Key Concepts The classic finding of an elevated osmolar and anion gap should raise suspicion of methanol or ethylene glycol toxicity but may not be present depending on the timing of ingestion. Early ingestion has a high osmolar gap without…
Key Concepts Toxidromes are constellations of signs and symptoms based primarily on vital signs and neuropsychiatric functions that are characteristic manifestations of certain toxic exposures. Recognition of the presence of a toxidrome can suggest a potential intoxicant and guide early…
Key Concepts Patients contaminated with radiation pose minimal risk to health care providers when appropriate precautions and decontamination procedures are employed. Decontamination should not delay or impede emergency stabilization of patients with radiation exposure. Tissues with greater rates of cellular…
Key Concepts Drowning is a leading cause of death and loss of years of life with over 90% of cases occurring in lower- and middle-income countries. Cost-effective prevention strategies have been developed for settings where resources limit treatment for drowning…
Acknowledgment The author would like to acknowledge Drs. Benjamin Honigman, Michael Yaron, Ryan D. Paterson, and Christopher B. Davis for their contributions to previous editions of this chapter. Key Concepts All forms of altitude illness can be treated with oxygen…
Key Concepts The majority of dive injuries are diagnosed on the basis of the focused dive history and physical examination and are best differentiated into disorders of descent, disorders of depth, and disorders of ascent. The U.S. Navy Diving Manual…
Acknowlegments The authors wish to acknowledge and thank Kelly P. O’Keefe and Rachel Semmons for their valuable contributions, expertise, and authorship of this chapter in previous editions. Key Concepts Electrical current follows the path of least resistance, which is often…
Key Concepts Classic heatstroke is generally diagnosed in older patients with comorbidities during heat waves, whereas exertional heatstroke is more common in young athletic patients or military personnel. Heat exhaustion and heatstroke are a continuum of the same pathophysiologic process.…
Accidental Hypothermia Key Concepts Patients with hypothermia should be actively rewarmed whenever possible. Specific indications for active rather than passive rewarming include trauma, cardiovascular instability, temperature below 32°C (89.6°F), poor rate of passive rewarming, and endocrine insufficiency. Rewarming methods should…
Key Concepts Sepsis is a progressive disease due to a dysregulated inflammatory cascade, leading to organ dysfunction and circulatory compromise in severe cases. Older adults, immunocompromised and neutropenic patients, and patients with multiple comorbidities are at increased risk for the…