Rosen's Emergency Medicine: Concepts and Clinical Practice

Blood and Blood Components

Key Concepts Red blood cell transfusion is indicated only to increase oxygen delivery at the tissue level. One unit of packed red blood cells (PRBCs) can be expected to raise an adult’s hemoglobin level by 1 g A similar increase…

Dermatologic Presentations

Key Concepts Accurate descriptions of dermatologic lesions are essential for diagnosis and management. Primary and secondary lesions are described in Tables 107.1 and 107.2 . TABLE 107.1 Primary Lesions Lesion Description Size Macule Flat circumscribed pigmented area <0.5 cm in…

Allergy, Anaphylaxis, and Angioedema

Key Concepts Anaphylaxis is a life-threatening systemic allergic (or nonallergic) reaction of acute onset and multiorgan involvement in which timely recognition and treatment remain essential. A history of sudden urticarial rash accompanied by respiratory difficulty, abdominal pain, or hypotension, strongly…

Systemic Lupus Erythematosus and the Vasculitides

Systemic Lupus Erythematosus Key Concepts Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder that can affect any organ system. A general approach to determine whether SLE is the cause of a nonspecific or single-organ symptom is to search for…

Musculoskeletal Back Pain

Key Concepts Most patients presenting to the emergency department (ED) with back pain have uncomplicated musculoskeletal pain that is self-resolving with conservative therapy and does not require imaging. Indications for emergent imaging include “red flags” such as an acute neurologic…

Tendinopathy and Bursitis

Tendinopathy Foundations Background and Importance Tendons are collagenous, dynamic structures that connect muscle to bone. They transmit forces originating in muscles to bone by stiffening, thereby enabling joint motion. Key Concepts Tendinopathy Mechanical overload and repetitive microtrauma are key underlying…

Arthritis

Key Concepts 1. Arthritis can be considered in three broad classes: degenerative, infectious, and inflammatory. The number of joints involved, time course, and presence of other systemic symptoms can help in classification. 2. Septic (acute infectious) arthritis should be considered…

Suicidal Behavior

Key Concepts Many suicidal individuals see a physician shortly before their death. An ED visit for suicidal thoughts or behaviors represents an opportunity for a critical intervention that may prevent a subsequent suicide. Suicidal thoughts or behaviors are often triggered…

Factitious Disorders and Malingering

Key Concepts Patients who have consciously synthesized symptoms and signs may be divided into two broad diagnostic categories: (1) those with obvious secondary gain (malingering), who control their actions, and (2) those with a motivation of achieving the sick role…

Somatic Symptoms and Related Disorders

Key Concepts Several conditions previously classified in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as somatoform disorders are now classified under DSM-V as Somatic Symptom and Related Disorders (SSRD). These include somatic symptom disorder…