... 70 percent in the
very elderly.
9, 13
• The most common causes of abdominal pain are
listed in Table 3 8-1 .
• Causes of abdominal pain stratified by age are
listed in Table 3 8-2 .
TABLE 3 8-1 Most Common ... dif -
cile in 10 to 25 percent of cases.
• Broad-spectrum antibiotics—most notably clin-
damycin, cephalosporins, and ampicillin/amoxicil-
lin—alter the gut...
... Emergency Medicine
(ABEM) administers three written exams each
year: the Certification Exam, the Recertification
Exam, and the In- Training Exam. For the most
up-to-date information concerning these ... double-blind
study on sedatives and hemodynamics during rapid-se-
quence intubation in the emergency department: The
SHRED study. Ann Emerg Med 31 :31 3, 1998.
7. Zink BJ,...
... needles (2 7- to 3 0-
gauge), and injecting the anesthetic slowly.
• The addition of epinephrine to lidocaine extends
the length of anesthesia and slows systemic ab-
sorption. However, epinephrine decreases ... fluid.
12
• If blood pressure remains Ͻ70 mmHg despite pre-
ceding measures, a norepinephrine 8- to 1 2- g/
min loading dose and a 2- to 4- g/min infusion
to mai...
... authori-
ties begin with a continuous infusion. If the acido-
sis has not improved after2hofinsulin therapy
the insulin infusion should be increased to 0.15 to
0.2 U/kg/h. Both the insulin infusion ... age. The classic presentation is sudden
epigastric pain with pain-free intervals during
which the examination can reveal the classic sau-
sage-shaped mass in the right side of...
... drawn if clinically indicated or if the acetamino-
phen level falls in the toxic range on the Rumack-
Matthew nomogram.
• Activated charcoal 1 g/kg is indicated for GI de-
contamination and in case ... are all sources of in-
fections in humans.
1,2
• Most zoonoses in the United States, including
those spread by ticks, have their highest incidence
in the spring and summer...
... oxy-
gen therapy.
DIAGNOSIS AND DIFFERENTIAL
• The primary key to the diagnosis is maintaining
a high degree of clinical suspicion.
• The most useful laboratory test is the determina-
tion of the ... Forensic Sci Int
90 :33 , 1997.
3. Ma OJ, Kefer MP: An unusual cause of hypotension asso-
ciated with penetrating trauma. J Trauma 40:161, 1996.
For further reading in Emergency M...
... small cell
lung carcinoma, primary and metastatic brain can-
CHAPTER 142
•
VERTIGO AND DIZZINESS 433
placed in the supine, head-hanging position of the
Dix-Hallpike maneuver.
2
The nystagmus reverses
torsional ... Oyhaugen S: The
Norwegian polio study 1994: A nationwide survey of prob-
lems in long-standing poliomyelitis. Spinal Cord 36 :280,
1998.
For further reading in Emer...
... injury with subsequent increase in
pain and swelling as the patient continues to am-
bulate suggests a sprain rather than a fracture.
• On physical examination, significant findings in-
clude the ... of abdominal injury in the pedi-
atric patient, the physical examination has both a
high false-positive and relatively high false-nega-
tive rate. Therefore, either CT scanning or dia...
... in an active patient reduces the likelihood that chronic
ischemic heart disease is the underlying cause. The absence of a resting
Chapter 0 03. Decision-Making
in Clinical Medicine
(Part 3) ... refining, and discarding diagnostic hypotheses. The
questions they ask in the history are driven by the hypotheses they are working
with at the moment. Even the physical...