By Piers Page, Greg Skinner
An easy-to-use advisor to the administration of universal scientific emergencies; this booklet is an important for all junior medical professionals or medical scholars. Emergencies almost always current first to the junior health care professional, both because of direct statement at the ward, or a mobile name from nursing employees whilst on name. the most important to their administration is well timed attractiveness and intervention. This publication provides the junior health professional and senior scientific scholar the boldness to do that. The textual content covers emergencies from either a problem-based and disease-based technique, with the publication being divided into sections - shows and illnesses.
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Extra resources for Emergencies in Clinical Medicine
Oxford: Oxford University Press, p. 1308. 39 40 CHAPTER 2 Presentations Palpitations 2 Palpitations Palpitations describe the increased awareness of the heartbeat, and can be very worrying for patients. The common usage of the word ‘palpitations’ can vary, however, so it is important to ask the patient specifically what they mean if they describe this as a symptom. Often they will not cause serious problems, but it is essential to rule out the rarer, more serious causes. Immediate management Assess ABC Start high flow O2 via non-rebreath mask—tachyarrhythmias may reduce cardiac output leading to reduced tissue oxygen delivery Check central pulse—if absent or inadequate start ALS (see Inside cover) Attach cardiac monitor—observe rate, rhythm (regular or irregular) and QRS complexes (broad or narrow) Gain large bore IV access into large, proximal vein Any IV drugs given may require large flushes and elevation of the limb as circulation might be sluggish Are there any signs of imminent collapse?
The clinical picture will help to guide your diagnosis. Acute type 1 respiratory failure A primary insult will cause hypoxia, and the response will be to increase ventilation. The patient will have increased work of breathing. Acidosis may be caused by tissue hypoxia leading to anaerobic metabolism (lactic acidosis). Acute exacerbation of asthma (see p. 196–198) Acute exacerbation of COPD—with normal respiratory drive (see p. g. due to acute heart failure (see p. 144–146) PE (see p. 200–203) Pneumonia (see p.
164–186) Pericardial effusion/tamponade (see p. 148–155) Other Pain (see p. g. DKA (see p. 422–424) Shock/sepsis (see p. g. head injury, malignant hypertension (see p. g. following trauma, hypovolaemia, shock, sepsis, etc. Guillain–Barré syndrome Carbon monoxide poisoning Psychogenic Further reading OCHM, 7th edn. Oxford: Oxford University Press, p. 58, 770. Oxford Textbook of Medicine, 4th edn, vol. 2. Oxford: Oxford University Press, p. 1285. 31 32 CHAPTER 2 Presentations Haemoptysis 2 Haemoptysis This refers to blood being coughed up from the lower respiratory tract, but is easily confused with haematemesis or upper airway bleeding.
Emergencies in Clinical Medicine by Piers Page, Greg Skinner