Evidence-Based Emergency Care : Diagnostic Testing and Clinical Decision Rules

by Pines, Jesse M.; Everett, Worth W.

• ISBN13: 9781405154000
• ISBN10: 1405154004
• Edition: 1st
• Format: Paperback
• Copyright: 2008-07-08
• Publisher: John Wiley & Sons Inc

Summary

This useful handbook provides a concise compilation of the evidence supporting diagnostic testing and clinical decision rules in emergency care. Clinical decision rules are now widely recognised as best practice for the ordering of diagnostic tests in the emergency department. Aimed at all physicians working with emergency and acute patients, the book begins with an overview of how to evaluate a diagnostic test using an evidence-based approach, followed by an explanation of the clinical decision rules and the methods of assessing the strength and applicability of the clinical prediction rule. These introductory chapters are followed by sections covering the following clinical areas: * Traumatic Injuries * Cardiology * Infectious Disease * Surgical and Abdominal Complaints * Urology * Neurology * Ophthalmology, Hematology, Rheumatology * Pulmonology. For each test and clinical decision rule, the most current and best available studies in the literature are discussed and applied to emergency department and acute care patients in addressing the question at hand, followed by an overall recommendation on how to use the test or rule in the clinical context. Evidence-Based Emergency Care is an accessible and extremely useful reference for physicians at all levels to use in applying an evidence-based approach to ordering and interpreting tests in an acute care environment.

Author Biography

Worth W. Everett is Assistant Professor, Department of Emergency Medicine at the University of Pennsylvania School of Medicine, Philadelphia, USA.

Table of Contents

Preface	p. vii
Foreword	p. ix
About the Authors	p. xi
The Science of Diagnostic Testing and Clinical Decision Rules
Diagnostic Testing in Emergency Care	p. 3
Evidence-Based Medicine: the Process	p. 10
The Epidemiology and Statistics of Diagnostic Testing	p. 16
Clinical Decision Rules	p. 32
Traumatic Injuries
Cervical Spine Fractures	p. 41
Cervical Spine Fractures in Older Adults	p. 53
Cervical Spine Fractures in Children	p. 59
Blunt Abdominal Trauma	p. 62
Acute Knee Injuries	p. 67
Blunt Head Injury	p. 72
Blunt Head Trauma in Children	p. 83
Acute Ankle and Foot Injuries	p. 91
Occult Scaphoid Fractures	p. 96
Blunt Chest Trauma	p. 101
Occult Hip Fracture	p. 108
Cardiology
Heart Failure	p. 115
Syncope	p. 122
Acute Coronary Syndrome	p. 127
Infectious Disease
Serious Bacterial Infections and Occult Bacteremia in Children	p. 143
Bacterial Meningitis in Children	p. 149
Necrotizing Fasciitis	p. 152
Pharyngitis	p. 156
Infective Endocarditis	p. 160
Urinary Tract Infection	p. 167
Sinusitis	p. 171
Pneumonia	p. 176
Spontaneous Bacterial Peritonitis	p. 181
Surgical and Abdominal Complaints
Acute Nonspecific, Nontraumatic Abdominal Pain	p. 189
Bowel Obstruction	p. 194
Acute Pancreatitis	p. 198
Acute Appendicitis	p. 201
Acute Cholecystitis	p. 208
Urology
Kidney Stones	p. 215
Testicular Torsion	p. 220
Neurology
Subarachnoid Hemorrhage	p. 229
Acute Stroke	p. 234
Miscellaneous: Ophthalmology, Hematology, Rheumatology, and Pulmonology
Pulmonary Embolism and Deep Vein Thrombosis	p. 243
Temporal Arteritis	p. 254
Intraocular Pressure	p. 259
Asthma	p. 266
Index	p. 277
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