Emergency Pediatrics: A Guide to Ambulatory Care

Author: Roger M. Barkin
Published: May 2003
Publisher: Elsevier Science
ISBN: 0323019013
Paperback Book
Number of Pages: 800

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The book contains predominantly black-and-white illustrations, with some two-color illustrations. This time-tested book provides rapid access to information on all aspects of emergency pediatric care. The book's outline format delineates a wide range of pediatric problems, including antibiotics, back pain, splinting, suturing, soft tissue injuries, seizure control, and AIDS. Bringing special attention to the information doctors need in emergencies, this guide addresses the special demands of pediatric care, with sections on cardiac life support, fluid and electrolyte balance, newborn patients, emergent complaints, urgent complaints, environmental emergencies, poisoning, trauma, orthopedic injuries, and diagnostic categories. Individual chapters focus on specific conditions, providing information on their etiology, diagnosis, and management. This fourth edition (third edition published in 1990) contains very up-to-date material. This review/guidebook follows an outline format. Emergent and urgent pediatric problems are discussed first, followed by other clinical entities arranged alphabetically according to organ system. The stated purpose of the book is to make information accessible that will be immediately required to appropriately care for the acutely injured child. It is meant to be a very practical, on-duty reference. The reader is referred to Barkin's more weighty textbook for deeper reading. The book is valuable for the stated purpose and for use as a study guide. Because of the succinctness and accessibility of the material, the book is highly successful in meeting its objectives. The authors intend for this reference to be used by all healthcare providers of acutely ill children, including pediatricians, nurse practitioners, emergency medical technicians, and students. Surprisingly, the material is understandable and useful for all of these levels. The authors are widely known authorities in emergency medicine and pediatrics. They are known for producing practical works for the emergency practitioner. There are few illustrations, but the book does not lack for this. The book depends more on decision trees and reference tables located adjacent to pertinent text. The references are up-to-date but limited, which is appropriate for this type of work. The organizational value of this book is that each chapter focuses on immediately useful aspects of clinical entities: etiology, diagnostic approach, and management. Explicit drug doses and alternatives are included. Of special value to emergency clinicians is the emphasison disposition and patient instruction keyed to each problem. A procedure section briefly but succinctly describes important techniques. Of note, the authors use a system of ""alert"" statements meant to address frequent areas of pitfall. Unfortunately, the appendixes, which include mainly reference tables, are small and poorly reproduced. Frequently needed information such as tube sizes, etc., is difficult to find. This is a highly useful reference book for the practicing clinician to quickly ascertain information needed to solve clinical problems. It would also make a useful study guide. This book would make an excellent addition to every emergency department and might only benefit by supplementation of useful charts of critical information for children of various ages. This book is the fifth edition of a text first published in 1984. The previous edition was released in 1994. The purpose is to provide information in an accessible format to be used when it is immediately required in the care of the acutely ill child. It is not meant to be a comprehensive textbook of pediatric emergencies. The objectives are adequately met. It is written for pediatricians, emergency physicians, nurse practitioners, emergency medicine technicians, and students of medicine, and is appropriately focused. The contributors are credible and include emergency physicians, pediatricians (including subspecialists), and pediatric emergency physicians. Illustrations are limited to an appendix on procedures. Multiple tables are used to facilitate access to material and are quite helpful. References are limited but current. The text focuses on diagnostic findings and differential diagnosis and management, not on pathophysiology. Useful appendixes include procedures, reference standards, and a formulary of emergency drugs for pediatricians, including a detachable pediatric emergency reference card. This textbook is a concise review of pediatric emergency medicine. It serves its purpose as a resource for students and as a brief guide to be used in patient care. It is not a comprehensive textbook and should not be the only pediatric emergency textbook on the Emergency Department's bookshelf. The new edition expands on analgesia and sedation, pharmaceutical agents, and advanced life support, but otherwise adds relatively little to the previous edition. Barkin, Roger M., MD, MPH, FAAP (Univ of Colorado); Rosen, Peter, MD, FACEP (UCSD)The contributors are all MDs from North American medical centers. The majority are emergency physicians; most of the remainder are pediatricians. More than 40% of the contributors are from Univ of Colorado or Denver General Hospital.

Table of Contents
Part I Pediatric Care in the Emergency Department
1 Approaching the Pediatric Patient 3
Part II Advanced Cardiac Life Support
2 Emergency Department Environment 9
3 Transport of the Pediatric Patient 15
4 Cardiopulmonary Arrest 17
5 Shock 36
6 Dysrhythmias 50
Part III Fluid and Electrolyte Balance
7 Dehydration 65
8 Maintenance Requirements and Abnormalities 75
Part IV Newborn Emergencies
9 Resuscitation in the Delivery Room 83
10 Distress at Birth 92
11 Postnatal Emergencies 95
Cardiovascular Disorders 95
Endocrine and Metabolic Disorders 99
Gastrointestinal Disorders 101
Hematologic Disorders 104
Infectious Disorders 111
Intoxication 117
Neurologic Disorders 117
Pulmonary Disorders 119
Renal and Genitourinary Disorders 124
Part V Emergent Complaints
12 Anaphylaxis 129
13 Apnea 133
14 Chest Pain 137
15 Coma 141
16 Congestive Heart Failure 149
17 Cyanosis 159
18 Hypertension 165
19 Pulmonary Edema 175
20 Respiratory Distress (Dyspnea) 179
21 Status Epilepticus 187
22 Sudden Infant Death Syndrome 192
23 Syncope (Fainting) 195
Part VI Urgent Complaints
24 Acute Abdominal Pain 201
25 Abuse 204
Child Abuse: Nonaccidental Trauma 204
Sexual Abuse 209
26 Anemia 212
27 Arthralgia and Joint Pain 217
28 Ataxia 222
29 Bleeding 224
30 Constipation 227
31 Cough 230
32 Acute Diarrhea 236
33 Dysphagia 241
34 Fever in Children 244
35 Gastrointestinal Hemorrhage: Hematemesis and Rectal Bleeding 254
36 Headache 261
37 Hematuria and Proteinuria 266
38 Hypoglycemia 271
39 Irritability 275
40 Limp 279
41 Paralysis and Hemiplegia 284
42 Rash 288
43 Vaginal Bleeding 294
44 Vomiting 297
Part VII Environmental Emergencies
45 Bites 307
Animal and Human Bites 307
Arthropod (Insect) Bites 310
Snake Bites 315
46 Burns, Thermal 318
47 Drowning, Near-Drowning, and Dysbarism 323
Drowning and Near-Drowning 323
Dysbaric Diving Injuries 326
48 Electrical and Lightning Injuries 329
49 High-Altitude Sickness 332
50 Hyperthermia 335
51 Hypothermia and Frostbite 340
52 Radiation Injuries 345
53 Smoke Inhalation 347
Part VIII Poisoning and Overdose
54 Management Principles 351
55 Specific Ingestions 367
Acetaminophen 367
Alcohols: Ethanol, Isopropyl, Methanol, Ethylene Glycol 369
Alkalis and Acids 372
Anticholinergics 374
Carbon Monoxide 376
Cardiovascular Drugs 378
Cocaine 380
Cyclic Antidepressants 381
Hallucinogens: Phencyclidine, LSD, Mescaline 383
Hydrocarbons 384
Iron 386
Narcotics and Sedative-Hypnotics 388
Organophosphates and Carbamates 390
Phenothiazines 392
Salicylates (Aspirin) 394
Sympathomimetics 397
Theophylline 397
Part IX Trauma
56 Evaluation and Stabilization of the Multiply Traumatized Patient 401
57 Head Trauma 417
58 Facial Trauma 432
59 Eye Trauma 440
60 Dental Injuries 449
61 Spine and Spinal Cord Trauma 456
62 Thoracic Trauma 468
63 Abdominal Trauma 484
64 Genitourinary Trauma 496
65 Soft Tissue Injuries 505
Appendix to Chapter: Procedural Analgesia and Sedation 515
Part X Orthopedic Injuries
66 Management Principles 525
67 Upper Extremity Injuries 533
68 Hand and Wrist Injuries 543
69 Lower Extremity Injury 553
70 Ankle and Foot Injuries 561
Part XI Diagnostic Categories
71 Cardiovascular Disorders 567
Bacterial Endocarditis 567
Myocarditis 572
Pericarditis 574
Acute Rheumatic Fever 575
Deep Vein Thrombosis 578
72 Dermatologic Disorders 580
Acne 580
Atopic Dermatitis (Eczema) 581
Cellulitis and Periorbital Cellulitis 582
Contact Dermatitis 586
Dermatophytosis 586
Diaper Dermatitis and Candidiasis 588
Eczema 589
Erythema Multiforme 589
Impetigo 591
Lice (Pediculosis) 592
Pinworms 593
Pityriasis Rosea 593
Scabies 594
Seborrheic Dermatitis 595
Staphylococcal Scalded Skin Syndrome 595
Sunburn 596
Urticaria 597
Warts and Molluscum Contagiosum 597
73 Ear, Nose, and Throat Disorders 599
Dentoalveolar Infections 599
Epistaxis (Nosebleed) 600
Foreign Bodies in the Nose and Ear 601
Acute Necrotizing Gingivitis 602
Cervical Lymphadenopathy 602
Acute Mastoiditis 604
Acute Otitis Media 605
External Otitis Media 610
Acute Parotitis 611
Peritonsillar Abscess 612
Pharyngotonsillitis (Sore Throat) 613
Retropharyngeal Abscess 617
Rhinitis (Common Cold) 618
Acute Sinusitis 619
Acute Stomatitis 621
74 Endocrine Disorders 623
Adrenal Insufficiency 623
Diabetic Ketoacidosis 624
Failure to Thrive 629
Thyroid Disease 631
75 Eye Disorders 635
Chalazion and Hordeolum 635
Conjunctivitis 635
76 Gastrointestinal Disorders 640
Acute Infectious Diarrhea 640
Gastrointestinal Foreign Bodies 647
Viral Hepatitis 649
Pancreatitis 654
Reye Syndrome 655
Conditions Requiring Surgery 658
Appendicitis 658
Hernia, Inguinal 662
Hirschsprung's Disease 662
Infussusception 664
Meckel's Diverticulum 666
Pyloric Stenosis 668
Volvulus 669
77 Genitourinary Diseases 671
Epididymitis 671
Hernias and Hydroceles 672
Penile Disorders 672
Testicular Torsion 673
78 Gynecologic Disorders 676
Gynecologic Examination 676
Menstrual Problems 677
Pelvic Inflammatory Disease 679
Vulvovaginitis and Vaginal Discharge 682
Complications of Pregnancy 686
79 Hematologic Disorders 694
Disseminated Intravascular Coagulation 694
Hemophilia 696
Idiopathic Thrombocytopenic Purpura 709
Oncologic Presentations 711
Sickle Cell Disease 714
80 Infectious Disorders 722
Acquired Immunodeficiency Syndrome 722
Botulism 723
Diphtheria 724
Kawasaki's Disease 726
Meningococcemia 729
Mononucleosis, Infectious 730
Pertussis (Whooping Cough) 731
Rabies 733
Tetanus 734
Toxic Shock Syndrome 736
Tuberculosis 739
81 Neurologic Disorders 740
Breath-Holding Spells 740
Meningitis 741
Migraine Headache 750
Pseudotumor Cerebri 753
Seizures 754
Febrile Seizures 763
82 Orthopedic Disorders 767
Septic Arthritis 767
Osteomyelitis 769
83 Psychiatric Disorders 773
Management Principles 773
Conversion Reactions 774
Acute Psychoses 775
Psychophysiologic Presentations 777
Suicide Attempts 778
Posttraumatic Stress Disorder 779
Acute Grief Reaction 780
Substance Abuse 780
84 Pulmonary Disorders 781
Asthma 781
Bronchiolitis 797
Croup and Epiglottitis 800
Foreign Body in Airway 808
Pneumonia 811
85 Renal Disorders 817
Acute Glomerulonephritis 817
Hemolytic-Uremic Syndrome 819
Henoch-Schonlein Purpura 822
Nephrotic Syndrome 824
Acute Renal Failure 828
Urinary Tract Infection 833
Appendixes
A Procedures 839
A-1 Arterial Punctures 839
A-2 Arthrocentesis 839
A-3 Venous Infusion 840
A-4 Lumbar Puncture 848
A-5 Pericardiocentesis 850
A-6 Subdural Tap 851
A-7 Suprapubic Aspiration 852
A-8 Thoracentesis 852
A-9 Thoracostomy 854
B Reference Standards 856
B-1 Growth Curves 857
B-2 Vital Signs and Ancillary Ventilatory Support 863
B-3 Electrocardiographic Criteria 866
B-4 Normal Laboratory Values 868
B-5 Conversions, Estimates, and Nomograms 871
B-6 Denver Developmental Screening Test 873
B-7 Recommended Childhood Immunization Schedule United States 874
C Formulary 878
C-1 Common Medications 878
C-2 Simplified Schedule for Administration of Pediatric Resuscitation Drugs 910
C-3 Antiparasitic Drugs 913

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