Rosen & Barkin's 5-Minute Emergency Medicine Consult

Jeffrey J. Schaider, MD

Professor, Department of Emergency Medicine

Rush Medical College

Chairman, Department of Emergency Medicine

Cook County Health and Hospital System

Chicago, Illinois

Roger M. Barkin, MD, MPH

Clinical Professor of Emergency Medicine and Pediatrics

University of Colorado School of Medicine

Attending Physician

Department of Emergency Medicine

Denver Health Medical Center

Denver, Colorado

Stephen R. Hayden, MD

Professor of Clinical Medicine

Program Director, Residency Program

Department of Emergency Medicine

University of California

Editor-in-Chief, Journal of Emergency Medicine

Medical Center

San Diego, California

Richard E. Wolfe, MD

Associate Professor

Division of Emergency Medicine

Harvard Medical School

Chief of Emergency Medicine

Beth Israel Deaconess Medical Center

Boston, Massachusetts

Adam Z. Barkin, MD, MPH

Assistant Clinical Professor

Department of Emergency Medicine

University of Colorado School of Medicine

Aurora, Colorado

Associate Medical Director

Emergency Medicine

Rose Medical Center

Denver, Colorado

Philip Shayne, MD

Professor of Emergency Medicine

Vice Chair for Education and Program Director

Department of Emergency Medicine

Emory University School of Medicine

Atlanta, Georgia

Peter Rosen, MD

Senior Lecturer on Medicine

Harvard Medical School

Attending Physician

Beth Israel Deaconess Medical Center

Boston, Massachusetts

Visiting Professor

University of Arizona

Tucson, Arizona

Jeffrey J. Schaider, MD

Roger M. Barkin, MD, MPH

Stephen R. Hayden, MD

Richard E. Wolfe, MD

Adam Z. Barkin, MD, MPH

Philip Shayne, MD

Peter Rosen, MD

R
osen and Barkin’s 5-Minute Emergency Medicine Consult
continues to reflect the evolving nature of our clinical emergency medicine practices. Emergency medicine provides unique challenges to the clinician; the remarkable breadth of clinical conditions encountered, the time constraints of an acute illness, environmental considerations, and the logistical demands of busy emergency departments. Time is of the essence, and this book is truly designed to meet the needs of clinicians working in settings providing urgent and emergent care. To look for a diagnosis, one must think of it, and the very nature of the emergency department (ED) makes prolonged deliberation difficult. Nevertheless, it must become instinctive to think about the statistically rare, but clinically serious entity, rather than to just reach for the statistically probable but nonlife-threatening diagnosis.

R
osen
and Barkin’s 5-Minute Emergency Medicine Consult
provides concise formatted information allowing the busy clinician to respond to each patient appropriately. It is meant to be readily available in the ED, and frequently used in the trenches. Written and edited by practicing clinicians for their colleagues, the book is designed to synthesize a mountain of information into tightly formatted chapters that stimulate analysis and subsequent assessment.

We have attempted to integrate our authors’ expertise, experience, and knowledge base onto the pages of this book. The chapters are not meant to be a diagnostic engine, but rather a place to confirm a diagnosis supported by clinical judgment and the subjective and objective evidence of a patient’s presentation. Our authors attempt to provide a precise and clinically relevant summary useful in caring for the patient while also equipping students and residents with the structure needed to approach individual disease processes. We are indebted to our contributors for their commitment to this task.

The book is intended to be accurate, focused, and readily integrated into practice, rather than being definitive and all encompassing. As in the past, this new edition incorporates new information and approaches to management, while allowing us to modify topics that reflect some of the new challenges we face.

Our goal is to make
Rosen and Barkin’s 5-Minute Emergency Medicine Consult
useful to both novices in emergency medicine and experienced clinicians. The information and organization is designed to be easily used within the “chaos” that surrounds our clinical settings.

Clinical acumen, judgment, and experience are the foundations for our clinical practice. It is our hope that this book will serve students, nurses, emergency medical personnel, residents, and practicing emergency physicians as a readily used resource in excellent patient care and knowledge acquisition.

J
EFFREY
J. S
CHAIDER
R
OGER
M. B
ARKIN
S
TEPHEN
R. H
AYDEN
R
ICHARD
E. W
OLFE
A
DAM
Z. B
ARKIN
P
HILIP
S
HAYNE
P
ETER
R
OSEN

T
he dedication of our authors and the input of our readers is appreciated and forms the foundation for this book. Ashley Fischer of Lippincott Williams & Wilkins held our hands throughout the production.

To my wife Anna and sons Jacob and Isaac—thank you for your continued support and inspiration. Thanks to the Cook County Emergency Medicine Attendings and Residents for their contributions to the book and to enhancing my knowledge and understanding of our unique field.

J.J.S.

I am most appreciative for my family’s support. Suzanne Barkin, MD is an exemplary clinician and has been a remarkable role model and teacher for the residents she has trained. Adam, Jill, Jacob, Eli, Michael, and Rachael remind us daily of the importance of our roles as clinicians and reaffirm our commitment to excellence.

It is also important to acknowledge and thank our colleagues nationally and internationally who continue to teach each of us on an ongoing basis and will hopefully find this book useful in their practices.

R.M.B.

To my wife Marina, and my children Connor, Maia, and Kenny; without your support and understanding, my involvement in academic emergency medicine and this book would be not possible. To my current residents and past graduates; I hope the information in this book helps guide your clinical decisions and prompts you to always maintain your intellectual curiosity.

S.R.H.

To my wife Alice whose unflagging support, patience, and humor provide the support for these efforts. To the faculty members at BIDMC who share the vision and high standards that this book strives to achieve. To Peter who has been a lifelong mentor and a role model.

R.E.W.

To Jill, Jacob, and Eli who provide so much joy, support, laughter, and love.

A.Z.B.

To my wife Helen for her unending patience, support, guidance, and understanding for her support in allowing me the freedom to work on this book. And to my sons Dylan and David for keeping me grounded to what really matters.

P.S.

James G. Adams, MD

Department of Emergency Medicine

Feinberg School of Medicine

Northwestern University

Chair

Department of Emergency Medicine

Northwestern Memorial Hospital

Chicago, Illinois

Erik Adler, MD

Senior Resident

Emergency Medicine

Denver Health

Denver, Colorado

Rami A. Ahmed, DO

Assistant Professor

Department of Emergency Medicine

Northeastern Ohio Medical University

Rootstown, Ohio

Simulation Medical Director

Emergency Medicine

Summa Akron City Hospital

Akron, Ohio

Murtaza Akhter, MD

Senior Resident

Emergency Medicine

Grady Memorial Hospital

Atlanta, Georgia

Steven E. Aks, DO, FACMT, FACEP

Associate Professor

Department of Emergency Medicine

Rush University

Director

The Toxikon Consortium

Division of Toxicology

Department of Emergency Medicine

Cook County Hospital (Stroger)

Chicago, Illinois

Nadeem Alduaij, MD, MPH

Adjunct Assistant Professor

Institute of Public Health

UAE University

Abu Dhabi, UAE

Staff Physician

Department of Emergency Medicine

Adan Hospital

Riqqa, Kuwait

Paul J. Allegretti, DO, FACOEP, FACOI