This state-of-the-art book provides a concise and up-to-date review of key emergency medicine topics in a predominantly visual format along with extensive practice questions to assist in preparing for the emergency medicine board exams. It is comprised of numerous illustrations, created by Dr. Joseph Violaris, which are specifically tailored toward the visual learner studying and preparing for board exams in emergency medicine. The book is organized by organ system, with chapters on ophthalmology, cardiology, pulmonology, gastroenterology, nephrology, orthopedics, immunology, and more. Special chapters that conclude the book are dedicated to trauma, pediatrics, toxicology, environmental disorders, and epidemiology. Each chapter contains a visual learning guide followed by board practice questions at the end to reinforce topics addressed in the illustrations. Emergency Medicine Board Review for the Visual Learner is an essential guide for medical students, residents, and fellows in emergency and internal medicine studying for board exams as well as EM physicians and related professionals preparing for recertification.

This book is aimed at broad spectrum of intensive and coronary care personnel and provides rapid access to important information on the treatment of the patient in the coronary care unit (CUU), in an easily readable and accessible format. It comprises a series of articles on key aspects of emergency care of the cardiac patient and reviews some of the most advanced concepts in the CCU. Whilst assuming a basic knowledge of underlying problems, the book nonetheless outlines key physiological principles where necessary, and critically reviews current literature and best practice. The book focuses on providing key practical information on treatment techniques for busy CUU personnel and features some important topics such as shock, sever sepsis, echocardiography, catheter-based treatments for acute cardiac emergencies, cardiac arrest and CPR, cardiogenic shock, heart failure and the role of surgical intervention.

The anesthesia and intensive care in infants and children have assumed positions of primary importance in contemporary medicine. In these delicate sectors of medicine, clinical research activities must be continually supported by interdisciplinary collaborations. Neonatal and pediatric intensive care requires that all involved physicians, including the surgeon and anesthesiologist, be willing to work together as a team. However, coordination of the various pathophysiological and clinical aspects of neonatal and pediatric critical medicine is highly complex. A complete and current review of the anaethesia and intensive care of infants and children must include discussions of morbidity rates, so as to guide the clincians in choosing the diagnostic approach, as well as of monotoring techniques appropriate to support the therapeutic decision. Recent progress in intensive care medicine for infants and children has been significant.

Management of the intensive care patient afflicted by respiratory insufficiency requires knowledge of the pathophysiological basis for altered functions. The etiology and therapy of pulmonary diseases, such as acute respiratory distress syndrome (ARDS) and chronic obstructive pulmonary disease (COPD) are highly complex. While physiologists and pathophysiologists work prevalently with theoretical modes, clinicians employ sophisticated ventilation support technologies in the attempt to understand the pathophysiological mechanisms of the pulmonary diseases which can present with varying grades of severity. Despite the availability of advanced technologies it is common to personalize the treatment protocol according to the patient's physiologic structure.Given the complexity and difficulties of treating respiratory disease, a strong collaboration between clinicians and physiologists is of fundamtental importance.

The critically ill patient in intensive care may present with serious metabolic alterations caused directly by the illness or secondarily by complications (e.g. infections, organ failure or sepsis) developing within a few hours of hospitaliza tion or in the following days. Among the situations which maintain and further trigger rapidly evolving altered metabolism are complex hormonal reactions, particularly those of the hypothalamus-hypophysis-adrenal axis, and abnormal stimulation of the autonomic nervous system. In fact, the sympathetic nervous system is known to cause significant metabolic alterations. For example, a surgery patient afflicted by septic complications may become hypercatabolic and experience significant nitrogen loss; the altered protein metabolism may in turn heavily influence carbohydrate and lipid metabolism as well. Thus, it is apparent that for optimal care of patients with altered metabolic functions, further knowledge is necessary regarding the physiopathology of metabolism and the physiopathological mechanisms, which alter the consump tion of principal energy substrates. Many experimental and clinical studies have investigated the metabolic aspects of individual organs or organ systems. However, for a correct evaluation of such metabolic events, in addition to studying the roles of metabolic enzymes, active metabolites, and the glutathione system, it is interesting to consider the use of indirect calorimetry as a valid and important investigative technique. The critically ill patient with major alterations in nutritional status may require artificial nutritive support administered through either parenteral or enteral routes."

The management of critically ill patients has, in the past few years, been a discipline at the forefront of development which continues to make progress with the support of basic and clinical research in the broadest sense. The application of biotechnology in this particular area has revealed itself to be essential in an attempt to provide the best interpretation of the bio-humoral and functional alterations present in a long series of often complex clinical conditions. The care of the critically ill is also at the forefront in the application of increasingly sophisticated clinical monitoring systems that also contribute to standardizing certain procedures, establish guidelines, and evaluate the efficacy of therapeutic interventions and their costs

This volume on scientific advances in critical care testing com piles a number of clinical and laboratory studies related to criti cally ill patients that involve new technology, therapy options, application or interpretation of new tests, patient management and cost benefits. There were a total of 340 applicants for this first International Federation of Clinical Chemistry-AVL Award, and from these, National Winners were selected in 26 member countries of the IFCC. This publication presents the full papers of the ten finalists among the National Winners selected for the international final held in London in July 1996. These ten were chosen by the Inter national Awards Committee of the IFCC. In addition, the editors have decided also to include their choice of the best abstracts from the National Winners, thus giving a broad overview of cur rent research being conducted in the field of critical care medi cine among IFCC members. In keeping with the title of this volume, all major fields of in tensive care medicine are represented, including inflammation, infection, stress, hypoxia, ischaemia, cardiology, haemodynamics, blood gases, electrolytes, trace -elements, nephrology, gastroenter ology and haematology. In addition, there is also a chapter on new technology in critical care testing and on miscellaneous top ics."

Because of their therapeutic safety, hydroxyethylstarch, gelatin and dextrans are among the most frequently used drugs in the world. Recent studies have shown that bleeding disorders, anaphylactic reactions and storage in the body depend decisively on the nature of the administered plasma substitute. Through interdisciplinary cooperation the "First European Volume Replacement Conference" has established indications for the use of individual plasma substitutes to improve the efficacy and therapeutic safety of volume replacement therapy.

Many patients come to the Accident and Emergency department in pain or with conditions requiring local or general anaesthesia. Close co-operation between the staff of the Anaesthesia and Accident and Emergency departments is vital if anaesthesia and analgesia are to be dealt with efficiently and safely. This new edition has been extensively revised throughout, especially with regard to resuscitation techniques. It provides a concise guide to anaesthesia and pain relief in emergency medicine. Throughout, the emphasis is on the practical management of problems, giving clear instructions about the treatment of common conditions.

The Yearbook compiles the most recent, widespread developments of experimental and clinical research and practice in one comprehensive reference book. The chapters are written by well recognized experts in the field of intensive care and emergency medicine. It is addressed to everyone involved in internal medicine, anesthesia, surgery, pediatrics, intensive care and emergency medicine.

This critical care medicine book substantially differs from others due to the range of peculiarities that characterize it. Since it deals with acute patients in critical conditions, this is, as it were, a 'borderline'book, in the sense that it is intended for those, who, in their activity, need a continuous and in-depth interdisciplinary approach to optimize the quality of the treatments offered to critically-ill patients. This book helps to have a better understanding of the current limits of human intervention and aims at supplying updated guidelines; in particular, it is intended for those who, although having to guarantee continuity and top-quality therapies, must decide when and why the collaboration with and intervention by experts is necessary

At the APICE '96 research scientists and clinicians were provided with updated guidelines for the treatment of patients with acute and chronic critical conditions. This volume contains 100 chapters,in which the main pathophysiological concepts were reviewed, with special emphasis on the cardiovascular, respiratory, metabolic, and neurologic systems. Special reference is made to the pharmacologic and biotechnologic strategies currently being used to support those vital functions that are affected by severe and sometimes devastating diseases. The topics of infection, sepsis,and SIRS have been reviewed and updated in keeping with the most recent information available, and particular focus has been directed to ethics.

This volume presents an overview of the pathophysiology, clinical features, and treatment of disseminated intravascular coagulation with regard to those conditions encountered most often during intensive medical care. The excellent organization of the book enables the reader to easily find answers to specific, individual questions.

For courses in emergency medical responder programs. Help students think like EMRs The leader in the field, Emergency Medical Responder: First on Scene provides clear, first responder?-level training for fire service, emergency, law enforcement, military, civil, and industrial personnel. The text is based on the new National Emergency Medical Services Education Standards for Emergency Medical Responders and includes the 2017 Focused Updates from the American Heart Association Guidelines for Cardiopulmonary Resuscitation and First Aid. The fully updated 11th edition covers new topics recently introduced into emergency medical responder programs.

The Yearbook compiles the most recent, widespread developments of experimental and clinical research and practice in one comprehensive reference book. The chapters are written by well recognized experts in the field of intensive care and emergency medicine. It is addressed to everyone involved in internal medicine, anesthesia, surgery, pediatrics, intensive care and emergency medicine.

The yearbook compiles the most recent, widespread developments of experimental and clinical research and practice in one comprehensive reference book. It is an excellent source for all clinical physicians.

Developments in surgery have enabled more ambitious operations to be attempted than ever before, while similar advances in anaesthesia and monitoring have meant that many patients who were previously considered unfit now undergo surgery. It is essential that standards of patient care during surgery are continued post-operatively until the depressant effects of anaesthesia have worn off and it is safe for patients to return to the wards or to their homes. The importance of adequate supervision by well-trained nurs ing staff in properly equipped surroundings has been recognised by the introduction of recovery rooms in most hospitals. Despite this, many patients still emerge from anaesthesia in wards or departments where they are supervised by inexperienced nursing staff in unfamiliar surroundings. Recovery from anaesthesia may be accompanied by a variety of dangerous and potentially fatal complications, many of which can be avoided by the detection of early warning signs and the institution of appropriate therapy before an irreversible situation is allowed to develop. This book describes the major complications liable to be encountered and suggests how they may be avoided by careful monitoring, vigilant nursing and sound organisation. The patient's behaviour at recovery is influenced by his pre-operative condition, by drug therapy pre- and intra-operatively and by the nature of the surgery, and sections have been devoted to these aspects since a basic understanding of them is essential in anticipating events in the recovery room."

Recent technological innovations - influenced primarily by the development of more sophisticated, faster and cheaper computer systems - permitted also the evolution of more affordable systems for Patient Data Management, so called PDM-Systems. The experience of the authors, on one of the first PDMS installation sites in Europe, shows that the purchase of such a system is not an easy task, since accurate data are not available in a comparable format. Therefore the first part of the book is devoted to a comparison of already installed, commercially distributed bedside based PDMS with regard to their specifications, functions and performance. The methods included a questionnaire with detailed questions for the vendors to answer and a "table of functions" comparing the most important functions which should be included in a PDMS. With that list the different systems (which were all in clinical use) were checked for the availability and the way of use of these functions. To evaluate variations in the systems performance an "information retrieval test" was designed and executed. In the second part the different vendors, whose systems were included in the study, were to describe the systems from their viewpoints. The third part contains papers describing the users' experiences. The fourth and last part shows how to use PDMS-data for scientific and therapeutic purposes including two papers on clinical expert systems. Thus, this book provides valuable information for clinicians and hospital managers who have to decide on the purchase of a Patient Data Management System.

E.MARTIN Acute pain services are now established worldwide and guidelines have been drawn for the management of acute pain resulting from surgical or medical procedures and trauma. However, the treatment of pain after surgery is still inadequate and no progress has been made in recent years in several coun tries, including Germany. There are still innumerable patients who find the is also no early postoperative period to be an unpleasant experience. There doubt that pain plays a role in the pathogenesis of postoperative complica tions that could be avoided with effective pain management. However, concern about side effects and inadequate knowledge of the pharmacokinet ics and -dynamics of drugs is still putting constraints on treatment. An acute pain service should be responsible for adequately treating pain, training medical and nursing staff, and evaluating new and existing methods of treatment. As anesthesiologists deal with pain in the operating theater, it is not surprising that they claim a leading role for themselves in acute pain services choosing from the various postoperative pain treatment options."

A pocket-sized self-test book designed for junior doctors. It features not only multiple choice questions, but also case histories, questions on ECGs, data interpretation, x-ray and picture questions. The range of subjects covered is comprehensive and the answers informative and unambiguous. Designed for junior doctors, Self Assessment in Accident and Emergency Medicine features not only MCQs but also case histories, questions on ECGs, data interpretation, X-ray and picture questions. The range of subjects covered is comprehensive, covering all the common problems encountered in the Accident and Emergency Department. Also included are the rarer conditions which many inexperienced doctors find difficult to diagnose. This entertaining and informative guide provides a convenient way of aquiring information and testing knowledge for all doctors working in A&E. It will also become an indispensible study aid for candidates for the Accident and Emergency Fellowship and the Accident and Emergency Faculty exams.

H. KIESEWETTER, J. KosciELNY, and F. JuNG Tbe byperoncotic colloid-osmotic pressure of tbe 10% Haes solution causes an increased intravascular volume because free tissue water flows into the vascular system [206]. Witb a volume expansion effect of about 50% an increase in intravascular volume of 750 ml (500 mi Haes and 250 mi tissue water) is expected immediately after hypervolemic hemodilution, after isovolemic bemodilution only an in crease of 250 mi ( only tissue water due to a pblebotomy of 500 mi). The blood is diluted by overloading the vascular system [245]. After isovolemic bemodilution tbe dilution effect is more marked due to the pblebotomy. Estimated by means of the total protcin concentration (Fig. 67) the dilution of plasma was 22% 1 h after isovolemic hemodilution but only 14% after bypervolemic bemodilution. Tbe plasma dilutions were almost confirmed by the concentration changes of albumin (Fig. 68). Therefore, the mixing ratio is 4. 1 to 1 (plasma to bydroxyetbyl starcb) for bypervolemic infusion of 500 ml Haes-sterillO% (200/0. 5) and 3. 7 to 1 for isovolemic dilution. Consequently, the hydroxyethyl starch concentration after isovolemic hemodilution was signifi- cantly bigher at all measuring times tban after hypervolemic hemodilution (Fig. 61). If tbe infusion was performed quickly so that no renal output of the Haes solution could ensue, a mean bydroxyetbyl starch concentration of 10. 3 g per liter plasma would be expected immediately after isovolemic hemodilution for tbe above mixing ratio, and one of 9. 0 g after hypervolemic bemodilution.

Epidural opioids are widely used in the management of post- operative pain. On the basis of an extensive review of the literature the authors here present their own interpretation of current knowledge of how the distribution and effectiveness of epidurally administered opiods are fundamentally determined. They conclude that all opioids that are currently being used to treat postoperative epidural pain carry the potential risk of severe side effects if the dose regimens are not tailored to the patients individual analgesic need. This book will serve to stimulate new ideas among pain specialistst.

The Yearbook compiles the most recent, widespread developments of experimental and clinical research and practice in one comprehensive reference book. It is addressed to everyone involved in internal medicine, anesthesia, surgery, pediatrics, intensive care and emergency medicine.

The Yearbook 1992 continues one part of the tradition established by the publication of updates. The Update Series itself will continue with several volumes being published per year on topical special issues. The Yearbookcompiles the most recent, widespread developments of clinical research and practice in one comprehensive reference book. It is addressed to everyone involved in cardiology, internal medicine, anesthesia, intensive care, surgery, pediatrics and emergency medicine.