe) 134 Torticollis (Wryneck) 135 Ulnar Collateral LigamentTear of theThumb (Ski Pole or Gamekeeper1sThumb)

P A R T 10 Soft Tissue Emergencies

Ph~llp Buttaravoll, Mlchael Sheeser, and Kevln Wyne

Bicycle Spoke Injury and Other Crush Injuries Contusion (Bruise) Fingernail orToenail Avulsion Fingertip Avulsion, Superficial Fishhook Removal Foreign Body Beneath Nail Impalement Injuries, Minor Laceration, Simple Mammalian Bites Marine Envenomations Nail Bed Laceration Nail Root Dislocation Needle (Foreign Body) in Foot Paronychia Pencil Point Puncture Puncture Wounds Ring Removal Sliver, Superficial (Splinter) Subcutaneous Foreign Bodies (Metal, Dental Fragments, Glass, Gravel, and Hard Plastic) Subungual Ecchymosis (TennisToe) Subungual Hematoma TornISplit Earlobe Traumatic Tattoos and Abrasions Zipper Entrapment (Penis or Chin)

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Dermatologic Emergencies Phrlip Buttaravoli and Page Hudson

160 Allergic Contact Dermatitis 161 Arachnid Envenomation (Spider Bite) 162 Arthropod Bites (Bug Bites, Insect Bites) 163 Cutaneous Abscess or Pustule 164 Cutaneous Larva Migrans (Creeping Eruption) 165 Diaper Dermatitis (Diaper Rash) 166 Erysipelas, Cellulitis, Lymphangitis 167 Fire Ant Stings 168 Friction Blister 169 Frostnip, Frostbite, and Mild Hypothermia 170 Herpes Zoster (Shingles) 171 Hymenoptera (Bee, Wasp, Hornet) Envenomation (Bee Sting) 172 Impetigo 173 Partial-Thickness (Second-Degree) Burns andTar Burns 174 Pediculosis (Lice, Crabs) 175 Pityriasis Rosea 176 Pyogenic Granuloma or Lobular Capillary Hemangioma (Proud Flesh) 177 Scabies (Human Itch Mite) 178 Sea Bather's Eruption (Sea Lice) 179 Sunburn 180 Tick Bite, Tick Removal 181 Tinea Pedis,Tinea Cruris,Tinea Corporis (Athlete's Foot, Jock Itch, Ringworm) 182 Toxicodendron (Rhus), Allergic Contact Dermatitis (Poison Ivy, Oak, or Sumac) 183 Urticaria, Acute (Hives) 184 Warts (Common Wart, Plantarwart)

Appendixes A Complete Eye Examination 757 B Digital Block 758 C Fingertip Dressing, Simple 761 D Oral Nerve Blocks 763 E Procedural Sedation and Analgesia 765

Alfred Sacchetti 765 F Rabies Prophylaxis 769 G State and Regional Poison Control Centers 772 H Tetanus Prophylaxis 779