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Challenging and Emerging Conditions in Emergency Medicine Emergency Medicine Conditions in Conditions Challenging and Emerging Edited by Arvind Venkat Challenging and Emerging Conditions in Emergency Medicine Emergency Medicine Emergency Edited by Arvind Venkat, MD, FACEP, Allegheny General Hospital, Pittsburgh, PA, and Drexel University College of Medicine, Philadelphia, PA, USA With growing numbers of chronically ill patients surviving longer and Challenging receiving novel medical and surgical treatments, emergency departments are increasingly the venue for associated acute presentations. How can emergency physicians respond to these challenging and emerging conditions? and Emerging This book focuses on the unusual and complex disease presentations not covered in detail in the standard textbooks, helping you manage patients with conditions such as congenital heart disease, cystic fibrosis, morbid obesity, intellectual disability and intestinal failure. Conditions in Not only does this book provide guidance on evaluation and diagnosis, but it also addresses the practical issues of acute management and continuing referral. The individual chapters are written by high profile Venkat Emergency emergency physicians, in conjunction with appropriate specialists, and include authoritative evidence to back up the clinical information. Medicine Titles of related interest Emergency Medicine: Avoiding the Pitfalls and Improving the Outcomes Amal Mattu and Deepi Goyal, 2007 [9781405141666] Practical Teaching in Emergency Medicine Robert L. Rogers, Amal Mattu, Michael Winters and Joseph Martinez 2009 [9781405176224] Cover images: ©iStockphoto / Dr Heinz Linke / Jacob Wackerhausen / aldra ISBN 978-0-470-65500-9 9 780470 655009 www.wiley.com/go/emergency P1: PAB/UKS P2: PAB Color: 1C BLBK370-FM BLBK370-Venkat April 15, 2011 14:13 Trim: 229mm X 152mm ii P1: PAB/UKS P2: PAB Color: 1C BLBK370-FM BLBK370-Venkat April 15, 2011 14:13 Trim: 229mm X 152mm Challenging and Emerging Conditions in Emergency Medicine i P1: PAB/UKS P2: PAB Color: 1C BLBK370-FM BLBK370-Venkat April 15, 2011 14:13 Trim: 229mm X 152mm ii P1: PAB/UKS P2: PAB Color: 1C BLBK370-FM BLBK370-Venkat April 15, 2011 14:13 Trim: 229mm X 152mm Challenging and Emerging Conditions in Emergency Medicine Edited by Arvind Venkat, MD, FACEP Director of Research Department of Emergency Medicine Ethics Consultant Allegheny General Hospital Pittsburgh, PA; Associate Professor of Emergency Medicine Drexel University College of Medicine Philadelphia, PA USA A John Wiley & Sons, Ltd., Publication iii P1: PAB/UKS P2: PAB Color: 1C BLBK370-FM BLBK370-Venkat April 15, 2011 14:13 Trim: 229mm X 152mm This edition first published 2011, C 2011 by John Wiley & Sons Ltd. BMJ Books is an imprint of BMJ Publishing Group Limited, used under licence by Blackwell Publishing which was acquired by John Wiley & Sons in February 2007. Blackwell’s publishing programme has been merged with Wiley’s global Scientific, Technical and Medical business to form Wiley-Blackwell. Registered office: John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK Editorial offices: 9600 Garsington Road, Oxford, OX4 2DQ, UK The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK 111 River Street, Hoboken, NJ 07030-5774, USA For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell The right of the author to be identified as the author of this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher. Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought. The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting a specific method, diagnosis, or treatment by physicians for any particular patient. The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of fitness for a particular purpose. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. Readers should consult with a specialist where appropriate. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom. Library of Congress Cataloging-in-Publication Data is available for this title. A catalogue record for this book is available from the British Library. This book is published in the following electronic formats: ePDF 9781119971573; Wiley Online Library 9781119971603; ePub 9781119971580; Mobi 9781119971597 Set in 9.5/12 pt Meridien by AptaraR Inc., New Delhi, India 1 2011 iv P1: PAB/UKS P2: PAB Color: 1C BLBK370-FM BLBK370-Venkat April 15, 2011 14:13 Trim: 229mm X 152mm Contents List of contributors, vii Acknowledgments, xiv Chapter 1 Introduction, 1 Arvind Venkat Chapter 2 The post-cardiac arrest patient, 5 Ankur A. Doshi and Clifton W. Callaway Chapter 3 Adults with congenital heart disease, 26 Kara M. Iskyan and Craig R. Cohen Chapter 4 The renal transplant patient, 51 Joseph B. Miller and K. K. Venkat Chapter 5 The end-stage renal disease patient on dialysis, 74 K. K. Venkat and Arvind Venkat Chapter 6 Adults with cystic fibrosis, 96 Arvind Venkat and Joseph M. Pilewski Chapter 7 Adults with sickle-cell disease: implications of increasing longevity, 115 Ward Hagar and Claudia R. Morris Chapter 8 HIV-positive adults on HAART, 141 Arvind Venkat and Sukhjit S. Takhar Chapter 9 Adults receiving chemotherapeutic regimens, 158 Moira Davenport and Mary Ann Howland Chapter 10 The bariatric surgery patient, 184 Melissa B. Bagloo and Alfons Pomp Chapter 11 The obese patient, 204 Andra L. Blomkalns and David W. Silver Chapter 12 The geriatric trauma patient, 228 John M. O’Neill and Elan Jeremitsky v P1: PAB/UKS P2: PAB Color: 1C BLBK370-FM BLBK370-Venkat April 15, 2011 14:13 Trim: 229mm X 152mm vi Contents Chapter 13 Children with intestinal failure and complications from visceral transplant, 251 Melissa A. Vitale, Jeffrey A. Rudolph and Richard A. Saladino Chapter 14 Family violence, 271 Daniel M. Lindberg and Esther K. Choo Chapter 15 The intellectually disabled patient, 299 Jonathan S. Anderson and Shamai A. Grossman Chapter 16 Adults with conditions causing chronic pain, 319 Victoria L. Thornton and Lauren T. Southerland Index, 342 P1: PAB/UKS P2: PAB Color: 1C BLBK370-FM BLBK370-Venkat April 15, 2011 14:13 Trim: 229mm X 152mm List of contributors Jonathan S. Anderson, MD Attending Physician Department of Emergency Medicine Beth Israel Deaconess Medical Center and Milton Hospital; Instructor in Medicine (Emergency Medicine) Division of Emergency Medicine Harvard Medical School Boston, MA USA Melissa B. Bagloo, MD Fellow Section of Laparoscopic and Bariatric Surgery Department of Surgery Weill Medical College of Cornell University New York Presbyterian Hospital New York, NY USA Andra L. Blomkalns, MD, FACEP Vice Chair, Academic Affairs Associate Professor of Emergency Medicine Department of Emergency Medicine University of Cincinnati College of Medicine Cincinnati, OH USA Clifton W. Callaway, MD, PhD, FACEP Associate Professor and Executive Vice Chair of Emergency Medicine Ronald D. Stewart Endowed Chair in Emergency Medicine Department of Emergency Medicine University of Pittsburgh School of Medicine Pittsburgh, PA USA vii P1: PAB/UKS P2: PAB Color: 1C BLBK370-FM BLBK370-Venkat April 15, 2011 14:13 Trim: 229mm X 152mm viii List of contributors Esther K. Choo, MD, MPH, FACEP Attending Physician Department of Emergency Medicine Rhode Island Hospital and The Miriam Hospital; Assistant
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