The procedures presented in this chapter are most effectively performed with special equipment and techniques ( Videos 63.1 – 63.10 ). Some are within the realm of general emergency medicine clinical expertise; others are not. They are reviewed from the…
The following discussion focuses on procedures performed by emergency clinicians during the evaluation and treatment of injuries and diseases of the eye. Emphasis is placed on practical application of the techniques; cautions to be heeded by the emergency clinician are…
Evaluation of the Comatose Patient Coma is defined as a state of deeply reduced consciousness from which a patient cannot be aroused by verbal, tactile, or noxious external stimuli. This subsection will review procedures that have important diagnostic and prognostic…
Cerebrospinal fluid (CSF) examination is performed in the emergency department (ED) to obtain information relevant to the diagnosis and treatment of specific disease entities. Many urgent and life-threatening conditions require immediate and accurate knowledge of the nature of the CSF.…
Headache and head injury are encountered commonly in the emergency department (ED). If either is accompanied by vomiting, decreased level of consciousness, or abnormal vital signs, the possibility of increased intracranial pressure (ICP) should be considered. Acutely increased ICP is…
The majority of sexually assaulted individuals do not share the experience with anyone, suffering in silence. An estimated one-third of all sexual assaults are reported to law enforcement. In many cases, after contact with law enforcement, patients are taken to…
Pelvic Examination In an emergency department (ED) there are several reasons to perform a pelvic examination: lower abdominal pain, vaginal discharge, vaginal bleeding, suspected sexually transmitted disease (STD), retained foreign body, and possible Bartholin abscess (BA) of the vulva. Emergency…
Background Of the more than 3.9 million births in the United States in 2013, 98.6% were delivered in a hospital setting. Although a physician was present for 91.7% of these births, the percentage of these births that occur in the…
Introduction This chapter addresses urologic conditions that are either initially or eventually associated with an emergency procedure or may need to be performed in the absence of a urologic surgeon. Testicular torsion is a scrotal emergency that can be challenging…
Open fractures, dislocations, and exposed joints are true orthopedic emergencies that must be managed aggressively to prevent morbidity and mortality. Even when managed appropriately, these injuries may be further complicated by a compartment syndrome, a condition of increased pressure within…