Emergency Procedures and Techniques

Author: Robert R. Simon
Published: December 2001
Publisher: Lippincott Williams & Wilkins
ISBN: 0781726999
Paperback Book
Number of Pages: 560

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This is a quick-reference guide to the various procedures likely to be used in the emergency department. This third edition follows a second published in 1987. The purpose is to provide an easy-to-use, step-by-step approach to emergency department procedures. The authors have purposely minimized background material, such as history and research, in favor of practical aspects. The discussions systematically include preparatory procedural and aftercare steps as well as complications related to each procedure. Indications and contraindications are briefly discussed. Although the authors target emergency physicians and other practicing physicians, including surgeons, family practitioners, and critical care specialists, the approach will be most valued by emergency department personnel and medical students. Although the authors are extensively published and well-known authorities in the practice of emergency medicine, the text is limited by the relatively personal approaches described. The material often does not discuss widely used alternatives to the chosen procedures or the unresolved controversies surrounding certain points. In some cases, recommendations are quoted that, although potentially valid, are not consistent with more familiar authorities, such as ACLS, PALS, or ATLS. The authors have adopted a system of highlighted ""cautions,"" ""notes,"" and ""axioms"" to emphasize critical aspects of procedures. Although highly useful, this can fragment the text. Illustrations, which are critical to this subject, are in simple black-and-white and of mediocre quality. The text is at times inconsistent with the pictures, which may be difficult to visually interpret. The references areextensive but generally predate 1990. The organization and concept of the approach are valuable. The material is practically organized. Inexperienced readers should be cautious in applying the described approaches because a number of subjects reflect the personal choices of the authors. Despite this limitation and the mediocre illustrations, the book is a valuable addition to an emergency department's clinical references. A step-by-step introductory manual for physicians of procedures performed in the emergency department. Organized by body system, procedures are divided into preparatory steps, procedural steps, and aftercare. Illustrated with diagrams. The latest edition describes procedural advances including coverage of implantable defibrillators, indwelling devices, and percutaneous feeding tubes. A practical text, primarily for emergency physicians, providing a step-by-step approach to procedures performed in an emergency center. Each procedure is divided into preparatory steps, procedural steps, and aftercare. Preparatory steps discuss positioning the patient, prepping the patient, etc. Procedural steps go through the actual procedure in detail, supplying clear illustration of key points. Aftercare discusses and summarizes treatment of the patient after a procedure is completed. Finally, possible complications resulting from a procedure are listed, usually accompanied by a detailed discussion and information on prevention. Simon, Robert R., MD (Rush Medical Coll of Rush Univ); Brenner, Barry E., MD, PhD (UCLA)

Table of Contents
Contributing Authors
Preface
Acknowledgments
1 Abdominal Procedures
Nasogastric Intubation 1
Foreign Bodies in the Esophagus 7
Gastric Lavage for Hemorrhage into the Upper Gastrointestinal Tract 8
Sengstaken-Blakemore Balloon Tamponade 9
Abdominal Stab Wound Exploration 13
Peritoneal Lavage 13
Sigmoidoscopy 22
Anoscopy 25
External Thrombosed Hemorrholds 27
Internal Hemorrholds 30
Foreign Bodies in the Anus 34
Colostomy Problems Seen in the Emergency Center 34
2 Airway Procedures
Essential Anatomy of the Airway 40
Obstruction 40
Foreign Bodies in Pediatrics 42
Basic Airway Maneuvers 44
Intubation of the Trachea 55
Intubating Laryngeal Mask 77
Laryngeal Mask Airway 78
Infant and Child Endotracheal Intubation 79
Neonatal Resuscitation 83
Tracheotomy 87
Ancillary Procedures 98
3 Anesthesia and Regional Blocks
The Clinical Pharmacology of Local Anesthetics 109
Head and Neck Blocks 113
Upper Extremity Blocks 126
Nerve Blocks of the Foot 134
Sural and Saphenous Nerve Blocks 136
Blocks of the Torso and Other Areas 142
4 Cardiothoracis Procedures
Pericardiocentesis 153
The Blind and Electrocardiographically Guided Percutaneous Pericardiocentesis 154
Resuscitative Thoracotomy 158
Cardiac Repair 164
Intracardiac Injection 171
Needle Decompression of Tension Pneumothorax 172
Thoracentesis 179
Transthoracic Pacemaker Insertion 181
5 Neurosurgical Procedures
Burr Holes 186
Lumbar Puncture 193
Skeletal Traction for Cervical Spine Dislocations and Fractures 203
6 Obstetric and Gynecologic Procedures
Normal Delivery of the Infant 208
Breech Extraction 215
Casarean Section 221
Suction Curettage 226
Culdocentesis 229
Removal of an Intrauterine Device (IUD) 231
7 Orthopedic Procedures
Arthrocentesis 234
Fracture Principles, Casting Techniques, and Common Splints 249
Reduction of Selected Common Fractures 271
Reduction of Selected Common Dislocations 276
Injection and Aspiration of Selected Soft Tissue Disorders 286
Compartment Syndromes 290
8 Otolaryngologic and Ophthalmologic Procedures
Examination of the Head and Neck 296
Airway and Esophageal Foreign Bodies 299
Ear Emergencies 302
Eye Emergencies 304
Nasal Emergencies 307
Epistaxis 309
Nasal Fractures 316
Head and Neck Abscesses 321
9 Common Dental Emergencies
Local Anesthesia 325
Fractured Teeth 327
Displacement Injuries of the Teeth 330
Post Extraction Bleeding 331
Pain: Post-Extraction Pain and Dry Socket 331
Dental Caries 331
Periodontal Abscess 333
10 Plastic Surgery Principles and Techniques
Introduction 335
Skin Anatomy and Function 335
Mechanism of Wound Injury 342
Suture Material and Adjuncts for Wound Closure 342
Tools for Suturing 355
Traumatic Wounds (General Principles) 356
Anesthesia for Wounds 364
Hemorrhage and Hemostasis 365
Basic Principles in Wound Closure 366
Relation of Suture to the Wound Edge 368
Basic Suturing Techniques 374
Repair of Specific Types of Wounds 391
Gunshot Wounds 395
Escharotomy for Burns 395
Special Repairs 397
Aftercare of Selected Wound Injuries 412
Abscesses 416
Antiseptic Preparation and Technique of Anesthesia 417
Foreign-Body Removal 419
11 Urologic Procedures
Anatomy 426
Bladder Catheterization 427
Suprapubic Catheterization and Aspiration 432
Catheterization of the Infant 434
Urethral Sounding 435
Catheterization With a Filiform and Follower 435
Emergency Urethrogram 437
Priapism 438
Management of Phimosis and Paraphimosis 440
Management of Testicular Torsion 441
Radiologic Techniques 441
12 Vascular Procedures
Basic Principles in Intravenous Cannulation 443
Peripheral Intravenous Techniques 447
Central Intravenous Techniques 452
Vein Cutdown Techniques 470
Intravenous Cannulation of the Infant 477
Intraosseous Infusion in the Infant 484
Umbilical Vessel Catheterization 485
Special Procedures Related to Intravenous Cannulation 491

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