Migraine is an extremely common condition affecting 28 million Americans. Fully 1 in every 6 adult women suffers from this malady. Patients with migraine are frequently seen in the Emergency Room and Urgent Care Clinic for acute treatment of their headaches. Headache generally accounts for nearly 3 % of all ER visits, resulting in almost 3.5 million visits annually.

There currently are no widely used guidelines for the treatment of patients with headache in the ER or UCC, and reducing the number of CT scans remains a key goal for administrators in many ER or urgent care settings. In one study, 35 drugs, alone or in combination, were used to treat migraine. The most common medication class used was narcotics, which were used in 25% of the visits. The next two most commonly used classes were antiemetics and NSAIDs. Only 5% of patients seen for headache received headache-specific medications during their visit.

ER and Urgent Care physicians generally have little or no formal training in treating these patients. Consequently, they often feel less comfortable ruling out secondary causes of headaches and using appropriate headache treatment medications and procedures. Since many patients have received narcotics in previous visits, providers may view them as drug seekers. Patients seen in ERs and UCCs for acute treatment of their headaches often report high levels of dissatisfaction. They often end up in the ER or UCC because they don t have a formal treatment strategy for their severe headaches.

Health plans and insurance agencies are often frustrated by the high cost of fragmented care for patients with headaches. Because of the environment that most ER and UCC providers operate in, many unnecessary scans and tests are done because of uncertainty of the diagnosis and unfamiliarity of the patient. Primary care physicians are also frustrated by patients with headaches presenting to them after being seen in the ER or UCC, wanting a refill of their narcotics that they were given. Many patients don t follow up with their PCPs and simply keep returning to the ER/UCC for their treatment.

In short, all involved in the care for patients with headache are frustrated by the current system. The care for these patients is clearly not optimal. It doesn t have to be that way. There are a wide variety of effective treatment options available, but are underutilized in the acute setting. With these treatment options, patients no longer have to be treated only with parenteral narcotics, only to perpetuate the cycle of suboptimal care described above.

This concise handbook covers all aspects of acute headache care, including care of the child and adolescent with acute headaches, treatment of pregnant and breastfeeding women with acute headaches and appropriate evaluation of secondary headaches. In addition, two other novel chapters are included: one on caring for older patients with acute headaches as well as a chapter describing how to ensure a seamless transition of the patient back to a headache interested provider.

Representing an important milestone in the care of patients with headache, this is the first concise handbook available to exclusively address the issue of headache treatment in the acute care setting. Including protocols and strategies that can be used right away, Management of Headaches in Emergency Room and Urgent Care Settings: Diagnosis and Management provides information about lesser known, but effective strategies such as greater occipital nerve blocks that can be easily learned and incorporated in the acute care setting. It emphasizes the continuity of care that is so vital to keep headache patients from returning to the ER and UCC for acute treatment.

* Offers a concise, comprehensive overview of the diagnosis, treatment and management of common and rarer movement disorders * Written by two key international movement disorder experts * Clinically focused and accessible * Provides a practical guide to the assessment of movement disorders where diagnosis relies on examination and observation rather than radiology and serological assessments Movement disorders attack the part of the brain that controls our movements, they are a complex group of disorders, spanning all aspects of neurological illnesses. Such disorders are widespread, often destroying the independence of those affected. Movement Disorders in Clinical Practice provides a concise, practical overview of the diagnosis, treatment and management of patients with these debilitating conditions, including a brief evaluation of ongoing clinical trials. Edited by two key international movement disorder experts, chapters cover: * Parkinson's disease * Parkinsonian syndromes * Dystonia * Tremor * Restless legs syndrome * An overview of other movement disorders

In Paramedics On and Off the Streets, Michael K. Corman embarks on an institutional ethnography of the complex, mundane, intricate, and exhilarating work of paramedics in Calgary, Alberta. Corman's comprehensive research includes more than 200 hours of participant observation ride-alongs with paramedics over a period of eleven months, more than one hundred first hand interviews with paramedics, and thirty-six interviews with other emergency medical personnel including administrators, call-takers and dispatchers, nurses, and doctors. At the heart of this ethnography are questions about the role of paramedics in urban environments, the role of information and communication technologies in contemporary health care governance, and the organization and accountability of pre-hospital medical services. Paramedics On and Off the Streets is the first institutional ethnography to explore the role and increasing importance of paramedics in our healthcare system. It takes readers on a journey into the everyday lives of EMS personnel and provides an in-depth sociological analysis of the work of pre-hospital health care professionals in the twenty-first century.

In the twentieth-century, evidence-based injury prevention and control strategies have contributed to a substantial decline in the number of deaths associated with injury. However, researchers in the field of injury prevention have often gathered their study methods from other disciplines; it can be difficult for injury investigators to locate all of the research tools that can be applied to problems related to injury. Injury Control: A Guide to Research and Program Evaluation addresses the growing need for a comprehensive source of knowledge on all research designs available for injury control and research. Included in this accessible guidebook is information about choices in study design, details about study execution and discussion of specific tools such as injury severity scales, programme evaluations and systematic reviews. Epidemiologists, health service investigators, trauma surgeons and emergency medicine physicians will find this a useful source for understanding, reviewing and conducting research related to injuries.

Nowhere in medicine is there a greater imperative to act than in the recognition and management of a patient's pain. This practical and evidence-based resource for emergency medicine and acute care providers will guide physicians in the selection of an effective therapy, define appropriate dosages to use and, equally important, when a treatment doesn't work, explain why, and what to do next. Starting with chapters on the assessment of pain, the safe and effective provision of analgesia in special populations, and featuring a reference table of drug names and interactions; the bulk of the coverage moves on to describe the provision of analgesia in the wide range of conditions likely to be encountered in the emergency department. The fundamental strengths of this approach are the comprehensive coverage, focus on practicality, basis in sound evidence, and authorship by specialists with extensive experience based on years of clinical practice.

Dr. Drew Pinsky is best known as the cohost of the long-running radio advice program Loveline. But his workday is spent at a major Southern California clinic, treating the severest cases of drug dependency and psychiatric breakdown. In this riveting book, Pinsky reveals the intimate and often shocking stories of his patients as they struggle with emotional trauma, sexual abuse, and a host of chemical nemeses: alcohol, marijuana, Ecstasy, heroin, speed, cocaine, and prescription drugs. At the center of these stories is Pinsky himself, who immerses himself passionately, almost obsessively, in his work. From the sexually compulsive model to the BMW-driving soccer mom, Cracked exposes, in fast-moving, powerful vignettes, the true scope and severity of addiction, a nationwide epidemic.

This book helps family physicians understand their roles in preparing for and responding to terrorist events. The text considers the physical and psychological impact of terrorism on providers and patients who are directly affected, as well as the spillover effects. Proactive measures are outlined, such as addressing concerns about risk. The text also details how to detect terrorist-caused illness as early as possible, how to provide defensive or preventative therapy, and how to treat ill patients. In-depth coverage of biologic agents (anthrax, plague, smallpox, botulism, tularemia, and hemorrhagic viruses), chemical agents (nerve and blister), and radiologic agents is provided. Readers also learn how to counsel traumatized families. In addition, the text examines the structure, function, and planning efforts of the public health system at the local, state, and federal levels. Emphasis is placed on how physicians can work with health officials on the delivery of preventive and therapeutic measures.

Designed for learning success. Overcome your fears and build your confidence while you master the mathematic and pharmacology knowledge you need to pass your licensure exams and prepare for professional practice. The 5th Edition of this popular resource presents often complex information is an way that's easy to understand and easy to follow, emphasizing the relevance of the drug information to your work as a paramedic as well as the calculations required to safely administer the correct drug dosages. Access more online. Redeem the Plus Code inside new, printed texts to access a wealth of resources online at DavisPlus. You'll find your Davis Digital Version, your complete text online, study questions, and fifteen animated learning modules that show you how drugs work. "Good book." "This book is VERY helpful! I found that it breaks the math down and makes it very simple and easy to follow! I recommend this book to anyone going through Paramedic School!" - Kimberly Wright, review of a previous edition

The cutting edge in medical training for wilderness rescue and self care "Wilderness First Responder" is a comprehensive text for the recognition, treatment, and prevention of backcountry emergencies. It's essential reading for wilderness educators, trip leaders, guides, search and rescue groups, and anyone who works or plays far from definitive medical care. This invaluable resource includes expert, step-by-step instructions, clear illustrations, and "Signs and Symptoms" sidebars designed to help anyone provide immediate care in the wilderness--whenever they are more than an hour away from an ambulance or a hospital. It shows how to conduct a patient assessment, improvise when ideal materials are not handy, and decide whether or not to evacuate a patient. Readers will learn how to assess and treat: Airway obstructions Cardiac arrest External and internal bleeding Shock Spine injuries Head injuries Chest injuries Abdominal injuries Fractures and dislocations Athletic injuries Soft-tissue injuries Cold- or heat-induced injuries Altitude sickness Insect bites & stings Diabetic emergencies Poisoning emergenciesAllergic reactions and anaphylaxisAnd much, much more

Why Critical Care Evolved METs? In early 2004, when Dr. Michael DeVita informed me that he was cons- ering a textbook on the new concept of Medical Emergency Teams (METs), I was surprised. At Presbyterian-University Hospital in Pittsburgh we int- duced this idea some 15 years ago, but did not think it was revolutionary enough to publish. This, even though, our fellows in critical care medicine training were all involved and informed about the importance of "C- dition C (Crisis)," as it was called to distinguish it from "Condition A (Arrest). "We thought it absurd to intervene only after cardiac arrest had occurred, because most cases showed prior deterioration and cardiac arrest could be prevented with rapid team work to correct precluding problems. The above thoughts were logical in Pittsburgh, where the legendary Dr. Peter Safar had been working since the late 1950s on improving current resuscitation techniques, ?rst ventilation victims of apneic from drowning, treatment of smoke inhalation, and so on. This was followed by external cardiac compression upon demonstration of its ef?ciency in cases of unexpected sudden cardiac arrest. Dr. Safar devoted his entire professional life to improvement of cardiopulmonary resuscitation. He and many others emphasized the importance of getting the CPR team to o- of-hospital victims of cardiac arrest as quickly as possible.

The American State Normal School is the first comprehensive history of the state normal schools in the United States. Although nearly two-hundred state colleges and regional universities throughout the U.S. began as 'normal' schools, the institutions themselves have buried their history, and scholars have largely overlooked them. As these institutions later became state colleges and/or regional universities, they distanced themselves from the low status of elementary-literally erasing physical evidence of their normal-school past. In doing so, they buried the rich history of generations of students for whom attending normal school was an enriching, and sometimes life-changing experience. Focusing on these students, the first wave of 'non-traditional' students in higher education, The American State Normal School is a much-needed re-examination of the state normal school.This book was subject of an annual History of Education Society panel for best new books in the field.

Das Handbuch der gefahrlichen Guter ist das Standardwerk fur den Transport von Gefahrgutern. Es gibt Informationen zu nationalen und internationalen Transportvorschriften und zu Notfallmassnahmen bei Unfallen mit gefahrlichen Gutern sowie Hinweise fur die arztliche Erstbehandlung von Personen. Fur alle Gefahrguter, die im Hommel enthalten sind, wurden die GHS-Kennzeichnungen mit aufgenommen: Signalworte, Piktogramme, sowie die neuen Gefahrenhinweise (H-Statements) und Sicherheitshinweise (P-Statements). Diesem Band liegt das Update der Einzelplatzversion 21.0 auf 22.0 als Download bei.

Das Buch spannt einen weiten Bogen A1/4ber die Transplantationsmedizin und gibt einen Aoeberblick A1/4ber Immunologie, Chirurgie, Vorbereitung und Nachsorge sowie die Randbereiche der Transplantationschirurgie. Es dient Chirurgen, Internisten, Allgemeinmedizinern als auch Medizinstudenten als Nachschlagewerk fA1/4r die thorakale und abdominelle Organtransplantation und soll Grundlagen der Transplantationschirurgie bzw. -medizin vermitteln. Ausserdem informiert es den Leser A1/4ber rechtliche, ethische und organisatorische Aspekte der Transplantationsmedizin und nicht zuletzt A1/4ber die "Physiologie des Hirntodes und die Spenderkonditionierung" sowie A1/4ber den Themenkomplex "Organkonservierung, Transport und Allokation."

Accident and emergency departments are the doorway to the hospital for acutely ill and injured patients. Whereas casualty departments have existed for over 150 years, they were often poorly staffed and managed. This book describes the fight to create a new medical specialty of accident and emergency medicine against much opposition from established specialties. The specialty was first recognised in 1972. The book also charts the major developments that occurred in the first 30 years of the specialty.

Le situazioni critiche in medicina d urgenza e in terapia intensiva rappresentano una tra le sfide piu difficili nella pratica clinica. La natura stessa dell ambiente di cura, l incertezza, il rischio elevato, i tempi ristretti e lo stress, rendono queste discipline particolarmente vulnerabili agli errori nella gestione dei pazienti. Nell ultimo decennio e diventato sempre piu evidente, che la capacita di erogare trattamenti sicuri in queste circostanze dipende da un approfondita conoscenza dei meccanismi all origine dell errore umano. Questo volume, che e la traduzione italiana della seconda edizione di Crisis Management in Acute Care Settings, propone una rassegna originale e completa di tutti i problemi correlati ai fattori umani, rilevanti per la sicurezza dei pazienti durante l erogazione di trattamenti urgenti. Le energie di medici e psicologi si sono mescolate in un testo facilmente accessibile, che aiutera i medici e altri professionisti della salute a comprendere meglio i principi del comportamento umano e del processo decisionale nelle situazioni critiche, per evitare errori e garantire un trattamento piu sicuro ai loro pazienti.

Sudden Death and the Myth of CPR is for anyone who has taken a CPR course or who believes the images from television dramas. It is also for families of victims and survivors of CPR. It will engage emergency personnel, others in the medical field, and anyone concerned with ethical issues of death and dying.

Anyone who has ever taken a CPR course has wondered, "What would happen if I actually had to use CPR?" In Western societies, the lifesaving power of resuscitation has the status of a revered cultural myth. It promises life in the face of sudden death, but the reality is that lives are rarely saved. Medical researchers estimate the survival rate for out-of-hospital CPR to be between 1 and 3 percent. Sudden Death and the Myth of CPR explores the history of this medical innovation and the promotion of its effectiveness.

The overuse of resuscitation, Timmermans explains, defines people's experience with sudden death, something he learned firsthand by following the practice of lifesaving from street comer to emergency room. He argues that very few people are successfully resuscitated without brain damage despite the promotion of CPR's effectiveness through powerful media images. In vivid accounts of the day-to-day practices of cardiopulmonary resuscitation in one of the only studies of sudden death, Timmermans records the astonishingly frank comments of emergency personnel. Doctors, nurses, social workers, and paramedics express emotions from cynicism about going through the futile motions to genuine concern for victims' family members.

If a person who was supposed to keep on living dies at the end of a resuscitative attempt, how socially meaningful is the dying? Timmermans askstough questions and addresses the controversial ethical issues about the appropriateness of interfering with life and death. He suggests policy reforms and the restoration of dignity to sudden death.

Based on Dr. Auerbach's renowned Wilderness Medicine text, Field Guide to Wilderness Medicine, 5th Edition, is your portable, authoritative guide to the full range of medical and emergency situations that occur in non-traditional settings. Useful for experienced physicians as well as advanced practice providers, this unique medical guide covers an indispensable range of topics in a well-illustrated, highly condensed format - in print or on any mobile device - for quick access anytime, anywhere. An easy-access presentation ensures rapid retrieval and comprehension of wilderness medical information, with "Signs and Symptoms" and "Treatment" sections, bulleted lists, and quick-reference text boxes in every chapter. All chapters are thoroughly up to date, including new information on travel medicine, medications, immunizations, and field treatment of common conditions. Step-by-step explanations from wilderness medicine experts cover the clinical presentation and treatment of a full range of wilderness emergencies and show you how to improvise with available materials. Comprehensive coverage includes dive medicine and water-related emergencies, mountain medicine and wilderness survival, global humanitarian relief and disaster medicine, high-altitude medicine, pain management, and much more. Line drawings and color plates help you quickly and accurately identify skin manifestations, plants, poisonous mushrooms, snakes, insects, and more. Useful appendices address everything from environment-specific situations to lists of essential supplies, medicines, and many additional topics of care. Expert ConsultT eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, tables and figures from the book on a variety of devices.

Core Principles of Acute Neurology is a series of short volumes that handles major topics not found in sufficient detail elsewhere and provides useful context. Identifying Neuroemergencies provides practical information how to best manage and triage patients in the first hour of admission in the emergency department. Physicians consider a neurologic emergency when the patient has clearly worsened and their neurologic signs have changed. Correct decisions are imperative: any type of neurocritical illness demands immediate treatment in the emergency department. Neurologist can assist further with the successful triage of the neurologic emergency and this volume in the Core Principles of Acute Neurology will serve as a handy, concise, reference to both the neurologist and the emergency physician.

Palliative Care Nursing: Caring for Suffering Patients continues to explore the concept of suffering as it relates to nursing practice in an updated new edition. This text helps practicing nurses and students define and recognize various aspects of suffering across the lifespan and within various patient populations, while providing guidance in alleviating suffering. In addition, the authors discuss ways nurses that witness suffering can optimize their own coping skills and facilitate personal growth. The Second Edition aligns with the recently updated ELNEC and AACN competencies and features three new chapters discussing advance care planning, palliative care for those with serious illnesses, and strategies for having difficult conversations with patients and families. How do we identify a patient who is suffering? How do we assess whether our patient (and/or their family) is coping with the event? What can we do to alleviate patient suffering? How can we convey the extent of the suffering to the other members of the healthcare team and advocate excellent palliative care for our patients? Palliative Care Nursing: Caring for Suffering Patients, Second Edition answers these questions and more, making it an indispensable resource for nursing students and nurses employed in a variety of health care settings.

El curso de Soporte Vital Cardiovascular Avanzado (ACLS por sus siglas en ingles) de ECSI, esta disenado para lograr en los participantes el desarrollo, no solo de los conocimientos y habilidades necesarios para la reanimacion del paciente, si no que ademas fomenta el pensamiento critico y la toma de decisiones basada en evidencia. Todas las lecciones y clases practicas estan disenadas para construir un aprendizaje significativo en cada uno de los participantes al realizar preguntas clave y desarrollar casos de manera simultanea. En el programa tradicional (16 horas) cuenta con los elementos fundamentales de aprendizaje con herramientas teoricas y practicas. Lecciones de clase: - Medicina basada en evidencia - Reanimacion cardiopulmonar y Equipo de Alto Desempeno (RAD) - Sindrome Coronario Agudo - Identificacion del STEMI en EKG de 12 derivaciones - IAM no STEMI y shock cardiogenico - Cuidados post-PCR: Retorno de la circulacion espontanea - Cuidados post-PCR: Fin de la RCP y notificacion de la muerte - Accidente cerebrovascular Clases practicas: - Modelo RAD en soporte vital basico - Modelo RAD en soporte vital avanzado - Integracion del equipo RAD - SVB y SVCA - Codigo PCR: ritmo desfibrilable - Codigo PCR: ritmo no desfibrilable - Codigo PCR: integral con via aerea dificil - Bradicardia - Taquicardia estable - Taquicardia inestable - Codigo PCR: retorno de la circulacion espontanea - Codigo PCR: fin de las maniobras de reanimacion - Retroalimentacion en el equipo RAD En la version extendida del programa (24 horas) se incluyen lecciones adicionales, que permitiran fortalecer, en los participantes, sus conocimientos en: - Via Aerea - Capnografia - Farmacologia aplicada al SVA - Interpretacion del electrocardiograma - Impostores del STEMI -Bradicardias -Taquicardias Los materiales de estudio y de clase fueron disenados, para facilitar el aprendizaje y comprension de los temas, por expertos profesionales medicos y paramedicos de toda Latinoamerica y EE.UU.

The Oxford Clinical Imaging Guides are specifically designed to help doctors master imaging techniques. Each guide explains the principles and practice of using imaging in an easy-to-read, highly-illustrated, and authoritative manner. Point of Care Ultrasound for Emergency Medicine and Resuscitation is the definitive guide to using this indispensable clinical tool quickly, safely, and accurately to diagnose patients in emergency, acute, and critical care settings. With a practical focus on how to perform ultrasound and interpret images, this book demonstrates how the reader can use ultrasound safely in patient management to diagnose and manage shock, acute presentations, or the acute phases of key conditions. Extensively illustrated, this resource also comes with online access to 160 ultrasound clips and over 130 annotated ultrasound images. Written by expert educators, this book is mapped to the curriculum for the International Federation for Emergency Medicine to teach emergency and acute medics exactly what they need to know. This guide is highly relevant for the syllabi of Emergency Medicine colleges and associations in the USA, Canada, UK, Australasia and South Africa.

This book uses the case of the National Health Service to examine the management of ambiguity and change. Studies of the implementation of the Griffiths Report have identified a number of unintended consequences, but it is argued that they have not adequately theorised these outcomes in the policy implementation process. It is suggested that the process-sociological approach of Elias, and in particular his game models, enable us to better understand the complex interweaving of planned and unplanned processes which is involved in the management of change.

Das Handbuch der gefahrlichen Guter ist das Standardwerk fur den Transport von Gefahrgutern. Es gibt Informationen zu nationalen und internationalen Transportvorschriften und zu Notfallmassnahmen bei Unfallen mit gefahrlichen Gutern sowie Hinweise fur die arztliche Erstbehandlung von Personen. Fur alle Gefahrguter, die im Hommel enthalten sind, wurden die GHS-Kennzeichnungen mit aufgenommen: Signalworte, Piktogramme, sowie die neuen Gefahrenhinweise (H-Statements) und Sicherheitshinweise (P-Statements).

Das Handbuch der gefahrlichen Guter ist das Standardwerk fur den Transport von Gefahrgutern. Es gibt Informationen zu nationalen und internationalen Transportvorschriften und zu Notfallmassnahmen bei Unfallen mit gefahrlichen Gutern sowie Hinweise fur die arztliche Erstbehandlung von Personen. Fur alle Gefahrguter, die im Hommel enthalten sind, wurden die GHS-Kennzeichnungen mit aufgenommen: Signalworte, Piktogramme, sowie die neuen Gefahrenhinweise (H-Statements) und Sicherheitshinweise (P-Statements). Diesem Band liegt das Update der Einzelplatzversion 20.0 auf 21.0 bei.

Over the years Oxfam has been involved in a wide variety of health-related projects. The Practical Health Guides draw on this experience to put forward ideas on best practice in the provision of health care and services in developing countries. Drawing on the experience of Oxfam staff in many different emergency situations, this text is a short, practical introduction to the provision of health care in emergencies. It provides a checklist of the information required to build up a rapid picture of the situation and of healthcare needs and describes the implementation of health care procedures and the necessary facilities, including information on feeding, preventive health care, clinical care and control of common diseases such as measles, diarrhoea and malaria. Issues arising from long term displacement and information about evaluation are also provided. Detailed information on aspects of health care such as nutrition, deficiency diseases, drugs, water and treatment protocols is given in the form of appendices.