MOH Pocket Manual in Emergency Medicine.pdfVIP专享VIP免费原创优质

MOHPocketManualinEmergencyMOHPocketManualinEmergency3cardiacemergencyCOntents4MOHPocketManualinEmergencycontentContentsChapter1:Cardiacemergency:•AcuteSTElevationMyocardialInfarction1.•NonSTElevationMyocardialInfarction.Atrialfibrillation.•Bradydysrhythmias.•Hypertension.•AcuteAorticSyndromes.•DeepVenousThrombosis.Chapter2:Pulmonaryemergency:•AcutebronchialAsthma.Chapter3:Neurologicalemergency:•Headache.•AdultAcuteBacterialMeningitis.Chapter4:Toxicology:•Acetaminophen(Paracetamol,APAP)Overdose.•CarbonMonoxidePoisoning.Chapter5:Hematologicalemergency:•Sicklecelldiseaseinemergencydepartment.•AnticoagulationEmergencies.Chapter6:Endocrinologyandelectrolyteemergency:•HypokalemicandHyperkalemiaEmergencies.•Diabeticemergency.MOHPocketManualinEmergency5content•ThyroidStormandMyxedemaComaChapter7:Urologicalemergency:•Rhabdomyolysis.•AcuteUrinaryRetention.Chapter8:Traumaandenvironmental:•SevereTraumaticBrainInjury.•ElectricalInjuries.•Heatinjury.Chapter9:MedicationsList6MOHPocketManualinEmergencycardiacemergencyChapterMOHPocketManualinEmergency7cardiacemergencyChapterCRADIACEMERGENCY18MOHPocketManualinEmergencycardiacemergencyAcuteSTElevationandNonSTElevationMyocardialInfarctionOverviewAcutecoronarysyndromeinvolves:1.STelevationacutemyocardialinfarction2.Non–ST-segmentelevationacutemyocardialinfarction3.Unstableangina(UA).AcuteSTelevationmyocardialinfarctiontypicallyoccurswhenaclotleadstocompleteocclusionofacoronaryarterywithtransmural,orfullthicknessmyocardialinfarction.TheECGwillshowSTsegmentelevationintheinvolvedareaoftheheart.Non–ST-segmentelevationacutecoronarysyndromes(NSTE-ACS)referstoadiseaseprocesscharacterizedbyreducedcoronarybloodflowresultingincoronaryischemiawithoutST-segmentelevationsonanelectrocardiogram(ECG).NSTE-ACSincludebothnon–ST-segmentelevationacutemyo-cardialinfarction(MI),asdefinedbypositivebiomarkersforMI,andunstableangina(UA),asdefinedbynegativebiomarkers.MOHPocketManualinEmergency9cardiacemergencyClinicalPresentationoHistory•Chestpain,whenitstarted,whatitfeelslike(stabbing,crushing,pressure,aching),andifitradiatestootherpartsofthebody.•Jaw/shoulder/neck/armpain.•Dizziness,nausea.•Shortnessofbreath.oPhysicalExamination•Hemodynamicstability,signsofheartfail-ure/leftventriculardysfunction.•Exclusionofnoncardiacandnonischemiccardiaccausesrequiresathoroughexaminationofthepa-tient’schestwall―includinginspectionandpal-pation―aswellascarefulexaminationofcardiacandpulmonaryfunctions.10MOHPocketManualinEmergencycardiacemergencyDifferentialdiagnosisoHeartAcutecoronarysyndromePericarditisMyocarditisEndocarditisValvulardiseaseoLungsPulmonaryembolusPneumothoraxPneumoniaEmpyemaHemothoraxCOPDoEsophagusEsophagitisGERDSpasmForeignbodyRupture(Boerhaave’s)EsophegealTearoWorkup•CBC.•Electrolytes.•Coagulationstudies.•Cardiacenzymes.•ECG.•Cardiacbiomarkers.MOHPocketManualinEmergency11cardiacemergencyManagementoPrehospitalCare:•Threegoals:(1)Deliveringpatientstoanappropriatehealthcarefacilityasquicklyaspossible.(2)Preventingsuddendeathandcontrollingarrhythmiasbyusingacutecardiaclifesupport(ACLS)protocolwhennecessary.(3)Initiatingorcontinuingmanagementofpatientsduringinter-facilitytransport.•ChecklisttogetfromtheEMSteamincludesthefol-lowinginformation:1.ThepersonwhoinitiatedEMSinvolvement(patient,family,bystander,transferringhospital)an...