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or cause whatsoever whether such claim or cause arises in contract, t01i or otherwise.

To my parents, for teaching me the meaning of hard work and reminding me when to

slow down. To Mason and Colin, you bring me all the joy and happiness that a father

could imagine. To Michelle, for your constant love and support.

Scott C. Sherman, MD

To my parents for a lifetime of encouragement; to Bridget, Elsie, and Jane, who give

meaning to my life; and to our patients, who give us the opportunity to learn

something new every shift.

Joseph M. Weber, MD

To my beautiful wife, loving parents, and gracious sisters, without whose c ompassion

and support my career would not be possible. And to teachers everywhere, helping

the next generation achieve their dreams.

Mike Schindlbeck, MD

To my students, who continually show me how much

more I have to learn.

Rahul Patwari, MD

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Contents

Contributors viii

Preface XVI

Acknowledgments xvii

I. Common Procedures IV. Pulmonary Emergencies

1. Incision and Drainage 1 20. Dyspnea 84

2. Arterial Blood Gas 4 21. Asthma 89

3. Central Venous Access 8 22. Chronic Obstructive Pulmonary

Disease 95

4. Procedural Sedation 13

23. Pneumonia 100

5. Lumbar Puncture 16

24. Pneumothorax 105

6. Laceration Repair 20

25. Pulmonary Embolism 108

7. Needle and Tube Thoracostomy 24

V. Abdominal Emergencies

8. Introduction to Emergency

Ultrasonography 27 26. Acute Abdominal Pain 112

II. Resuscitation 27. Appendicitis 118

9. Emergency Medical Services 30 28. Acute Cholecystitis 121

1 o. Cardiopulmonary Arrest 33 29. Abdominal Aortic Aneurysm 125

11. Airway Management 37 30. Gastrointestinal Bleeding 128

12. Shock 42 31. Intestinal Obstruction 131

Ill. Cardiovascular Emergencies 32. Mesenteric Ischemia 135

13. Chest Pain 46 VI. Infectious Disease Emergencies

14. Acute Coronary Syndromes 50 33. Fever 138

15. Congestive Heart Failure 57 34. Sepsis 142

16. Dysrhythmias 63 35. Meningitis and Encephalitis 147

17. Aortic Dissection 70 36. Soft Tissue Infections 151

18. Hypertensive Emergencies 75 37. Human Immunodeficiency Virus 156

19. Syncope 80 38. Blood and Body Fluid Exposure 162

v