Many primary care clinicians are busy to the point of being overwhelmed and there is not time to do thorough evaluations on every patient. The outpatient clinician must be able to quickly identify and manage the overtly ill but also those with potential or even hidden issues that require a referral to the emergency department.
This book provides a concise yet comprehensive summary of the various conditions the primary care practitioner could encounter in his/her office that require emergency department referral. Organized system by system, this manual provides short, readable yet detailed descriptions of situations where the clinician must make the quick decision to escalate the level of care.
The book is comprised of thirteen main sections, each detailing a medical specialty and is further broken down into specific conditions within these specialties. The specialties that are featured are cardiology, dermatology, endocrinology, gastroenterology, HEENT, hematology and oncology, infectious disease, nephrology, neurology, gynecology, ophthalmology, psychiatry, pulmonology and urology. The chapters are broken down into five key aspects. First, a brief synopsis of the problem is identified covering the incidence, the risk factors and general information to give the clinician the insight to manage the situation. Next, there is a review of key elements of the history that can elucidate whether the patient has or does not have the emergent condition. Physical exam findings that the clinician can look for during the evaluation are then discussed followed by diagnostics that the clinician can get quickly the same day to help evaluate the situation. Lastly, treatments that can be provided while waiting for the urgent or emergent condition to be evaluated are identified.
Written by experts in the field, Managing Emergencies in the Outpatient Setting is a valuable resource for primary care physicians, physician assistants and nurse practitioners alike.
Author(s): Gregory M. Booth, Sarah Frattali
Edition: 1
Publisher: Springer
Year: 2023
Language: English
Tags: Primary Care Medicine; Emergency Medicine; Outpatient Emergencies
Preface
Acknowledgments
Legal Disclaimer
Contents
Contributors
Cardiovascular Disease
1 Introduction
2 Coronary Artery Disease
2.1 General Considerations
2.2 History
2.3 The Exam
2.4 Diagnostics
3 Pericarditis
3.1 General Considerations
3.2 History
3.3 Exam
3.4 Diagnostics
4 Congestive Heart Failure
4.1 General Considerations
4.2 History
4.3 Exam
4.4 Diagnostics
5 Arrhythmias
5.1 General Considerations
6 Tachyarrhythmias
6.1 History
7 Sinus Tachycardia
7.1 General Considerations
7.2 Diagnostics
8 Atrial Fibrillation
8.1 General Considerations
8.2 Diagnostics
9 Atrial Flutter
9.1 General Consideration
9.2 Diagnostics
10 Multifocal Atrial Tachycardia
10.1 General Considerations
10.2 Diagnostics
11 Atrioventricular Nodal Reentrant Tachycardia
11.1 General Considerations
11.2 Diagnostics
12 Other Supraventricular Tachycardias
13 Ventricular Arrhythmias
13.1 General Considerations
14 Bradyarrhythmias
14.1 General Considerations
14.2 Diagnostics
15 Pulmonary Embolism
15.1 General Considerations
15.2 History
15.3 Exam
15.4 Diagnostics
16 Deep Vein Thrombosis
16.1 General Considerations
16.2 History
16.3 Exam
16.4 Diagnostics
17 Syncope
17.1 General Considerations
17.2 History
17.3 Exam
17.4 Diagnostics
18 Diseases of the Aorta
18.1 Abdominal Aortic Aneurysm (AAA)
18.1.1 General Considerations
18.1.2 History
18.1.3 Physical Exam
18.1.4 Diagnostics
18.2 Thoracic Aortic Aneurysm
18.2.1 General Considerations
18.2.2 History
18.2.3 Exam
18.2.4 Diagnostics
18.3 Aortic Dissection
18.3.1 General Considerations
18.3.2 History
18.3.3 Exam
18.3.4 Diagnostics
19 Acute Limb Ischemia
19.1 General Considerations
19.2 History
19.3 Exam
20 Hypertensive Urgencies and Emergencies
20.1 General Considerations
20.2 History
20.3 Exam
20.4 Diagnostics
21 Rheumatic Fever
21.1 General Considerations
21.2 History
21.3 Exam
21.4 Diagnostics
Further Reading
Infectious Disease
1 Introduction
2 Sepsis and Toxic Shock
2.1 General Considerations
2.2 History
2.3 Exam
2.4 Diagnostics
3 Skin and Soft Tissue Infections
3.1 General Considerations
3.2 History
3.3 Exam
3.4 Diagnostics
4 Septic Arthritis
4.1 General Considerations
4.2 History
4.3 Exam
4.4 Diagnostics
5 Osteomyelitis
6 Contiguous Osteomyelitis
6.1 General Considerations
6.2 History
6.3 Exam
6.4 Diagnostics
7 Vertebral Osteomyelitis
7.1 General Considerations
7.2 History
7.3 Exam
7.4 Diagnostics
8 Pyelonephritis
8.1 General Considerations
8.2 History
8.3 Exam
8.4 Diagnostics
9 Infective Endocarditis
9.1 General Considerations
9.2 History
9.3 Exam
9.4 Diagnostics
10 Pneumonia
10.1 General Considerations
10.2 History
10.3 Exam
10.4 Diagnostics
11 Tuberculosis
11.1 General Considerations
11.2 History
11.3 Exam
11.4 Diagnostics
12 Cases of Immunosuppression
12.1 Human Immunodeficiency Virus (HIV)
12.1.1 General Considerations
12.1.2 History
12.1.3 Exam
12.2 Transplant Patients
12.2.1 General Considerations
12.2.2 History
12.2.3 Exam
12.2.4 Diagnostics
13 Neutropenic Fever
13.1 General Considerations
13.2 History
13.3 Exam
14 The Febrile Traveler
14.1 General Considerations
15 Fever Without a Rash
15.1 Malaria
15.1.1 General Considerations
15.1.2 History
15.1.3 Exam
15.1.4 Diagnostics
15.2 Yellow Fever
15.2.1 General Considerations
15.2.2 History
15.2.3 Exam
15.2.4 Diagnostics
15.3 Leptospirosis
15.3.1 General Considerations
15.3.2 History
15.3.3 Exam
15.3.4 Diagnostics
16 Fever with a Rash
16.1 Enteric Fever
16.1.1 General Considerations
16.1.2 History
16.1.3 Exam
16.1.4 Diagnostics
16.2 Dengue Virus
16.2.1 General Considerations
16.2.2 History
16.2.3 Exam
16.2.4 Diagnostics
16.3 Chikungunya Virus
16.3.1 General Considerations
16.3.2 History
16.3.3 Exam
16.3.4 Diagnostics
16.4 Zika Virus
16.4.1 General Considerations
16.4.2 History
16.4.3 Exam
16.4.4 Diagnostics
16.5 Rocky Mountain Spotted Fever
16.5.1 General Considerations
16.5.2 History
16.5.3 Exam
16.5.4 Diagnostics
17 Miscellaneous Potentially Fatal Diseases
17.1 Rickettsial Diseases
17.2 Respiratory Infections
17.3 Viral Hemorrhagic Fevers
17.4 Measles
17.4.1 General Considerations
17.4.2 History
17.4.3 Exam
17.4.4 Diagnostics
17.5 Diphtheria
17.5.1 General Considerations
17.5.2 History
17.5.3 Exam
17.5.4 Diagnostics
17.6 Surgical Site Infection
17.6.1 General Considerations
17.6.2 History
17.6.3 Exam
17.6.4 Diagnostics
Further Reading
Gastroenterology
1 Introduction
2 Initial Evaluation
2.1 General Considerations
2.2 History
2.3 Physical Exam
3 Gastrointestinal Surgical Emergencies
3.1 Appendicitis
3.1.1 General Considerations
3.1.2 History
3.1.3 Exam
3.1.4 Diagnostics
3.2 Cholecystitis
3.2.1 General Considerations
3.2.2 History
3.2.3 Physical Exam
3.2.4 Diagnostic
3.3 Diverticulitis
3.3.1 General Considerations
3.3.2 History
3.3.3 Exam
3.3.4 Diagnostics
4 Small and Large Bowel Obstruction
4.1 General Considerations
4.2 History
4.3 Exam
4.4 Diagnostics
5 Miscellaneous
5.1 Mesenteric Ischemia
5.1.1 General Considerations
5.2 Hernias
5.3 Gastric Volvulus
5.3.1 General Considerations
5.4 Intestinal Volvulus and Malrotation
5.4.1 General Considerations
6 Gastrointestinal Medical Emergencies
6.1 Ascending Cholangitis
6.1.1 General Considerations
6.1.2 History
6.1.3 Exam
6.1.4 Diagnostics
6.2 Acute Liver Failure
6.2.1 General Considerations
6.2.2 History
6.2.3 Exam
6.2.4 Diagnostics
6.3 Acute on Chronic Liver Disease
6.3.1 General Considerations
6.3.2 History
6.3.3 Exam
6.3.4 Diagnostics
6.4 Pancreatitis
6.4.1 General Considerations
6.4.2 History
6.4.3 Exam
6.4.4 Diagnostics
6.5 Gastrointestinal Bleeding (GI Bleed)
6.5.1 General Considerations
6.5.2 History
6.5.3 Exam
6.5.4 Diagnostics
7 Miscellaneous
7.1 Esophageal Emergencies
7.1.1 Food Impaction
7.1.2 Esophageal Perforation
7.1.3 Inflammatory Bowel Disease
General Considerations
8 Miscellaneous Complications of Gastrointestinal Procedures
8.1 Bariatric Surgery
8.1.1 General Considerations
8.1.2 Endoscopic Procedures
8.1.3 Medicines Used in Gastroenterology
Further Reading
Neurology
1 Introduction
2 Transient Ischemic Attack
2.1 General Considerations
2.2 History
2.3 Exam
2.4 Diagnostics
2.5 Therapeutics
3 Cerebrovascular Accident (Embolic and Hemorrhagic)
3.1 General Considerations
3.2 History
3.3 Exam
3.3.1 Hemorrhagic Cerebrovascular Accident
3.4 General Considerations
3.5 History
3.6 Exam
3.7 Diagnostics
4 Traumatic Brain Injury
4.1 General Considerations
4.2 History
4.3 Exam
5 Bell’s Palsy
5.1 General Considerations
5.2 History
5.3 Exam
6 Meningitis and Encephalitis
6.1 General Considerations
6.2 History
6.3 Exam
7 Spinal Cord Compression
7.1 General Considerations
7.2 History
7.3 Exam
7.4 Diagnostics
8 Multiple Sclerosis
8.1 General Considerations
8.2 History
8.3 Exam
8.4 Diagnostics
9 Myasthenia Gravis
9.1 General Considerations
9.2 History
9.3 Exam
10 Seizures
10.1 General Considerations
10.2 History
10.3 Exam
10.4 Diagnostics
11 Miscellaneous
11.1 Guillain–Barre Syndrome
11.2 General Considerations
11.3 History
11.4 Exam
12 Transverse Myelitis
12.1 General Considerations
12.2 History
12.3 Exam
13 Wernicke’s Encephalopathy
13.1 General Considerations
13.2 History
13.3 Exam
14 Botulism
14.1 General Considerations
14.2 History
14.3 Exam
Further Reading
Nephrology
1 Introduction
2 Acute Kidney Injury
2.1 General Considerations
2.2 History
2.3 Exam
2.4 Diagnostics
3 Pre-renal Acute Kidney Injury
3.1 General Considerations
3.2 History
3.3 Exam
3.4 Diagnostics
4 Intrinsic Renal Disease
4.1 General Considerations
4.2 History
4.3 Exam
4.4 Diagnostics
5 Post-renal Acute Kidney Injury
5.1 General Considerations
5.2 History
5.3 Exam
5.4 Diagnostics
6 Renal Vein Thrombosis
6.1 General Considerations
6.2 History
6.3 Exam
6.4 Diagnostics
7 Electrolytes
7.1 Hyponatremia
8 Hypernatremia
9 Hypokalemia
10 Hyperkalemia
11 Hypocalcemia
11.1 General Considerations
12 Hypercalcemia
12.1 General Considerations
13 Hypomagnesemia
13.1 General Considerations
14 Hypermagnesemia
14.1 General Considerations
15 Hypophosphatemia
Further Reading
Urology
1 Introduction
2 Nephrolithiasis
2.1 General Considerations
2.2 History
2.3 Exam
2.4 Diagnostics
3 Urinary Retention
3.1 General Considerations
3.2 Causes of Urinary Retention
3.3 History
3.4 Exam
3.5 Diagnostics
4 Prostatitis
4.1 General Considerations
4.2 History
4.3 Exam
4.4 Diagnostics
5 Fournier’s Gangrene
5.1 General Considerations
5.2 History
5.3 Exam
5.4 Diagnostics
6 Testicular Torsion
6.1 General Considerations
6.2 History
6.3 Exam
6.4 Diagnostics
7 Other Scrotal Pathology
7.1 General Considerations
7.2 History
7.3 Exam
7.4 Diagnostics
8 Priapism
8.1 General Considerations
8.2 History
8.3 Exam
8.4 Diagnostics
9 Miscellaneous
9.1 Penile Fracture
10 Surgical Complications
10.1 History
10.2 Exam
10.3 Diagnostics
11 Cauda Equina Syndrome
12 Complication of Lithotripsy
13 Complications of Ureteral Stents
Further Reading
Obstetrics and Gynecology
1 Introduction
2 Ectopic Pregnancy
2.1 General Considerations
2.2 History
2.3 Exam
2.4 Diagnostics
3 Ovarian Torsion
3.1 General Considerations
3.2 History
3.3 Exam
3.4 Diagnostics
4 Pelvic Inflammatory Disease
4.1 General Considerations
4.2 History
4.3 Exam
4.4 Diagnostics
5 Vaginal Bleeding
5.1 Vaginal Bleeding in the Non-pregnant Patient
5.1.1 General Considerations
5.1.2 History
5.1.3 Exam
5.1.4 Diagnostics
5.2 Vaginal Bleeding in the Pregnant Patient
5.2.1 General Considerations
5.2.2 Exam
5.3 Vaginal Bleeding After Elective Abortion
5.3.1 General Considerations
5.3.2 History
6 Pre-eclampsia
6.1 General Considerations
6.2 History
6.3 Exam
6.4 Diagnostics
7 Hyperemesis Gravidarum
7.1 General Considerations
7.2 History
7.3 Exam
7.4 Diagnostics
8 Sexual Assault
8.1 General Considerations
Further Reading
Otolaryngology (Ear Nose and Throat)
1 Introduction
2 Epistaxis
2.1 General Considerations
2.2 History
2.3 Exam
2.4 Diagnostics
2.5 Treatment
3 Peritonsillar Abscess
3.1 General Considerations
3.2 History
3.3 Exam
3.4 Diagnostics
3.5 Treatment
4 Retropharyngeal Abscess
4.1 General Considerations
4.2 History
4.3 Exam
4.4 Diagnostic Testing
4.5 Treatment
5 Lemierre’s Syndrome
5.1 General Considerations
5.2 History
5.3 Exam
5.4 Diagnostics
5.5 Treatment
6 Epiglottitis
6.1 General Considerations
6.2 History
6.3 Exam
6.4 Diagnostics
7 Mastoiditis
7.1 General Considerations
7.2 History
7.3 Exam
7.4 Diagnostics
7.5 Treatment
8 Malignant Otitis Externa
8.1 General Considerations
8.2 History
8.3 Exam
8.4 Diagnostics
8.5 Treatment
9 Vertigo
9.1 General Considerations
9.1.1 Peripheral Vertigo
9.1.2 Central Vertigo
9.2 History
9.3 Exam
9.4 Diagnostics
9.5 Treatment
10 Sudden Sensorineural Hearing Loss
10.1 General Considerations
10.2 History
10.3 Exam
10.4 Diagnostics
10.5 Treatment
11 Acute Rhinosinusitis
11.1 General Considerations
11.2 History
11.3 Exam
11.4 Diagnostics
11.5 Treatment
12 Miscellaneous
12.1 Foreign Bodies
12.1.1 General Considerations
12.1.2 Ear
12.1.3 Nose
12.1.4 Throat
Further Reading
Pulmonology
1 Introduction
2 Asthma and COPD
2.1 General Considerations
2.2 History
2.3 Exam
2.4 Diagnostics
2.5 Treatment
3 Interstitial Lung Disease
3.1 General Considerations
3.2 History
3.3 Exam
3.4 Diagnostics
4 Hemoptysis
4.1 General Considerations
4.2 History
4.3 Exam
4.4 Diagnostics
5 Pleural Effusion
5.1 General Considerations
5.2 History
5.3 Exam
5.4 Diagnostics
6 Pneumothorax
6.1 General Considerations
6.2 History
6.3 Exam
6.4 Diagnostics
Further Reading
Endocrinology
1 Introduction
2 Diabetic Ketoacidosis
2.1 General Considerations
2.2 History
2.3 Exam
2.4 Diagnostics
3 Hyperglycemic Hyperosmolar State
3.1 General Considerations
3.2 History
3.3 Exam
3.4 Diagnostics
4 Hypoglycemia
4.1 General Considerations
4.2 Treatment
4.3 Diagnostics
5 Thyroid Storm
5.1 General Considerations
5.2 History
5.3 Exam
5.4 Diagnostics
6 Myxedema
6.1 General Considerations
6.2 History
6.3 Exam
6.4 Diagnostics
7 Adrenal Crisis
7.1 General Considerations
7.2 History
7.3 Exam
7.4 Diagnostics
8 Pituitary Apoplexy
8.1 General Considerations
8.2 History
8.3 Exam
8.4 Diagnostics
9 Hypercalcemia
9.1 General Considerations
9.2 History
9.3 Exam
9.4 Diagnostics
10 Hypocalcemia
10.1 General Considerations
10.2 History
10.3 Physical Exam
10.4 Diagnostics
11 Acute Suppurative Thyroiditis
11.1 General Considerations
11.2 History
11.3 Exam
11.4 Diagnostics
Further Reading
Hematology and Oncology
1 Introduction
2 Spinal Cord Compression
2.1 General Considerations
2.2 History
2.3 Exam
2.4 Diagnostics
3 Acute Leukemia
3.1 General Considerations
3.2 History
3.3 Exam
3.4 Diagnostic Tests
4 Hyperviscosity Syndrome
4.1 General Considerations
4.2 History
4.3 Exam
4.4 Diagnostics
5 Anemia
5.1 General Considerations
5.2 History
5.3 Exam
5.4 Diagnostics
6 Thrombocytopenia
6.1 General Considerations
6.2 History
6.3 Exam
6.4 Diagnostics
7 Hemarthrosis and Hemophilia
7.1 General Considerations
7.2 History
7.3 Exam
7.4 Diagnostics
8 Sickle Cell Disease
8.1 General Considerations
8.2 History
8.3 Exam
8.4 Diagnostics
Further Reading
Ophthalmology
1 Introduction
1.1 General Considerations
2 Painful Vision Loss
2.1 Chemical Exposure
2.1.1 General Considerations
3 Major Trauma
3.1 General Considerations
3.2 Exam
4 Minor Trauma
4.1 General Considerations
4.2 History
4.3 Exam
4.4 Treatment
5 Keratitis
5.1 General Considerations
5.2 History
5.3 Exam
5.4 Treatment
6 Scleritis and Uveitis
6.1 General Considerations
6.2 History
6.3 Exam
6.4 Treatment
7 Endophthalmitis
7.1 History
7.2 Exam
7.3 Treatment
8 Optic Neuritis
8.1 History
8.2 Exam
8.3 Treatment
9 Acute Angle Closure Glaucoma
9.1 History
9.2 Exam
10 Orbital Cellulitis
10.1 General Considerations
10.2 History
10.3 Exam
10.4 Diagnostics
11 Temporal Arteritis
11.1 General Considerations
11.2 History
11.3 Exam
11.4 Diagnostics
11.5 Treatment
12 Painless Vision Loss
12.1 Amaurosis Fugax and Central Retinal Artery Occlusion
12.1.1 General Considerations
12.1.2 History
12.2 Exam
12.3 Diagnostics
12.4 Treatment
13 Retinal Detachment
13.1 General Considerations
13.2 History
13.3 Exam
13.4 Treatment
14 Pinguecula and Pterygium
Further Reading
Dermatology
1 Introduction
2 Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN)
2.1 General Considerations
2.2 History
2.3 Exam
2.4 Diagnostics
3 Drug Eruption with Eosinophilia and Systemic Symptoms
3.1 General Considerations
3.2 History
3.3 Exam
3.4 Diagnostics
4 Pemphigus Vulgaris
4.1 General Considerations
4.2 History
4.3 Exam
4.4 Diagnostics
5 Purpura and Vasculitis
5.1 General Considerations
5.2 History
5.3 Exam
5.4 Diagnostics
6 Angioedema
6.1 General Considerations
6.2 History
6.3 Exam
6.4 Diagnostics
7 Viral Infections in the Immunosuppressed
7.1 General Considerations
7.2 History
7.3 Exam
7.4 Diagnosis
Further Reading
Psychiatry
1 Introduction
2 Depression and Anxiety
3 Suicide
3.1 General Considerations
3.2 History
3.3 Exam
3.4 Diagnostics
4 Psychosis
4.1 General Considerations
4.2 History
4.3 Exam
4.4 Diagnostics
5 Altered Mental Status and Delirium
5.1 General Considerations
5.2 History
5.3 Exam
5.4 Diagnostics
6 Withdrawal Syndromes
6.1 General Considerations
6.2 History
6.3 Exam
6.4 Diagnostics
7 Neuroleptic Malignant Syndrome (NMS)
7.1 General Considerations
7.2 History
7.3 Exam
7.4 Diagnostics
8 Serotonin Syndrome (SS)
8.1 General Considerations
8.2 History
8.3 Exam
8.4 Diagnostics
Further Reading
Index
