APLS: The Pediatric Emergency Medicine Resource

by Gausche-Hill, Marianne

• ISBN13: 9780763733162
• ISBN10: 0763733164
• Edition: 4th
• Format: Hardcover
• Copyright: 2003-10-01
• Publisher: Jones & Bartlett

Summary

Working in crisis situations demands your best. APLS: The Pediatric Emergency Medicine Resource is designed to provide health care providers with a core knowledge of pediatric emergency medicine. More than 15 years ago, AAP and ACEP joined forces to develop the highly regarded APLS course. APLS is much more than just a course, it is an educational tool kit that has helped thousands of emergency physicians and pediatricians to improve the quality of care they provide to infants and children with emergency conditions. The Revised Fourth Edition of APLS is truly the body of knowledge in pediatric emergency medicine. Developed by expert authors, editors, and faculty from both AAP and ACEP, the new APLS is a unique teaching and learning system for individual physicians, students, residents, teachers, and APLS instructors and course directors. APLS offers physicians, nurses, paramedics, and other allied health professionals the information necessary to assess and manage critically ill or injured children during the first hours in the emergency department. APLS goes beyond basic resuscitation and it designed to meet the advanced skills and knowledge of the physician dealing with serious pediatric diseases and problems in an emergency setting. The Revised Fourth Edition includes nine new chapters: Pedaitric Assessment, Central Nervous System, Metabolic Disease, Nontraumatic Surgical Emergencies, Nontraumatic Orthopaedic Emergencies, Disaster Management, Preparedness for Acts of Nuclear, Biological, and Chemical Terrorism, Children with Special Health Care Needs, and Medical-Legal Considerations. Classroom Packages Now Available! Order everything you need to run your APLS course with one of our money-saving classroom packages! Choose to receive either 10 or 25 copies of the student textbook along with one copy of the essential Instructor's Toolkit CD-Rom. To order a 10 copy classroom package, please go here: http://www.jbpub.com/catalog/0763736988 To order a 25 copy classroom package, please go here: http://www.jbpub.com/catalog/0763736996 APLS, Revised Fourth Edition has been expanded to cover new conclusions drawn from reason, fact, and experience to the benefit of sick and injured children worldwide. Together, AAP and ACEP developed APLS into a stand-alone course, offering continuing medical education units and an APLS course completion card upon successful completion. The course is highly interactive with small group scenarios, hands-on skill stations, and case-based lectures. APLS: bull; bull;appeals to a broad range of health care professionals bull;responds to emergency care provider needs bull;explores extensive case presentations bull;adapts to a variety of uses and situations bull;informs using small group scenarios, hands-on skill stations, and case-based lectures bull;is easy to implement quickly If you are a physician who wants the newest, most comprehensive reference on pediatric emergency medicine, the Revised Fourth Edition will meet your needs. Its 31 chapters address all aspects of providing emergency care to pediatric patients from respiratory distress and shock to trauma and medical emergencies, from neonatal care and assessment of pediatric patients to emergency department preparedness and procedures. All content is presented in the popular, highly effective case-based format, with full-color photos and illustrations. Want to take your continuing education further? Then read and answer the Check Your Knowledge questions in every chapter, either for your own study and self-assessment, or for Category I CME credit. This self-directed approach is great for everyone--practicing physicians, students, and residents alike. Take the Check Your Knowlege Online CME at www.APLSonline.com.<

Table of Contents

1 Preparedness for Pediatric Emergencies	2	(18)
Introduction	3	(1)
Emergency Department Preparedness	4	(1)
Triage	4	(1)
Child-Friendly Area	5	(3)
Staffing	8	(1)
Interface With Out-of-Hospital Care	8	(1)
Equipment and Supplies	8	(4)
Other Preparedness Issues	12	(1)
Interpersonal Violence	12	(1)
Parental Presence	13	(2)
Transfer to a Higher Level of Care	15	(1)
Disasters	16	(1)
Chapter Review	17	(3)
2 Pediatric Assessment	20	(32)
Introduction	21	(4)
Developing a General Impression: The Pediatric Assessment Triangle	25	(10)
Assessing the Pediatric ABCDEs	35	(9)
Summary of Initial Assessment	44	(1)
Focused History and Physical Examination	44	(3)
Ongoing Assessment	47	(2)
Chapter Review	49	(3)
3 The Pediatric Airway in Health and Disease	52	(54)
Introduction	53	(1)
Anatomic and Physiologic Responses to Airway Maneuvers	54	(2)
General Approach to Airway Emergencies	56	(5)
Upper Airway Obstruction	61	(10)
Croup	61	(3)
Foreign Body Aspiration	64	(2)
Retropharyngeal Abscess	66	(2)
Epiglottitis	68	(1)
Anaphylaxis	69	(2)
Lower Airway Obstruction
Bronchiolitis	71	(4)
Asthma	75	(10)
Disease of Oxygenation and Ventilation and Disease of the Lungs	85	(9)
Bronchopulmonary Dysplasia	85	(2)
Cystic Fibrosis	87	(4)
Pneumonia	91	(3)
Respiratory Failure	94	(3)
Chapter Review	97	(9)
4 Cardiovascular System	106	(40)
Introduction	107	(1)
Congenital Heart Disease	108	(8)
Cyanotic Heart Disease	109	(4)
Noncyanotic Heart Disease	113	(1)
Congestive Heart Failure	114	(2)
Acquired Heart Disease	116	(21)
Myocarditis	116	(2)
Acute Rheumatic Fever	118	(2)
Pericarditis	120	(2)
Bacterial Endocarditis	122	(2)
Kawasaki Disease	124	(2)
Rhythm Disturbances	126	(7)
Pulseless Arrest Rhythms	133	(1)
Cardiomyopathy	133	(1)
Postsurgical Complications	134	(3)
Shock	137	(4)
Hypovolemic Shock	137	(1)
Cardiogenic Shock	138	(1)
Distributive Shock	139	(2)
Chapter Review	141	(5)
5 Central Nervous System	146	(40)
Altered Level of Consciousness	148	(6)
Meningitis	154	(5)
Encephalitis	159	(4)
Headache	163	(3)
Weakness	166	(2)
Seizures	168	(6)
Febrile Seizures	168	(2)
Afebrile Seizures	170	(4)
Status Epilepticus	174	(5)
Chapter Review	179	(7)
6 Metabolic Disease	186	(22)
Introduction	187	(1)
Diabetic Ketoacidosis	187	(5)
Hypoglycemia in Diabetic Children	192	(1)
Hypoglycemia in Nondiabetic Children	192	(2)
Adrenal Insufficiency/Congenital Adrenal Hyperplasia	194	(2)
Diabetes Insipidus	196	(1)
Syndrome of Inappropriate Secretion of Antidiuretic Hormone	197	(2)
Water Intoxication	199	(2)
Metabolic Disease of the Newborn and Young Child	201	(4)
Chapter Review	205	(3)
7 Environmental
Emergencies	208	(1)
Introduction	209	(1)
Envenomations	209	(7)
Snake Bites	209	(4)
Spider Bites	213	(3)
Body Temperature Disturbances	216	(2)
Minor Heat Illnesses	218	(1)
Major Heat Illnesses	218	(2)
Hypothermia	220	(4)
Submersion Injury	224	(5)
Chapter Review	229	(5)
8 Toxicology: Ingestions and Smoke Inhalation	234	(34)
General Evaluation and Management of Ingestions	235	(5)
Specific Ingestions	240	(17)
Acetaminophen	240	(2)
Ethanol	242	(1)
Methanol and Ethylene Glycol	242	(1)
Anticholinergic Agents	243	(1)
Caustics	244	(1)
Clonidine	245	(1)
Cyanide	246	(1)
Cyclic Antidepressants	247	(1)
Hydrocarbons	248	(1)
Iron	249	(2)
Opioids	251	(1)
Organophosphates	252	(1)
Salicylates	253	(2)
Selective Serotonin Reuptake Inhibitors	255	(1)
y-Hydroxybutyrate	256	(1)
Ecstasy	256	(1)
Overall Management Issues	257	(1)
Additional Routes of Exposure	257	(1)
Smoke Inhalation	258	(5)
Chapter Review	263	(5)
9 Trauma	268	(56)
Introduction	270	(1)
Pathophysiologic and Anatomic Considerations	270	(3)
Assessment and Management	273	(1)
Primary and Secondary Surveys	274	(12)
Central Nervous System Injuries	286	(5)
Cranial and Intracranial Injuries	291	(4)
Seizures	295	(1)
Extracranial Head Injuries	295	(1)
Spinal injuries	296	(11)
Chest Injuries	307	(2)
Abdominal Injuries	309	(3)
Burns	312	(4)
Electrical Trauma	316	(2)
Other Burns	318	(1)
Summary	319	(1)
Chapter Review	320	(4)
10 Child Maltreatment	324	(36)
Introduction	325	(1)
Physical Abuse	326	(11)
Bruises and Bites	328	(1)
Burns	329	(1)
Head Injuries	330	(2)
Abdominal Injuries	332	(1)
Skeletal Injury	333	(4)
Sexual Abuse	337	(7)
Acute Sexual Assault	344	(5)
Neglect	349	(2)
Münchausen Syndrome By Proxy	351	(1)
Summary	352	(2)
Chapter Review	354	(6)
11 Nontraumatic Surgical Emergencies	360	(50)
Necrotizing Enterocolitis	361	(6)
Malrotation and Midgut Volvulus	367	(4)
Pyloric Stenosis	371	(5)
Intussusception	376	(6)
Meckel Diverticulum	382	(4)
Testicular Torsion	386	(3)
Pediatric Inguinal Hernia	389	(4)
Appendicitis	393	(5)
Chapter Review	398	(12)
12 Nontraumatic Orthopedic Emergencies	410	(36)
Developmental Dysplasia of the Hip	411	(5)
Rotational Deformities	416	(1)
Metatarsus Adductus	416	(1)
Internal Tibial Torsion	417	(1)
Excessive Femoral Anteversion	418	(3)
Angular Deformities	421	(1)
Blount Disease	421	(4)
Radial Head Subluxation	425	(2)
Legg-Calvé-Perthes Disease	427	(2)
Slipped Capital Femoral Epiphysis	429	(3)
Acute Septic Arthritis	432	(4)
Osgood-Schlatter Disease	436	(1)
Summary	437	(1)
Chapter Review	438	(8)
13 Medical Emergencies	446	(30)
Introduction	447	(1)
Sepsis	447	(4)
Fever in Children at Risk for Sepsis	451	(4)
Sickle Cell Disease	455	(3)
Dermatologic Emergencies	458	(4)
Epididymitis	462	(1)
Balanitis/Balanoposthitis	463	(1)
Urinary Tract Infections-Cystitis and Pyelonephritis	464	(2)
Hypertension	466	(2)
Acute Glomerulonephritis	468	(1)
Nephrotic Syndrome	469	(1)
Syncope	470	(3)
Chapter Review	473	(3)
14 Neonatal Emergencies	476	(22)
Introduction	477	(1)
Resuscitation of the Newly Born	477	(4)
Fever	481	(1)
Bacterial Sepsis	482	(2)
Lethargy	484	(1)
Irritability	485	(1)
Apnea	486	(1)
Cyanosis	486	(1)
Congenital Heart Disease	487	(1)
Grunting	487	(1)
Vomiting	487	(2)
Constipation	489	(1)
Diarrhea	490	(1)
Seizures	490	(1)
Withdrawal	491	(1)
Gastrointestinal Bleeding	491	(1)
Umbilical Problems	492	(1)
Hyperbilirubinemia	492	(2)
Chapter Review	494	(4)
15 Procedural Sedation and Analgesia	498	(26)
Introduction	499	(4)
Pain Assessment	503	(3)
Medications Used in Analgesia and Sedation	506	(8)
Medication Selections	514	(4)
Summary	518	(2)
Chapter Review	520	(4)
16 Interface With EMS	524	(18)
Introduction	525	(1)
Origin of EMS Systems	526	(1)
Federal EMSC Program	527	(6)
EMSC Landmarks	533	(3)
Physician's Role in EMSC	536	(1)
Future of EMSC	537	(1)
Chapter Review	538	(4)
17 Disaster Management	542	(26)
Introduction	543	(1)
Emergency Management Process	544	(1)
Children and Disaster Planning	545	(4)
Planning by Community Medical Practitioners	549	(1)
Planning by EMS Agencies	550	(2)
Planning by Hospitals	552	(2)
Planning by Community Agencies	554	(1)
Planning by Community Emergency Management	555	(1)
Response and Recovery Phases	556	(3)
Mitigation Phase	559	(1)
Pediatric Medical Issues After Community-wide Disasters	559	(3)
Pediatric Mental Health Issues After Disasters	562	(1)
Summary	562	(2)
Chapter Review	564	(4)
18 Preparedness for Acts of Nuclear, Biological, and Chemical Terrorism	568	(24)
Introduction	569	(2)
Major Biological Agents	571	(1)
Anthrax	571	(4)
Smallpox	575	(1)
Plague	576	(1)
Botulism	576	(1)
Tularemia	577	(1)
Viral Hemorrhagic Fevers	577	(1)
Chemical Agents	577	(1)
Nerve Agents	577	(3)
Vesicant Agents	580	(1)
Cyanide	580	(1)
Radiation Exposure	581	(6)
Early Recognition	587	(2)
Chapter Review	589	(3)
19 Children With Special Health Care Needs	592	(18)
Introduction	593	(2)
Tracheostomies and Home Ventilation	595	(4)
Feeding Tubes and Gastrostomy Tubes	599	(3)
Central Venous Catheters	602	(2)
Dialysis Shunts and Peritoneal Dialysis Catheters	604	(1)
Ventriculoperitoneal Shunts	605	(2)
Chapter Review	607	(3)
20 Medical-Legal Considerations	610	(28)
Introduction	612	(1)
Medical Malpractice and the ED	612	(1)
Statute of Limitations	613	(1)
High-Risk Cases in Pediatric Emergency Medicine	613	(1)
Documentation	614	(2)
Communication	616	(1)
Consultants	617	(2)
Issues of Consent	619	(3)
Refusal of Care	622	(1)
Transfer of Care	623	(2)
Family Presence	625	(2)
Death and Dying	627	(3)
Organ Donation	630	(1)
The Medical Examiner	631	(1)
Chapter Review	632	(6)
21 Office-Based Emergencies	638	(36)
Section 1. General Office Preparedness	640	(4)
1.1 Telephone Triage	640	(1)
1.2 Monitoring the Waiting Area	640	(1)
1.3 Staff Education	640	(2)
1.4 Equipment and Medications	642	(2)
1.5 Emergency Transport	644	(1)
1.6 Patient and Parent Education	644	(1)
Section 2.Trauma	644	(10)
2.1 Major Trauma	644	(1)
2.2 Minor Trauma	644	(1)
2.3 Minor Head Trauma	645	(1)
2.4 Minor Torso Trauma	646	(1)
2.5 Soft Tissue Injuries	646	(1)
2.6 Lacerations	647	(1)
2.7 Suturing	647	(4)
2.8 Staples	651	(3)
2.9 Tissue Adhesive Application	654	(1)
2.10 Human and Animal Bites	654	(1)
Section 3. Foreign Bodies	654	(6)
3.1 Subcutaneous Foreign Body Removal	655	(1)
3.2 Nail Bed Splinter Removal	656	(1)
3.3 Ocular Foreign Body Removal	656	(1)
3.4 Cerumen/Aural Foreign Body Removal	657	(2)
3.5 Nasal Foreign Body Removal	659	(1)
Section 4. Minor Burns	660	(2)
4.1 Minor Burns	660	(2)
Section 5. Miscellaneous Procedures	662	(9)
5.1 Subungual Hematoma Drainage	662	(1)
5.2 Paronychia	662	(1)
5.3 Skin Abscess Drainage	663	(1)
5.4 Fish Hook Removal	664	(1)
5.5 Ring Removal	665	(1)
5.6 Contact Lens Removal	666	(1)
5.7 Eye Patching	666	(1)
5.8 Tooth Reimplantation and Stabilization	667	(1)
5.9 Management of Penile Zipper Injury	667	(1)
5.10 Reduction of Inguinal Hernia	668	(1)
5.11 Reduction of Paraphimosis	668	(1)
5.12 Reduction of Rectal Prolapse	669	(2)
Chapter Review	671	(3)
22 Critical Procedures	674	(95)
Introduction	676	(1)
Section 1: Pediatric Length-Based Resuscitation Tape	676	(1)
Section 2: Cervical Spine Immobilization	677	(4)
Section 3: Monitoring	681	(5)
3.1 ECG Monitoring	681	(2)
3.2 Impedance Pneumatography	683	(1)
3.3 Blood Pressure Monitors	683	(1)
3.4 Pulse Oximetry	683	(2)
3.5 Exhaled CO2 Monitors	685	(1)
Section 4:Oxygen Administration	686	(2)
4.1 Nasal Cannula	686	(1)
4.2 Oxygen Mask	687	(1)
4.3 Nonrebreathing Masks	687	(1)
4.4 Oxygen Hoods	688	(1)
Section 5: Suction	688	(3)
Section 6: Opening the Airway	691	(1)
6.1 Chin-Lift Maneuver	691	(1)
6.2 Jaw-Thrust Maneuver	692	(1)
Section 7: Airway Adjuncts	692	(3)
7.1 Oropharyngeal Airways	692	(1)
7.2 Nasopharyngeal Airways	693	(2)
Section 8: Bag-Mask Ventilation	695	(4)
Section 9: Management of Upper Airway Foreign Bodies With Magill Forceps	699	(1)
Section 10: Emergent Intubation	700	(10)
10.1 Endotracheal Intubation	700	(2)
10.2 Rapid Sequence Intubation	702	(8)
Section 11: Rescue Airway Techniques	710	(6)
11.1 Supraglottic Devices	710	(4)
11.1 A Laryngeal Mask Airway	711	(2)
11.1 B Combitube	713	(1)
11.2 Specialized Laryngoscopes	714	(1)
11.2 A Fiberoptic Scopes	714	(1)
11.3 Laryngoscopes With Special Blades	714	(1)
11.3 A Lighted Stylet	714	(1)
11.4 Tracheal Guides	715	(1)
Section 12: Surgical Airway Techniques	716	(7)
12.1 Needle Cricothyrotomy	716	(2)
12.2 Retrograde Intubation	718	(2)
12.3 Wire-Guided Cricothyrotomy	720	(1)
12.4 Surgical Cricothyrotomy	720	(1)
12.5 Tracheostomy Management	721	(2)
Section 13: Cardioversion and Defibrillation	723	(4)
13.1 Cardioversion and Defibrillation	723	(2)
13.2 Automated External Defibrillator	725	(2)
Section 14: Vascular Access	727	(14)
14.1 Peripheral Venous Catheter Placement	727	(2)
14.2 External Jugular Vein Cannulation	729	(1)
14.3 Central Venous Catheter Placement	730	(4)
14.4 Umbilical Vein Catheterization	734	(2)
14.5 Intraosseous Needle Placement	736	(2)
14.6 Venous Cutdown	738	(3)
Section 15: Thoracic Procedures	741	(6)
15.1 Needle Thoracostomy (Thoracentesis)	741	(1)
15.2 Tube Thoracostomy	742	(2)
15.3 Emergency Thoracotomy	744	(1)
15.4 Pericardiocentesis	745	(2)
Section 16: Miscellaneous Procedures	747	(5)
16.1 Nasogastric/Orogastric Intubation	747	(2)
16.2 Catheterization of the Bladder	749	(3)
Section 17: Orthopedic Procedures	752	(13)
17.1 Compartment Syndrome	752	(4)
17.2 Dislocations	756	(1)
17.3 Shoulder Dislocation	756	(1)
17.4 Elbow Dislocation	757	(1)
17.5 Knee Dislocation	758	(1)
17.6 Hip Dislocation	759	(1)
17.7 Splinting	759	(5)
17.7 A Volar Arm Splint	760	(1)
17.7 B Sugar-Tong Splint (Forearm)	760	(1)
17.7 C Ulnar Gutter Splint	761	(1)
17.7 D Thumb Spica Splint	761	(1)
17.7 E Sugar-Tong Splint (Upper Extremity)	761	(2)
17.7 F Finger Splints	763	(1)
17.7 G Posterior Splint (Lower Extremity)	763	(1)
17.7 H Sugar-Tong Splint(Lower Extremity)	763	(1)
17.8 Crutch Walking	764	(1)
Chapter Review	765	(4)
Appendix A: Check Your Knowledge Answers	769	(12)
Index	781	(24)
Additional Credits	805