Lacking the capacity to store oxygen, the human organism depends on having an unimpaired and continuous supply of oxygen for its survival. Life-threatening disturbances can be encountered by the clinician at any step in the oxygen cascade from ambient air to tissue metabolism. It is therefore necessary for the mechanisms of oxygen uptake, transport, distribution and diffusion into tissues as well as the unaffected cellular metabolism to be well understood and monitored. An international symposium focusing on these issues was held in Munster, FRG, May 11-12, 1990. This book contains the lectures held at the symposium, and thus provides an excellent basis for further discussion.

More than 800 case-based Q&A combined with the authority of the field's leading text make this the best review for any Emergency Medicine examination McGraw-Hill Education Specialty Board Review: Tintinalli's Emergency Medicine Examination and Board Review, Eighth Edition delivers more than 800 case-based questions and answers. All answer options, both correct and incorrect, are keyed to Tintinalli's Emergency Medicine, Eighth Edition, the field's most authoritative and trusted text. This is an outstanding review for any examination in emergency medicine - including board certification - and can also be used as a clinical refresher. EKGs, radiographs, and clinical images are included to sharpen readers' diagnostic skills. This edition bolstered by enhanced answer explanations, an increased number of Q&A, and improved quality of photographs.

Pre-hospital care plays an increasingly important part in contemporary healthcare delivery and the skills of paramedics, emergency medical technicians and emergency care assistants are a vital part of this. This casebook supports readers to develop the necessary assessment and decision-making skills they need in order to effectively manage a variety of cases typically seen in UK paramedic practice. 100 Cases in UK Paramedic Practice allows for learning and revision through 100 scenarios which aim to encompass cases that may be seen in daily practice. The book covers scenarios that can occur at any moment of the day, from an ambulance shift to primary care settings to event standby duties. The bite-size structure of this book allows the reader to focus on body systems or random case scenarios, depending on their preference. This is an essential, evidence-based guide for students of pre-hospital care and a useful reference for qualified staff as a source of continued professional development or as a revision tool.

This little book has been written primarily for the senior house officer in Accident and Emergency and the registrar pursuing a career in the specialty. I hope also that it will be of interest to medical students. Thanks to the initiative of Professor Miles Irving, Professor of Surgery, University of Manchester, medical students have been taught Accident and Emergency in Hope Hospital since 1974. Many of the answers to the questions here have been elaborated as a result of their enquiring minds. It has been a pleasure to teach them. MCQs should be informative and entertaining and not regarded as a tiresome chore merely because of self assessment scoring. I have omitted the boxes and the "don't know" response. The answers are either true or false. I have attempted to slot the questions into various sections with some degree of sequence, but there is an inevitable overlap particularly with regard to the sections on the unresponsive patient, poisoning and injury. The final section is a selected mixture of Accident and Emergency and I thought "Pot pourri" an appropriate title. I have enjoyed compiling the questions and I hope that both undergraduates and postgraduates will find reading them a painless and worthwhile exercise. Finally my thanks are due to my secretary Eileen Bates for her typing and patience."

Pediatric patients are a unique subset of emergency patients, making up about one-quarter of all emergency department visits. Textbooks regarding the care of pediatric patients are almost universally organized by organ system, which does not facilitate an efficient diagnosis. Taking a case-based approach, Pediatric Emergency Medicine: Chief Complaints and Differential Diagnosis is arranged by chief complaint, using real patient scenarios to help the reader work through the inductive and deductive reasoning needed to assess, evaluate, treat, and disposition pediatric patients with urgent complaints. Cases are structured in the way in which they are presented during medical care, allowing practitioners to become comfortable with the general structure of case presentations: chief complaint, HPI, PMH, ROS, exam, and ancillary studies. This volume also discusses disease processes and their differentiations, providing in-depth knowledge regarding current standards of diagnosis and care.

Apley & Solomon's Concise System of Orthopaedics and Trauma is firmly established as the leading introductory textbook of orthopaedic practice and the principles of fracture and trauma management. Praised in previous editions for the systematic approach, balanced content and easy-to-read style, this fifth edition has been brought fully up to date under the direction of the new and distinguished authorial team, while remaining true to the teaching principles of Alan Apley and his successor Louis Solomon. Key features: Focused - on diseases and clinical signs with additional detail on anatomy where appropriate International - enhanced coverage of 'global orthopaedics' reflect the changing pattern of musculoskeletal disease and trauma around the world Relevant - provides helpful guidance on simple procedures without unnecessary operative detail Readable - increased emphasis on concise presentation Current - updates reflect developments in molecular biology, genetics and imaging technology This fifth edition remains the first choice for medical students, trainee surgeons and other health professionals seeking a convenient introduction to this large and complex subject and is a natural precursor to the more detailed coverage offered by its larger parent, Apley & Solomon's System of Orthopaedics and Trauma.

The significance of a change in Pa02 occuring in a patient with cardiovascular instability cannot be ascertained unless the values for PV0 and CV02 are known. A fall in Pa02 could 2 reflect worsening of pulmonary function or deterioration of cardiac output (with resultant increase in systemic oxygen extraction). PEEP/CPAP would be an appropriate therapy in the former case but frankly deleterious in the latter if applied prior to cardiovascular stabiliza- tion. References 1. Douglas ME, Downs JB, Dannemiller FJ et al (1976) Change in pulmonary venous admixture with varying inspired oxygen. Anesthesia and Analgesia 55:688-695 2. Kelman GR, Nunn JF, Prys-Roberts C et al (1967) The influence of cardiac output on arterial oxygena- tion. A theoretical study. Br J Anaesth 39:450-458 3. Kirby RR (1986) Respiratory vs cardiovascular dysfunction - How can we differentiate? ASA Refresher Course Lectures, 102 4. Nunn JF (1977) Applied respiratory physiology (2nd ed). Butterworth et Co 5. Van Aken H, Lawin P (1981) Der EinfluB des Herzminutenvolumens auf die arterielle Oxygenation.

Selected Figures and Tables from The Practice of Emergency and Critical Care Neurology, 2nd Edition condenses the main conclusions from each chapter of The Practice of Emergency and Critical Care Neurology, 2nd Edition into a concise and handy pocketbook. Designed as a quick reference, the pocketbook pulls together the most important tables and figures, putting hard to find information in one easy reference. This is by no means a replacement for the larger text, but rather, a quick, yet comprehensive volume to keep what is most vital on hand. Along with the tables and figures, the pocketbook includes important formulas and rating scales, guides to verifying a dose, guides to writing an order set and to provide emergency care of critically ill neurologic patients, guideline references, and a section at the back of the book to allow the practitioner to take notes. This is the go-to guide for every physician, staff neurologist, neurointensivist, resident, and fellow in training with managing acutely ill neurologic patients.

I felt highly honoured when I was asked to write about the achievements of my late brother, Dr Frank Wilson, MB, BS(Lond.), FF ARCS, DA, DCH, who was the editor of and a contributor to this book. Frank graduated in Medicine at St Bartholomew's Hospital Medical College in 1949 at the early age of 22. Born in Lancaster, his one wish was to return to the North. He held house appointments at Preston, spent his two years of National Service in the Royal Air Force and attained the rank of Squadron Leader. While on National Service, his interests turned to anesthetics, and as Senior Medical Officer on H.M. Troopship 'Devonshire', he developed a love for the sea. Convinced that anesthesia was his career, Frank came to Liverpool and attended the University course in this speciality. The vast experi ence he gained in anesthesia in the Liverpool Hospitals and on the Thoracic, Cardiac, Neurosurgical and Paediatric units, ensured his continued interest in resuscitation and neonatal anesthesia, which led him to design a new tracheostomy tube when he was at Alder Hey Children's Hospital. He became Lecturer in Anesthesia at the University of Liverpool and later Consultant Anesthetist to Southmead Hospital, Bristol, and then to the Burnley group of hospitals and to Lancaster in 1966."

The Police Emergency Unit concept for our Community has proven to be unique and highly practical. Highly skilled teams of college trained, physician- supervised Police Offi cers render emergency care for trauma and illness with remarkable expertise. The roving, constantly on duty concept has distinct merits. It does provide a low cost system to en sure the delivery of emergency medical care to a community with a minimum of confu sion and a maximum of efficiency. Special acknowledgement is noted herewith for Mrs. Candace Otte, R. N., Dr. Frede rick A. Doornbos, Dr. Ramon B. Lang, Dr. Lee R. Pool, Dr. John R. Wilson, and P. Rode rick Smithson, the E. M. T. County Coordinator. Emergency Unit Calls for Metropolitan Grand Rapids and Kent County Grand Rapids (2 Units E-1 and E-2) January 1973 thru December 1973 P. 1. Accidents 1237 Cardiac 410 Disregarded 76 Others 805 D. O. A. 's 114 Code K's 30 Total: 2672 Average Per Day 7. 3 Kent County (3 Units E-66, E-67, E-68) August 1973 thru April 1974 P. I. Accidents 553 Cardiac 202 Disregarded Others 241 Not Applicable D. O. A. 's l3 Code K's 3 Total: 1017 Average Per Day 4. 1 Wyoming (1 Unit E-50) February 18, 1974 thru May 8, 1974 P. I. Accidents 57 Cardiac 50 Disregarded Others 135 Not Applicable D. O. A. 's Code K's Total: 242 Average Per Day 3. 0 Kentwood (1 Unit E-35) P. I."

No local, os segundos contam. PHTLS: Suporte de Vida em Trauma Pre-hospitalar ensina e reforca os principios em avaliar rapidamente um paciente de trauma usando uma abordagem ordenada, tratando imediatamente os problemas com risco de vida, a medida que eles sejam identificados, e minimizando quaisquer atrasos em iniciar o transporte a uma destinacao apropriada. Desenvolvido pela Associacao Nacional de Tecnicos de Emergencia Medica (NAEMT) em colaboracao com o Colegio Americano do Comite dos Cirurgioes de Traumas (ASC-COT), o PHTLS, Nona Edicao reflete os conhecimentos e praticas atuais com base em evidencias, e promove o pensamento critico como a base para fornecer cuidados de qualidade. Avaliar rapidamente um paciente de trauma para identificar os cuidados de salvamento constitui o centro da nona edicao do PHTLS. Leva 2 minutos ou menos para um paciente exsanguinante. Nenhuma outra intervencao pre-hospitalar que os prestadores de cuidado realizam e mais importante do que parar esse nivel de sangramento em pacientes de trauma. A fim de refletir isso, o PHTLS, Nona Edicao utiliza a mnemonica XABCDE de avaliacao do paciente para colocar a hemorragia exsanguinante a frente de cada encontro com o paciente. A importancia de XABCDE (hemorragia grave exsanguinante, vias aereas, respiracao, circulacao, incapacidade neurologica e exposicao ao ambiente) e reforcada em cada capitulo clinico. Caracteristicas do PHTLS, Nona Edicao: Informacoes atuais sobre ressuscitacao com fluidos e imobilizacao espinhal a partir de pesquisas com base em evidencias e experientes provedores de cuidados pre-hospitalares que aplicam os principios e as praticas do PHTLS no local Tecnicas atualizadas de tratamento do paciente, incluindo colocacao de torniquete, locais de descompressao com agulha, o uso de ligantes pelvicos, ressuscitacao pediatrica com fluidos e manejo pediatrico das vias aereas Enfase em lesoes evitaveis, desde dirigir distraido ate quedas em adultos idosos, e violencia entre parceiros intimos Foco em ameacas e respostas tacticas civis, desde veiculos como armas de destruicao em massa ate um novo fluxograma de metodologia de avaliacao remota Componentes Dinamicos do Programa O manual do PHTLS, Nona Edicao e o recurso definitivo em cuidados de trauma que detalha as evidencias medicas por tras dos principios e praticas recomendados do curso do PHTLS. Como proximo passo na evolucao do programa do PHTLS, o manual principal sera acompanhado pelo novo manual do curso do PHTLS, que reforca e esclarece os conceitos-chave do curso; apresenta um design envolvente e interativo; e esta escrito de modo que voce sente estar participando de um bate-papo, versus ouvindo a uma aula expositiva.

This volume contains the results of the 7th International Symposium on Acute Care, held in Rio de Janeiro from 21st to 24th November 1977. I would like to thank all the participants for their wonderful cooperation which made this Symposium a real success. I am especially grateful to the excellent speakers from all special ist fields and from all nations: I assure you, we all learned a great deal I would also like to thank the members of the organizing and scientific committees whose combined efforts ensured the smooth running of the Symposium, a meeting with a high-level discussion of scientific and philosophic problems as its goal. But first and foremost, we should like to express profound gratitude to the man whose idea it was to hold an annual conference in Rio: Dr. Brenildo Tavares, the Director of the Rio Symposia on Acute Care. He is one of the great pioneers of intensive, critical, acute, and emergency care, not only in.south America, but allover the world. The secret of the success of his symposia lies in his interdisciplinary and international approach. The symposia have brought together a great number of people who have since become close friends and continue to meet throughout the world. We all congratulate and thank him and wish him much success in the future."

This scenario-based text provides answers to urgent and emergent questions in acute, emergency, and critical care situations focusing on the electrocardiogram in patient care management. The text is arranged in traditional topics areas such as ACS, dysrhythmia, etc yet each chapter is essentially a question with several cases illustrating the clinical dilemma - the chapter itself is a specific answer to the question.

This is a unique format among textbooks with an ECG focus. The clinical scenarios cover the issues involved in detecting and managing major cardiovascular conditions. Focused, structured discussion then solves these problems in a clinically relevant, rapid, and easy to read fashion.

This novel approach to ECG instruction is ideal for practicing critical care and emergency physicians, specialist nurses, cardiologists, as well as students and trainees with a special interest in the ECG.

Diagnostik und Therapie sind die Pfeiler, auf denen die Medizin ruht. Beide wurden in der letzten Zeit wesentlich erweitert und vertieft - teils zum Nutzen der Patienten, teils aber auch zu deren Nachteil. Betroffen sind alle Fachgebiete der nicht-operativen Medizin inklusive der Pneumologie. Im Bereich der Pharmakotherapie von Lungenerkrankungen fehlte bisher ein Nachschlagewerk im deutschen Sprachraum. Meistens wird das Thema lediglich kursorisch in Lehrbuchern der Inneren Medizin und Pneumologie abgehandelt: Wenig vertieft bzw. kritisch abgehandelt mit Therapieempfehlungen ohne wissenschaftliche Evidenz. Erstmalig im deutschen Sprachraum liegt nun dieses fachbezogene Lehrbuch mit neuesten Erkenntnissen der Pharmakotherapie vor. Es wendet sich vor allem an Internisten und Pneumologen, ist aber auch fur Padiater, Thoraxchirurgen und Allgemeinarzte von grossem Interesse.

Emergency care is improving throughout the world and thousands of lives are being saved each year. However, there are still too many patients who die before help reaches them in the form of advanced rescue and definitive emergency care techniques. In an effort to improve emergency care throughout the world, the International Committee of Emergency and Disaster Medicine meets bi annually. This meeting takes place in Mainz, Germany in September in order to discuss issues, exchange information, and establish re commendations designed to improve emergency care. The group is in dependent of political, national, racial, religious, or commercial influences and, in this sense, similar to the Club of Rome which attempts advances in sociology, biology and natural sciences. There fore, the organization could be called the "Club of Mainz" for the field of emergency and disaster medicine. The following book contains the proceedings of the International Symposiom on "Mobile Intensive Care Units and Advanced Emergency Care Units" at Mainz from September 24-27, 1973, and the discussions evoked by the first activities of the "Club of Mainz" and the inter nationally acknowledged "Recommendations." At this time we also announce the next meeting and International Symposium on Disaster Medicine, open to the public, organized by the "Club of Mainz" (October 1 - 2, 1977)."

This simple, jargon-free text fits in your pocket, providing an 'on-the-spot' guide to clinician-performed ultrasound in the emergency department, intensive care unit or in the field. Written by an international team of experts and comprehensively updated in its third edition, Emergency Ultrasound Made Easy brings together in one volume the latest indications for focused ultrasound, including those related to the COVID-19 pandemic. The text is highly accessible and easy to use in an emergency. It is aimed at the rapidly expanding cohort of non-radiologist clinical sonographers who use focused ultrasound. However, its broad scope (for example using ultrasound in the rapid diagnosis of DVT) makes it an invaluable addition to the library of any doctor with an interest in the technique, whether in primary care or the hospital setting. Simple to read and follow Free of jargon Fast step-by-step guide to ultrasound procedures Clear diagrams Tips and pitfalls to avoid Multiple accompanying videos featuring examples of ultrasound in clinical practice New chapter on the use of ultrasound in small anatomical structures such as the eyes and testes New chapter on paediatric ultrasound Respiratory chapter updated to include COVID-19 Multiple accompanying videos featuring examples of ultrasound in clinical practice New chapter on the use of ultrasound in small anatomical structures such as the eyes and testes New chapter on paediatric ultrasound Respiratory chapter updated to include COVID-19

Comparatively little is known about the risk of sudden death associated with exercise in young competitive athletes, and whether the benefits of sports activity outweigh the hazards of exercise-related fatal events is a clinical dilemma. This is only a small part of the story, however, as there are considerable effects of exercise whether it be at a competitive level or on a leisure level on patients of all ages. This in itself is of massive importance to the cardiac patient population as exercise is a key component of effective recovery and recommended as central in the prevention of much cardiac disease."

The Managing Obstetric Emergencies and Trauma (MOET) course teaches the practical skills and procedures needed to save the mother and fetus in life-threatening circumstances. The course includes lectures, skills stations and workshops covering: resuscitation of the mother and newborn, including cardiopulmonary resuscitation, amniotic fluid embolism, pulmonary embolism and airway management; trauma, including shock, spine and spinal cord injuries and musculoskeletal trauma; obstetric emergencies, including pre-eclampsia and eclampsia, shoulder dystocia, umbilical cord prolapse and anaesthetic emergencies; and triage and transfer. The Manual provides readers with a structured preparation and revision system for the course. It provides essential anatomical, physiological and pathological information which the authors use to explain basic logical principles of resuscitation and treatment. Based on sound principles, this comprehensive handbook is easy to read and provides useful practical advice and management plans, and will be of use to all those working in obstetrics as well as to course delegates.

Like the first edition, this is a seminal textbook for the advanced practice nursing care of the seriously ill and dying. This comprehensive work addresses all aspects of palliative care including physical, psychological, social, and spiritual needs. It brings to the forefront current issues of health equity, managing through crisis, and meeting the needs of diverse populations. Each chapter contains case examples and a strong evidence base to support the highest quality of care. The text is written by leaders in the field and includes authors who have pioneered the role of the advanced practice nurse in palliative care. This volume offers advanced practice content and practical resources for clinical practice across all settings of care and encompassing all ages, from pediatrics to geriatrics. This newly revised edition has been reorganized to meet the needs of the APRN according to role delineation and practice issues. It offers foundation information on leadership, practice, and the various roles of the APRN as an administrator, educator, policy advocate, and researcher. The various settings of APRN work includes acute care settings (clinical care unit, intensive care unit, and emergency department), clinic (specialty care, primary care, and palliative care), community, rehabilitation, residential facilities, and telehealth. This edition also gives particular attention to special populations, including chapters on health disparities, economic disadvantages for urban dwellers, members of the LGBTQ+ community, Veterans, and Survivorship. There are sections wholly devoted to pediatric care, end of life communication, and the ethics APRNs have to navigate on a daily basis. Written by current APRNs for fellow APRNs, this text provides practical resources for clinical practice across a variety of topics.

The first edition of this book, Chemical Warfare Agents: Toxicity at Low Levels, was published just prior to the terrorist attacks of September 11, 2001. The second edition titled, Chemical Warfare Agents: Pharmacology, Toxicology, and Therapeutics, included new epidemiological and clinical studies of exposed or potentially exposed populations; new treatment concepts and products; improved organization of the national response apparatus addressing the potential for CWA terrorism; and improved diagnostic tests that enable rapid diagnosis and treatment. Since the second edition, the chemical warfare agent community has worked hard to advance research for protection and treatment and develop/improve response approaches for individuals and definitive care. Consequently, in addition to updating previous chapters, Chemical Warfare Agents: Biomedical and Psychological Effects, Medical Countermeasures, and Emergency Response, Third Edition features several new chapters that address the Syrian War, chemical destruction, the Organisation for the Prohibition of Chemical Weapons, biomarkers for chemical warfare agent exposure, field sensors, aircraft decontamination, lung/human on a chip, chemical warfare response decision making, and other research advancements. Features: Describes the newest medical interventions, and the latest technologies deployed in the field, as well as developments in the international response to CW usage highlighting recent events in the Middle East Discusses the latest in organizational/interagency partitioning in terms of responsibilities for emergency response, not just in the United States but at the international level-whether prevention, mitigation, medical care, reclamation, or medico-legal aspects of such response Contains the most current research from bench-level experts The third edition contains the most up-to-date and comprehensive coverage of the question of chemical warfare agent employment on the battlefield or in terrorism. Edited by workers that have been in the field for 35+ years, it remains faithful to the scientific "constants," while evaluating and crediting the advances by the industry that have made us safer.

Chirurgische Sofortmassnahmen" by G. H. Willital an established classic in a new edition provides valuable orientation for every surgically active physician. The book covers all diseases and accidents which might make emergency surgical intervention necessary. The surgical procedures for each case are systematically structured and presented in a clear and concise manner for rapid consultation."

This new book provides evidence based guidelines for the immediate clinical management of major trauma.It has been written by clinicians with many years of trauma experience, and endorsed as authoritative by Trauma Care (UK). The UK now has highly effective trauma systems. Clinical developments include the introduction of damage control resuscitation, tranexamic acid, blood product resuscitation, novel hybrid resuscitation and an emphasis on the control of major external haemorrhage as part of a new ABCDE approach. Consequently, more individuals with major trauma are surviving than ever before. Optimal pre-hospital care is essential for improved survival rates and reduced morbidity.