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Tintinalli's Emergency Medicine:
A Comprehensive Study Guide

Judith E. Tintinalli, J. Stephan Stapczynski, David M. Cline,
O. John Ma, Rita K. Cydulka, and Garth D. Meckler
The American College of Emergency Physicians




Preface     Copyright     Contributors

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Section 1. Prehospital Care
8e Chapter 1Emergency Medical Services
8e Chapter 2Prehospital Equipment and Adjuncts
8e Chapter 3Air Medical Transport
8e Chapter 4Mass Gatherings
Section 2. Disaster Preparedness
 Chapter 6Disaster Preparedness and Response
 Chapter 7Natural Disasters
 Chapter 8Bomb, Blast, and Crush Injuries
 Chapter 9Chemical Agents and Mass Casualties
 Chapter 10Bioterrorism Recognition and Response: Implications for the Emergency Clinician
 Chapter 11Radiation Injuries
Section 3. Resuscitation
8e Chapter 11Sudden Cardiac Death in Adults
8e Chapter 12Basic Cardiopulmonary Resuscitation in Adults
8e Chapter 13ADefibrillation and Cardioversion
8e Chapter 13BAdvanced Cardiac Life Support
 Chapter 14Resuscitation of Neonates
 Chapter 15Resuscitation of Children
 Chapter 16Resuscitation Issues in Pregnancy
8e Chapter 16Post-Cardiac Arrest Syndrome
 Chapter 17Ethical Issues of Resuscitation
 Chapter 18Cerebral Resuscitation and Therapeutic Hypothermia
Chapter e18.1Hyperbaric Oxygen Therapy
 Chapter 19Acid-Base Disorders
 Chapter 20Blood Gases
 Chapter 21Fluids and Electrolytes
 Chapter 22Cardiac Rhythm Disturbances
 Chapter 23Pharmacology of Antiarrhythmics
 Chapter 24Pharmacology of Vasopressor Agents
 Chapter 25Approach to the Patient in Shock
 Chapter 26Fluid and Blood Resuscitation
 Chapter 27Anaphylaxis, Acute Allergic Reactions, and Angioedema
Section 4. Resuscitative Procedures
 Chapter 28Noninvasive Airway Management
 Chapter 29Pediatric Airway Management
 Chapter 30Tracheal Intubation and Mechanical Ventilation
 Chapter 31Surgical Airway Management
 Chapter 32Neonatal and Pediatric Intraosseous and Central Venous Access
 Chapter 33Venous and Intraosseous Access in Adults
 Chapter 34Hemodynamic Monitoring
 Chapter 35Cardiac Pacing
 Chapter 37Pericardiocentesis
Section 5. Analgesia, Anesthesia, and Procedural Sedation
8e Chapter 34Local and Regional Anesthesia
8e Chapter 35Procedural Sedation in Adults
 Chapter 38Acute Pain Management in Adults
 Chapter 42Adults with Chronic Pain
Section 6. Emergency Wound Management
8e Chapter 37Evaluation of Wounds
8e Chapter 38Wound Preparation
8e Chapter 39Methods for Wound Closure
 Chapter 46Lacerations to the Face and Scalp
8e Chapter 41Injuries to the Arm, Hand, Fingertip, and Nail
 Chapter 48Lacerations of the Leg and Foot
 Chapter 49Soft Tissue Foreign Bodies
8e Chapter 44Puncture Wounds and Bites
 Chapter 51Postrepair Wound Care
Section 7. Cardiovascular Disease
 Chapter 52Chest Pain: Cardiac or Not
 Chapter 53Acute Coronary Syndromes: Acute Myocardial Infarction and Unstable Angina
 Chapter 54Cardiogenic Shock
 Chapter 55Low Probability Acute Coronary Syndrome
8e Chapter 50Syncope
 Chapter 57Congestive Heart Failure and Acute Pulmonary Edema
 Chapter 58Valvular Emergencies
 Chapter 59The Cardiomyopathies, Myocarditis, and Pericardial Disease
 Chapter 60Thromboembolism
 Chapter 61Systemic and Pulmonary Hypertension
 Chapter 62Aortic Dissection and Related Aortic Syndromes
 Chapter 63Aneurysms of the Aorta and Major Arteries
 Chapter 64Occlusive Arterial Disease
Section 8. Pulmonary Emergencies
 Chapter 65Respiratory Distress
 Chapter 66Hemoptysis
 Chapter 67Acute Bronchitis and Upper Respiratory Tract Infections
 Chapter 68Community-Acquired Pneumonia, Aspiration Pneumonia, and Noninfectious Pulmonary Infiltrates
 Chapter 69Empyema and Lung Abscess
 Chapter 70Tuberculosis
 Chapter 71Spontaneous and Iatrogenic Pneumothorax
 Chapter 72Acute Asthma in Adults
 Chapter 73Chronic Obstructive Pulmonary Disease
Section 9. Gastrointestinal Emergencies
8e Chapter 68Acute Abdominal Pain
8e Chapter 69Nausea and Vomiting
8e Chapter 70Disorders Presenting Primarily with Diarrhea
8e Chapter 71Acute and Chronic Constipation
 Chapter 78Upper Gastrointestinal Bleeding
 Chapter 79Lower Gastrointestinal Bleeding
 Chapter 80Esophageal Emergencies, Gastroesophageal Reflux Disease, and Swallowed Foreign Bodies
 Chapter 81Peptic Ulcer Disease and Gastritis
 Chapter 82Pancreatitis and Cholecystitis
 Chapter 83Hepatic Disorders, Jaundice, and Hepatic Failure
 Chapter 84Acute Appendicitis
 Chapter 85Diverticulitis
 Chapter 86Bowel Obstruction and Volvulus
 Chapter 87Hernias in Adults
 Chapter 88Anorectal Disorders
 Chapter 89Gastrointestinal Procedures and Devices
 Chapter 90Complications of General Surgical Procedures
Section 10. Renal and Genitourinary Disorders
 Chapter 91Acute Renal Failure
8e Chapter 86Rhabdomyolysis
 Chapter 93Emergencies in Renal Failure and Dialysis Patients
 Chapter 94Urinary Tract Infections and Hematuria
 Chapter 95Acute Urinary Retention
 Chapter 96Male Genital Problems
 Chapter 97Urologic Stone Disease
 Chapter 98Complications of Urologic Procedures and Devices
Section 11. Obstetrics and Gynecology
 Chapter 99Vaginal Bleeding in the Nonpregnant Patient
 Chapter 100Abdominal and Pelvic Pain in the Nonpregnant Female
 Chapter 101Ectopic Pregnancy and Emergencies in the First 20 Weeks of Pregnancy
 Chapter 102Comorbid Diseases in Pregnancy
 Chapter 103Normal Pregnancy
8e Chapter 98Maternal Emergencies after 20 Weeks of Pregnancy and in the Postpartum Period
 Chapter 105Emergency Delivery
 Chapter 106Vulvovaginitis
 Chapter 107Pelvic Inflammatory Disease
 Chapter 108Breast Disorders
Chapter e108.1Urogynecologic Disorders and Gynecologic Oncology
 Chapter 109Complications of Gynecologic Procedures
Section 12. Pediatrics
8e Chapter 105Neonatal and Pediatric Transport
Chapter e109.1Assessment of the Child in the Emergency Department: A Practical Application of Normal Child Development
 Chapter 110Emergency Care of Children
8e Chapter 110Intravenous and Intraosseous Access in Children
8e Chapter 111Pain Management and Procedural Sedation in Infants and Children
8e Chapter 112Neonatal Emergencies and Common Neonatal Problems
 Chapter 112Sudden Infant Death Syndrome and Apparent Life-Threatening Event
8e Chapter 114AFever and Serious Bacterial Illness
8e Chapter 114BMeningitis in Infants and Children
 Chapter 114Ear and Mastoid Disorders in Infants and Children
 Chapter 115Eye Problems in Infants and Children
 Chapter 116The Nose and Sinuses
 Chapter 117The Mouth and Throat
 Chapter 118Neck Masses in Children
 Chapter 119Stridor and Drooling
 Chapter 120Wheezing in Infants and Children
 Chapter 121Pneumonia in Infants and Children
8e Chapter 123Congenital and Acquired Pediatric Heart Disease
 Chapter 123Vomiting, Diarrhea, and Dehydration in Children
8e Chapter 126Acute Abdominal Pain in Children
 Chapter 125Gastrointestinal Bleeding in Children
8e Chapter 128Urinary Tract Infection in Infants and Children
 Chapter 127Urologic and Gynecologic Problems and Procedures in Children
 Chapter 128Renal Emergencies in Infants and Children
8e Chapter 131Seizures and Status Epilepticus in Children
 Chapter 130Headaches in Children
 Chapter 131Altered Mental Status in Children
 Chapter 132Minor Head Injury in Infants and Children
 Chapter 133Musculoskeletal Disorders in Children
 Chapter 134Rashes in Infants and Children
 Chapter 135Sickle Cell Disease
 Chapter 136Oncology and Hematology Emergencies in Children
 Chapter 137Hypoglycemia and Metabolic Emergencies in Infants and Children
 Chapter 138The Child with Special Health Care Needs
 Chapter 139The Child with Diabetes
 Chapter 140Syncope and Sudden Death in Children
 Chapter 141Behavioral and Psychiatric Disorders in Children and Infants
 Chapter 142Fluid and Electrolyte Therapy in Infants and Children
 Chapter 143APediatric Procedures: Nasal and Otic Foreign Bodies
 Chapter 143BPediatric Procedures: Lumbar Puncture in Children
 Chapter 143CPediatric Procedures: Nursemaids' Elbow Reduction
 Chapter 143DPediatric Procedures: Electrocardiogram Interpretation
Section 13. Infectious Diseases
 Chapter 144Sexually Transmitted Diseases
 Chapter 145Toxic Shock Syndrome and Streptococcal Toxic Shock Syndrome
 Chapter 146Septic Shock
 Chapter 147Soft Tissue Infections
 Chapter 148Disseminated Viral Infections
 Chapter 149Human Immunodeficiency Virus Infection and Acquired Immunodeficiency Syndrome
 Chapter 150Infective Endocarditis
 Chapter 151Tetanus
8e Chapter 152Rabies
 Chapter 153Malaria
 Chapter 154Foodborne and Waterborne Diseases
 Chapter 155Zoonotic Infections
 Chapter 156World Travelers
 Chapter 157Occupational Exposures, Infection Control, and Standard Precautions
 Chapter 158Pharmacology of Antimicrobics, Antifungals, and Antivirals
Section 14. Neurology
Chapter e158.1The Neurologic Examination in the Emergency Setting
 Chapter 159Headache and Facial Pain
 Chapter 160Spontaneous Subarachnoid and Intracerebral Hemorrhage
 Chapter 161Stroke, Transient Ischemic Attack, and Cervical Artery Dissection
8e Chapter 162Altered Mental Status and Coma
8e Chapter 163Ataxia and Gait Disturbances
 Chapter 164Vertigo and Dizziness
 Chapter 165Seizures and Status Epilepticus in Adults
 Chapter 166Acute Peripheral Neurologic Lesions
 Chapter 167Chronic Neurologic Disorders
 Chapter 168Central Nervous System and Spinal Infections
 Chapter 169Central Nervous System Procedures and Devices
Section 15. Toxicology
8e Chapter 170General Management of Poisoned Patients
Chapter e170.1Principles of Drug Interactions
 Chapter 171Cyclic Antidepressants
 Chapter 172Atypical Antidepressants, Serotonin Reuptake Inhibitors, and Serotonin Syndrome
 Chapter 173Monoamine Oxidase Inhibitors
 Chapter 174Antipsychotics
 Chapter 175Lithium
 Chapter 176Barbiturates
 Chapter 177Benzodiazepines
 Chapter 178Nonbenzodiazepine Sedatives
 Chapter 179Alcohols
 Chapter 180Opioids
 Chapter 181Cocaine, Methamphetamine, and Other Amphetamines
8e Chapter 182Hallucinogens
 Chapter 183Aspirin and Salicylates
8e Chapter 184Acetaminophen
 Chapter 185Nonsteroidal Anti-Inflammatory Drugs
 Chapter 186Methylxanthines and Nicotine
 Chapter 187Digitalis Glycosides
 Chapter 188-Blockers
 Chapter 189Calcium Channel Blockers
 Chapter 190Antihypertensive Agents
8e Chapter 191Anticonvulsants
 Chapter 192Iron
 Chapter 193Hydrocarbons and Volatile Substances
 Chapter 194Caustics
 Chapter 195Pesticides
 Chapter 196Anticholinergics
 Chapter 197Metals and Metalloids
8e Chapter 198Industrial Toxins
8e Chapter 199Vitamins and Herbals
 Chapter 200Antimicrobials
 Chapter 201Dyshemoglobinemias
Section 16. Environmental Injuries
 Chapter 202Frostbite and Other Localized Cold Injuries
 Chapter 203Hypothermia
8e Chapter 204Heat Emergencies
 Chapter 205Bites and Stings
 Chapter 206Reptile Bites
 Chapter 207Trauma and Envenomations from Marine Fauna
 Chapter 208Dysbarism and Complications of Diving
8e Chapter 209Drowning
 Chapter 210Thermal Burns
 Chapter 211Chemical Burns
 Chapter 212Electrical Injuries
 Chapter 213Lightning Injuries
 Chapter 214Mushroom Poisoning
 Chapter 215Poisonous Plants
 Chapter 216High-Altitude Medical Problems
 Chapter 217Carbon Monoxide
Section 17. Endocrine Emergencies
8e Chapter 218Type 1 Diabetes Mellitus
 Chapter 219Type 2 Diabetes Mellitus
8e Chapter 220Diabetic Ketoacidosis
8e Chapter 221Alcoholic Ketoacidosis
8e Chapter 222Hyperosmolar Hyperglycemic State (HHS)
8e Chapter 223Thyroid Disorders: Hypothyroidism and Myxedema Crisis
8e Chapter 224Thyroid Disorders: Hyperthyroidism and Thyroid Storm
 Chapter 225Adrenal Insufficiency and Adrenal Crisis
Section 18. Hematologic and Oncologic Emergencies
 Chapter 226Anemia
 Chapter 227Tests of Hemostasis
 Chapter 228Acquired Bleeding Disorders
 Chapter 229Clotting Disorders
 Chapter 230Hemophilias and von Willebrand Disease
 Chapter 231Sickle Cell Disease and Other Hereditary Hemolytic Anemias
 Chapter 232Acquired Hemolytic Anemia
 Chapter 233Transfusion Therapy
8e Chapter 234Anticoagulants, Antiplatelet Agents, and Fibrinolytics
 Chapter 235Emergency Complications of Malignancy
Chapter e235.1Common Chemotherapeutic Agents
Section 19. Eyes, Ears, Nose, Throat, and Oral Surgery
8e Chapter 236Eye Emergencies
 Chapter 237Common Disorders of the External, Middle, and Inner Ear
 Chapter 238Face and Jaw Emergencies
 Chapter 239Epistaxis, Nasal Fractures, and Rhinosinusitis
 Chapter 240Oral and Dental Emergencies
 Chapter 241Infections and Disorders of the Neck and Upper Airway
 Chapter 242Complications of Airway Devices
Section 20. Skin Disorders
 Chapter 243Approach to Skin Disorders in the Emergency Department
 Chapter 244Treatment of Skin Disorders in the Emergency Department
 Chapter 245Serious Generalized Skin Disorders
 Chapter 246Disorders of the Face and Scalp
 Chapter 247Disorders of the Hands, Feet, and Extremities
 Chapter 248Disorders of the Groin and Skinfolds
 Chapter 249Skin Disorders Common on the Trunk
Section 21. Trauma
 Chapter 250Trauma in Adults
 Chapter 251Trauma in Children
8e Chapter 251Trauma in the Elderly
 Chapter 253Trauma in Pregnancy
 Chapter 254Head Trauma in Adults and Children
 Chapter 255Spine and Spinal Cord Trauma
 Chapter 256Trauma to the Face
 Chapter 257Trauma to the Neck
 Chapter 258Pulmonary Trauma
 Chapter 259Cardiac Trauma
 Chapter 260Abdominal Trauma
 Chapter 261Penetrating Trauma to the Flank and Buttocks
8e Chapter 261Genitourinary Trauma
 Chapter 263Penetrating Trauma to the Extremities
Chapter e263.1Wound Ballistics
Chapter e263.2Forensics
Section 22. Injuries to Bones and Joints
8e Chapter 263Initial Evaluation and Management of Orthopedic Injuries
 Chapter 265Injuries to the Hand and Digits
 Chapter 266Wrist Injuries
 Chapter 267Injuries to the Elbow and Forearm
 Chapter 268Shoulder and Humerus Injuries
 Chapter 269Pelvis Injuries
8e Chapter 269Hip and Femur Injuries
 Chapter 271Knee Injuries
 Chapter 272Leg Injuries
 Chapter 273Ankle Injuries
 Chapter 274Foot Injuries
8e Chapter 274Compartment Syndrome
Chapter e275.1Orthopedic Devices and Reconstruction
Section 23. Musculoskeletal Disorders
 Chapter 276Neck and Back Pain
 Chapter 277Shoulder Pain
 Chapter 278Hip and Knee Pain
 Chapter 279Emergencies in Systemic Rheumatic Diseases
 Chapter 280Nontraumatic Disorders of the Hand
 Chapter 281Acute Disorders of the Joints and Bursae
 Chapter 282Soft Tissue Problems of the Foot
Section 24. Psychosocial Disorders
8e Chapter 282Mental Health Disorders: ED Evaluation and Disposition
8e Chapter 283Management of Acute Agitation
8e Chapter 284Delirium, Dementia, and Other Mental Health Disorders of the Elderly
 Chapter 284Behavioral Disorders: Diagnostic Criteria
 Chapter 286Anorexia Nervosa and Bulimia Nervosa
 Chapter 287Panic Disorder
 Chapter 288Conversion Disorder
 Chapter 289Alcohol and Other Drugs of Abuse
Section 25. Abuse and Assault
 Chapter 290Child Abuse and Neglect
 Chapter 291Female and Male Sexual Assault
 Chapter 292Intimate Partner Violence and Abuse
 Chapter 293Abuse of the Elderly and Impaired
Chapter e293.1The Violent Patient
Section 26. Special Situations
 Chapter 294Injection Drug Users
 Chapter 295The Transplant Patient
Chapter e295.1The Mentally Retarded Adult
 Chapter 296The Morbidly Obese Patient
 Chapter 297Grief, Death and Dying, DNR/DNI Orders: Delivering Effective Death Notifications in the Emergency Department
8e Chapter 297.3Palliative Care in the Emergency Department
 Chapter 298Legal Issues in Emergency Medicine
Chapter e298.1Management of Prisoners Attending the Emergency Department
Chapter e298.2Military Medicine
Section 27. Principles of Imaging
Chapter e299.1Noninvasive Myocardial Imaging
Chapter e299.2Computed Tomography
Chapter e299.3Magnetic Resonance Imaging
Chapter e299.4Emergency Ultrasonography



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