Textbook of Paediatric Emergency - Booksca.ca

TextbookofPaediatricEmergencyMedicine

THIRDEDITION

Editors

PeterCameron,MBBSMDFACEMProfessorofEmergencyMedicine,TheAlfredHospitalandMonashUniversity,Melbourne,Australia

GaryBrowne,MDMBBSMSpMedFRACPFACEMProfessorofEmergencyMedicine,TheChildren’sHospitalatWestmeadChairofDisciplineofEmergencyMedicine,TheUniversityofSydneyHeadofAcademicEmergencyMedicine,TheChildren’sHospitalatWestmead,Sydney,Australia

BiswadevMitra,MBBSMHSMPhDFACEMProfessorofEmergencyMedicine,TheAlfredHospitalandMonashUniversity,Melbourne,Australia

StuartDalziel,MBChBFRACPPhDDirectorofEmergencyMedicineResearch,TheUniversityofAucklandandStarshipChildren’sHospital,Auckland,NewZealand

SimonCraig,MBBSMHPEMPHFACEMAdjunctClinicalAssociateProfessor,MonashUniversity;EmergencyPhysician,MonashMedicalCentre,MonashHealth,Melbourne,AustraliaForadditionalonlinecontentvisitExpertConsult.com

http://ExpertConsult.com

TableofContents

Coverimage

Titlepage

Copyright

Prefacetothirdedition

Prefacetosecondedition

Contributors

Acknowledgements

Section1.ApproachtothePaediatricPatient

1.1.Approachtothepaediatricpatient

Introduction

Childrenwithfever

Evolvingillnessinchildren

Theenvironment

Triage

Frontloadingcare

Thepaediatricapproach

History

Examination

Gentle,distraction,painfullast

Whentoinvestigate

Theparents

Managementoffebrilechildren

TheroleoftheGPinpaediatricemergencymanagement

ReflectiononthePracticeofPaediatricEmergency

1.2.Commonchronicpaediatricconditions

Introduction

Cerebralpalsy

Cysticfibrosis

Theex-prematureinfant

Autismspectrumdisorder

Section2.Resuscitation

2.1.Paediatriccardiopulmonaryarrest

Epidemiology

Aetiology

Preventingcardiacarrest

Outcome

Differencescomparedtoadults

Developmentofresuscitationguidelines

Ethicsofpaediatricresuscitation

2.2.Paediatricbasiclifesupport

Introduction

Paediatricversusadultbasiclifesupport

Basiclifesupporttechniquesandage

Preparationandequipment

Basiclifesupportsequence

Precautionsandcomplications

Reliefofforeignbodyairwayobstruction

2.3.Paediatricadvancedlifesupport

Introduction

Diagnosingcardiacarrest

Epidemiology

Oxygen,ventilationandadvancedairwaysupport

Ventilation

Advancedairwaysupport

Laryngealmaskairway

Managementofthedifficultairway

Monitoring

Vascularaccess

Fluidtherapy

Managementofpulselessarrhythmias

Managementofpulsatiledysrhythmias

Post-resuscitationmanagement

Cessationofcardiopulmonaryresuscitation

2.4.Paediatricresuscitationinspecificcircumstances

Avoidingcardiacarrestduringcriticalcaremanagement

Anaphylaxis

Asthma

Drowning

Traumaticcardiacarrest

Toxicologicalemergencies

Envenomation

Marineenvenomation

2.5.Shock

Introduction

Diagnosisandassessment

Initialmanagement

Furthermanagement

2.6.Sepsisrecognitionandinitialmanagement

Introduction

Background

Definition

Aetiology

Pathophysiology

Diagnosis

Initialemergencymanagement

Disposition

Section3.NeonatalEmergencies

3.1.Thenormalneonate

Definitionandintroduction

Commonreasonsforhealthyneonatestopresenttotheemergencydepartment

Summary

3.2.Thecryinginfant

Introduction

Recurrentcrying

Acutecrying

Disposition

3.3.NeonatalDermatology

SkinintheNeonatalPeriod

Neonatalerythroderma

Redscalyrashes

Vesiclesandblisters

Pustularlesions

Birthmarks

Blue/purplelesions

Vascularlesionsintheneonatalperiod

3.4.Acuteneonatalemergencies

TheNeonatalPeriod

Neonatalresuscitation

Assessmentoftheneonate

Theneonatewithvomiting

Theneonatewithseizures

Theneonatewithbreathingdifficulty

Theneonatewithprolongedjaundice

3.5.Neonatalresuscitation

Introduction

Aetiologyandpathophysiology

Preparation

Assessmentatbirth

Ventilation

Heartrate

Colour

Muscletoneandreflexirritability

Medications

Specificresuscitationsituations

Post-resuscitationstabilisation

Prognosis

Section4.TraumainChildren

4.1.Introductiontopaediatrictrauma

Prevalence

Prevention

Succincttreatment(salvage)

Primarysurvey

Paediatricdifferences

Otherissuesduringinitialstabilisation

Secondarysurvey

Orthopaedictrauma

Rehabilitation

4.2.Paediatricneurotrauma

Introduction

Epidemiology

Pathophysiology

Classification

Assessment

4.3.Spinalinjury

Introduction

Developmentalanatomyandphysiology

Initialassessment

Spinalimmobilisation

Cervicalspineinjuries

Thoracicandlumbarspineinjuries

Spinalcordinjury

Spinalcordinjurywithoutradiographicabnormality

4.4.Thoracicinjuriesinchildhood

Introduction

Initialapproachintheemergencydepartment

Chestwallinjury

Pulmonaryinjury

Tracheobronchialinjuries

Mediastinalinjury

Cardiacinjuries

Diaphragmaticinjury

Emergencydepartmentthoracotomy

4.5.Abdominalandpelvictrauma

Introduction

History

Examination

Investigations

Generalmanagement

Surgicalissues

Hollowviscusinjuries

Pancreaticandrenalinjuries

Penetratingtrauma

Pelvicfractures

Disposition

4.6.Burns

Introduction

Pathophysiology

Classification

History

Examination

Investigations

Management

Managementofburns

Electricalburns

Chemicalburns

4.7.Childreninadisasterresponse

Introduction

Phasesofdisasterresponse

4.8.Woundmanagement

Introduction

Classificationofwounds

Evaluationofthepatientwithalaceration

Treatmentofwounds

Woundclosure

Post-wound-closurecare

Treatmentofselectedinjuries

Section5.Cardiovascular

5.1.Cardiovascularassessmentandmurmurs

Introduction

History

Physicalexamination

ChestX-ray

Thechildwithanasymptomaticmurmur

Pathologicalmurmurs

Disposition

5.2.Chestpain

Introduction

Immediateapproach

Generalapproach

Summary

5.3.Syncope

Introduction

Aetiology

Typicalpresentations

Clinical

Investigationswithintheemergencydepartment

Furtherinvestigationsofsyncope

Managementofsyncopewithintheemergencydepartment

Summary

5.4.CyanoticheartdiseaseandtetralogyofFallotspells

Introduction

Cyanoticcongenitalheartdisease

Clinicalfeatures

Investigations

Management

Disposition

TetralogySpells

Investigations

Treatment

Disposition

5.5.Heartfailure

Definition

Causesofcongestiveheartfailure

Clinicalmanifestationsandinvestigations

Management

5.6.Congenitalheartdisease

Introduction

Undiagnosedcongenitalheartdisease

Complications/residuaofcongenitalheartdiseaseanditstreatment

Congenitalheartdiseaseandintercurrentillness

5.7.Acuterheumaticfever

Introduction

Investigations

Treatment

Preventionandprophylaxis

5.8.Infectiveendocarditis

Introduction

Epidemiology

Pathophysiology

Microbiology

History

Examination

ModifiedDukecriteria

Investigations

Differentialdiagnosis

Treatment

Prognosis

Prevention

5.9.Kawasakidisease

Introduction

Pathophysiology

Clinicalfeatures

IncompleteKawasakidisease


Complications

Investigations

Treatment

RefractoryKawasakidisease

Prognosis

5.10.Cardiacarrhythmias

Introduction

Normalconductionsystem

Thecardiacactionpotential

Pathogenesisofarrhythmias

Generalprinciplesforarrhythmiamanagement

Roleof‘molecularautopsy’insuddenunexplainedcardiacdeathintheyoung

Section6.Respiratory

6.1.Stridorandnoisybreathing

Introduction

Initialassessment

History

Examination

Commoncausesofacutestridorinchildren

Commoncausesofchronicstridorinchildren

6.2.Upperrespiratorytractinfections

Introduction

Nasopharyngitis

Stomatitis

Pharyngitis/tonsillitis

6.3.Inhaledforeignbody

Introduction

Upperairwayforeignbodies

Treatment

Lowerairwayforeignbody

Prevention

6.4.Croup

Introduction

Presentation

Investigations


Treatmentanddisposition

Prognosis

Prevention

6.5.Acuteasthma

Introduction

Diagnosisofasthma

Riskfactorsformortality

Clinicalassessment


Treatment

Dischargefromhospital

Prognosis

Prevention

Futuredirections/research

6.6.Pertussis

Introduction

Pathophysiology

Epidemiology

History

Examination

Investigations


Complications

Treatment

Prognosis

6.7.Community-acquiredpneumonia

Introduction

Definition

Aetiology

Clinicalfindings

Investigations

Management

Complications

Prevention

Conclusion

6.8.Bronchiolitis

Introduction

Clinicalassessment

Treatment

Prognosis

Prevention

Section7.GastroenterologyandHepatology

7.1.Abdominalpain

Introduction

Pathophysiology

Aetiology

Assessment

History

Examination

Investigations

Management

Disposition

AcuteAppendicitis

Clinicalfeatures

Differentialdiagnoses

Investigations

Management

Meckel’sDiverticulum

Clinicalfeatures


Investigations

Management

ChronicAbdominalPain

Assessment

Diagnosis

Management

7.2.Vomiting

Non-SurgicalVomiting

Definitions

Clinicalevaluation

Examination


Investigations

Management

Conclusions

Surgical(Bilious)Vomiting

Causes

Complications

Investigations

Treatment

7.3.Gastrointestinalbleeding

Introduction

Aetiology

History

Examination

Investigations

Initialmedicaltherapy

Surgery

Treatment

Dispositon

7.4.Gastro-oesophagealreflux

Introduction

Pathophysiology

History

Examination


Complications

Investigations

Treatment

Follow-up

7.5.Pyloricstenosis

Introduction

Epidemiology

Clinicalpresentation

Examinationfindings

Imagingstudies


Management

Complications

7.6.Ingestedforeignbodies

Introduction

History

Examination

Investigations

Treatment

Disposition

Prevention

7.7.Acuteliverfailure

Introduction

Aetiology

Pathophysiology

Presentation

Investigations

Management

Disposition

Prognosis

Prevention

7.8.Diarrhoea

Introduction

Definitions

Clinicalevaluation

Examination


Investigations

Management

Conclusions

7.9.Managementofacutehepatitisinchildrenpresentingtotheemergencydepartment

Introduction

Aetiology

History

Examination

Investigations

Viralhepatitis

Drug-andtoxin-inducedliverinjury

Chronicliverdiseasepresentingasacutehepatitis

Othercausesofchronicliverdiseasepresentinginchildhood

7.10.Intussusception

Introduction

Aetiology

Epidemiology

Clinical

Investigations

Management

Outcome

7.11.Herniae

Introduction

Typesofherniae

Complications

Treatment

7.12.Gastroenteritis

Introduction

Aetiology

History

Examination


Investigations

Treatment

Severelydehydrated

Othertreatments

Disposition

Prognosis

7.13.Constipation

Introduction

Definitions

Pathophysiology

Managementbasics

Constipationinbabies

Acuteconstipation

Chronicconstipation

Investigations

Management

Medications

7.14.Inflammatoryboweldisease

Introduction

Newdiagnoses

KnownIBDpatients

Commontreatmentsandtheircomplications

Section8.Neurology

8.1.Cerebrospinalfluidshuntcomplications

Introduction


Examination

Investigations

8.2.Raisedintracranialpressure

Introduction

Particularissuesinchildren

Clinicalfeaturesofraisedintracranialpressure

Otherexaminationfindingsinraisedintracranialpressure

Investigations

Someparticularcausesofraisedintracranialpressure

8.3.Seizuresandnon-epilepticevents

Introduction

Generalcomments

Classificationofseizures

Febrileseizures

PresentationtoEmergencyDepartment

Presentationpostapossibleseizure

Presentationofaseizure

8.4.Acuteweakness

Introduction

Presentation

Primarysurveyapproach

History

Examination

Investigations

Specificconditionscausingacuteweakness

8.5.Acuteataxia

Introduction

Pathophysiology


Chronicataxia

Clinicalevaluationofthepatient

Examination

Investigations

Management

Disposition

8.6.Headache

Introduction

Incidence

Pathophysiology

Clinicalassessment

Management

Disposition

Migraine

Pathophysiology

Clinicalfeatures

Treatment

Disposition

Conclusions

8.7.Centralnervoussysteminfections:Meningitisandencephalitis

Introduction

Meningitis

Brainabscess

Encephalitis

Conclusion

Section9.InfectiousDiseases

9.1.Infectiousdiseases

Fever

Empiricantibiotictherapy

Commoninfectiousexanthems

Whatspecimens,whenshouldtheybeorderedandwhattests?

Infectioncontrolintheemergencydepartment

Needlestickinjury

Immunisation

Section10.MetabolicEmergencies

10.1.Inbornerrorsofmetabolism

Introduction

Physiologyandpathogenesis

Clinicalfeatures

Investigation

Management

Chronicpresentations

Extendednewbornscreening

Conclusion

10.2.Hypoglycaemiainthenon-diabeticchild

Introduction

Thehypoglycaemiascreen

Causesofhypoglycaemia

Treatmentofhypoglycaemia

10.3.Diabeticemergenciesinchildren

Diagnosis

Diabeticketoacidosis

Hypoglycaemia

Thechildwithaninsulinpump

Thechildwithdiabetesandintercurrentillness

Diabeticchildandsurgery

Long-termmanagement

10.4.Thyroidemergencies

Thyrotoxicosis

Neonatalthyrotoxicosis

Hypothyroidism

Congenitalhypothyroidism

Hashimoto’sthyroiditis

10.5.Adrenalemergencies

AdrenalCrisis


Disposition

Prevention

Cushing’sSyndrome

Presentingsymptoms

Diagnostictesting

Treatment

10.6.Disordersoffluids,electrolytesandacid–base

Introduction

Physiology

Clinicalassessment

Investigations

Treatment

Investigationandmanagementoffluidsindifferentconditions

Acid–basedisorders

Section11.Haematologyandoncology

11.1.Theuseofbloodproductsinchildren

Introduction

Packedredbloodcells

Platelets

Freshfrozenplasma

Cryoprecipitate

Clottingfactorconcentrates

Albumin

Normalhumanimmunoglobulin

Hyperimmuneimmunoglobulins

Risksofbloodcomponentuse

11.2.Anaemia

Introduction

Acutemanagement

Neonatalanaemia

Anaemiasofchildhood

Haemolyticanaemias

11.3.Disordersofcoagulation

Haemophilia

vonWillebranddisease

11.4.Plateletdisorders

Introduction

Immunethrombocytopaenia

Chronicimmunethrombocytopaenia

11.5.Vasculitis

Introduction


Classification

Small-VesselVasculitis

Anti-cytoplasmic-antibody-associatedvasculitis

Medium-VesselVasculitis

Polyarthritisnodosa

Large-VesselVasculitis

SecondaryVasculitisandVasculitisMimics

11.6.Acuteleukaemia

Introduction

Classification



Investigations

Prognosis

Complications

Management

11.7.Febrileneutropaenia

Introduction

Presentation

Investigations

Treatment

11.8.Emergenciesinpaediatriconcology

EmergencyComplicationsofPaediatricMalignancy

Feverandinfection

Gastrointestinalemergencies

Bloodproductuseinoncology

Cardiothoracicemergencies

Metabolicemergencies

Genitourinaryemergencies

Neurologicalemergencies

BrainandSpinalCordTumoursinChildren

Braintumours

Spinalcordcompression

Section12.Dermatology

12.1.Dermatology

Introduction

Erythrodermaandskinfailure

Vesiculobullousrashes

Pustularrashes

Papular(raised)rashes

Redscaly(papulosquamous)rashes

Eczematousrashes

Redblanchingrashes(erythematous)

Purpuricrashes

Vasculartumours–haemangiomasandhaemangiomavariants

Vascularmalformations

Managementofvascularmalformations

Hyperpigmentation

Hypopigmentation

Skintexture

Mouthdisorders

Anogenitalrashes

Zincandothernutritionaldeficiencies

Anogenitalpapulesandlumps

Immunodeficiencystates

Hairproblems

Nailproblems

Itchwithoutrash

Section13.Eyes

13.1.Ophthalmologicalemergencies

Introduction

History

Examination

Theredeyeinpaediatrics

13.2.Congenital,developmentalandneoplasticconditionsoftheeye

Deficitsinvisualacuity

Strabismus

Paediatriccataracts

Congenitalnasolacrimalductobstruction

Infantileglaucoma

Oculartumours

Retinoblastoma

Rhabdomyosarcoma

Neuroblastoma

13.3.Oculartrauma

Introduction

Globetrauma

Eyelidtrauma

Orbitaltrauma

Section14.EntandDental

14.1.Theear

Otitisexterna

Acuteotitismedia

Dischargingotitismedia–chronicsuppurativeotitismedia

Otitismediawitheffusion

Mastoiditis

Trauma

14.2.Thenose

Rhinitisandsinusitis

Epistaxis

Nasaltrauma

14.3.Themouthandthroat

Stomatitis


Pharyngitis/tonsillitis

Peritonsillarabscess

Post-tonsillectomyhaemorrhage

Oral/dentaltrauma

Oral/dentalinfection

Otherdentalissues

14.4.Retropharyngealabscess

Introduction

History

Examination

Investigation

Treatment

14.5.Foreignbodiesandcausticingestion

Nasalforeignbodies

Auralforeignbodies

Complications

Causticingestion

Section15.ObstetricsandGynaecology

15.1.Paediatricgynaecology

Infantandprepubescentgynaecology

Adolescentgynaecology

15.2.Emergencycontraception

Introduction

Clinicalassessment

Availablemedicines

Medicineinteractions

Medicinecontraindications

Medicineadverseeffects

Medicineoutcomes

Copperintrauterinedevices

Section16.Renal

16.1.Acutekidneyinjury

Introduction

Pathophysiology


Treatment

Acutepresentationofchronicrenalfailure

Acutekidneyinjuryintherenaltransplantrecipient

16.2.Haematuria

Isolatedmicroscopichaematuria

History

Examination

Investigation

Disposition

16.3.Hypertension

Introduction

History

Examination

Emergencydepartmentmanagement

16.4.Urinarytractinfectioninpre-schoolchildren

Introduction

Historyandexamination

Diagnosis

Treatment

Prognosis

Prevention

16.5.Haemolyticuraemicsyndrome

Introduction

Definitionofhaemolyticuraemicsyndrome

Classificationofhaemolyticuraemicsyndrome

Pathophysiologyofhaemolyticuraemicsyndrome

History

Examination

Investigations


Treatment

Prognosis

Complications

Prevention

16.6.Idiopathicnephroticsyndrome

Introduction

Pathophysiologyofproteinuria

Mechanismsofproteinuria

Definitionofnephroticsyndrome

Classificationofpaediatricnephroticsyndrome

Idiopathicnephroticsyndrome:epidemiology

Clinicalfeaturesofidiopathicnephroticsyndrome

Investigations


Complicationsofidiopathicnephroticsyndrome

Treatmentofinitialnephroticphase

Prognosis

16.7.Henoch–Schönleinpurpura

Introduction

Epidemiology

Pathogenesis

DiagnosticcriteriaforHenoch–Schönleinpurpura

Clinicalfeatures

Diagnosisandinvestigation


Treatment

Long-termprognosisandfollow-up

Section17.Psychiatric

17.1.Paediatricpsychiatricemergencies

Introduction

Generalapproach

CommonPaediatricPsychiatricPresentations

Suicidalpatients

Anxietydisorders

Psychosis

Otherpsychiatricpresentations

Acknowledgement

17.2.Thetreatmentofthebehaviourallydisturbedadolescent

Introduction

Theprinciplesofpsychiatrictriage

TheABCCofrapidpsychiatricassessment

ManagingtheABCCincludingrestraintandacutesedation

Conclusion

17.3.Autismandbehaviouraldisturbanceinthepre-adolescentchild

Introduction

Underlyingmechanismsinaustisticspectrumofdisorders/neurodevelopmentaldisorders

Approachtoassessment

Challengesinemergencydepartmentpresentations

Approachtomanagement

Management

Ongoingmanagementinthecommunity

Conclusion

Section18.CrisisIntervention

18.1.Sexualassault

Introduction

Definitions

Attitudes/mythssurroundingchildsexualassault

Epidemiologyofchildsexualassault

Childsexualassaultandemergencymedicine

Recognitionofchildsexualassault

Signsandsymptoms

Genitoanalanatomy

Sexuallytransmittedinfections

Diagnosticconsiderations

Roleoftheemergencyphysician

18.2.Childatrisk

Introduction

Definition

Thecommunityresponsetothechildatrisk

Section19.AdministrationInEMS

19.1.Managingthedeathofachildintheemergencydepartment:Bereavementissues

Introduction

Theresuscitationprocess

Talkingtoparentsandfamilies

Layingoutofthechild

Viewingthebody–quietsuite

Thegriefresponse

Supportofthefamily

Culturalimplications

Legalissues

Organandtissuedonationandcollection

Debriefingandsupportforemergencydepartmentstaff

Collaborationwithpaediatricpalliativecareservices

Theconceptofagooddeath

Conclusion

Section20.AnalgesiaandSedation

20.1.Analgesia

Introduction

Assessmentofpain

Management

Non-pharmacologicalmethods

Pharmacologicalmethods

20.2.Paediatricproceduralsedationwithintheemergencydepartment

Introduction

Pre-procedure

Intra-procedure

Post-procedure

Non-pharmacologicalmethods

Pharmacologicalmethods

Section21.Poisoning

21.1.Generalapproachtopoisoning

Introductionandepidemiology

Diagnosis

Riskassessment

Investigations

Resuscitation

Decontamination

Antidotes

Enhancedelimination

Supportivecare

Consultationanddisposition

21.2.Specificpoisons

Commonpoisons

Rareanddangerouspoisons

Section22.Environmental

22.1.Envenomation

Introduction

Snakebite

Scorpionstings

Spiderbite

Tickbiteparalysis

Jellyfishstings

Venomousfishstings

Venomousmarinemolluscs

22.2.Drowning

Introduction

Epidemiology

Aetiology

Pathophysiology

History

Examination

Investigations


Treatment

Disposition

Prognosis

Prevention

22.3.Heat-inducedillness

Introduction

Causesofheat-relatedillness

Investigations

Management

Prognosisanddisposition

22.4.Coldinjuries

Introduction

Normalphysiology:areview

Hypothermia

Localisedcoldinjuries

Frostbite

Hypothermianotduetoenvironmentalcauses

22.5.Anaphylaxis

Introduction

Pathophysiology

Aetiology

Clinicalfeatures

Investigations

Treatment

Diagnosis

Prevention

Section23.Ultrasound

23.1.Ultrasound

23.2.Diagnosticultrasoundinpaediatricemergencymedicine

23.3.Ultrasoundguidanceforprocedures

Ultrasoundguidanceforprocedures

23.4.Incorporatingultrasoundintopaediatricresuscitation

Section24.CommonProcedures

24.1.Estimatingtheweightofinfantsandchildren

Background

Age-basedtoolstoestimatebodyweight

Length-andbody-habitus–basedtools

Tips

24.2.Basicairwaymanagementtechniques

Background

OropharyngealandNasopharyngealAirways

Contraindications

Equipment

Preparation

Positioning

Procedure

Complications

Tips

LaryngealMaskAirway

Equipment

Preparation

Positioning

Procedure

Complications

Tips

Bag-Valve-MaskandFlow-InflatingMaskVentilation

Contraindications

Bag-Valve-MaskEquipment

Preparation

Positioning

Procedure

Complications

Tips

Flow-InflatingBag

Equipment

Preparation

Procedure

24.3.Non-InvasiveVentilation

Non-InvasiveContinuousPositivePressureVentilation

Contraindications

HumidifiedHigh-FlowNasalProngOxygenation

Equipment

Procedure

Complications

Tips

T-PieceVentilationDevice

Equipment

Procedure

Complications

Tips

ContinuousPositiveAirwayPressure/BiphasicPositiveAirwayPressure

Equipment

Contraindications

Relativecontraindications

Procedure

Complications

Tips

24.4.Endotrachealintubation

Background

Indications

Contraindications

Equipment

Preparation

Positioning

Procedure

Complications

Tips

ConfirmationofIntubation

Indications

Contraindications

Equipment

Preparationandpositioning

Procedure

Complications

Tips

24.5.Thesurgicalairway

Background

Indications

Contraindications

Needlecricothyroidotomy

Surgicalcricothyroidotomy

24.6.Chestprocedures

Introduction

NeedleThoracostomy

Indications

Contraindications

Equipment

Preparation

Procedure

Complications

Tips

TubeThoracostomy

Indications

Contraindications

Equipment

Preparation

Procedure

Complications

Tips

Three-SidedDressing

Indications

Contraindications

Equipment

Preparation

Procedure

Pericardiocentesis

Indications

Contraindications

Equipment

Standardpreparation

Procedure

Complications

Tips

24.7.Removingandreplacingatracheostomytube

Background

Indicationsforemergentreplacement

Contraindications

Equipment

Preparation

Procedure

Complications

Tips

24.8.Centralandperipheralintravenouslines

Background

Indications

Contraindications

Peripheralvenouscatheterplacement

Centralvenouslineplacement

24.9.Intraosseousinfusions

Background

Indications

Contraindications

Equipment

Preparation

Procedure

Complications

Tips

24.10.Umbilicalvesselcannulation

Background

Indications

Contraindications

Equipment

Preparation

Procedure

Complications

Tips

24.11.Defibrillation

Background

Indicationsfordefibrillation(asynchronous)

Indicationsforsynchronouscardioversion

Contraindications

Equipment

Standardpreparation

Standardprocedure

Automatedexternaldefibrillatorsprocedure

Complications

Tips

24.12.Transurethralcatheterisationandsuprapubicbladderaspiration

Background

Indications

Contraindications

Transurethralcatheterisation

Suprapubicaspiration

24.13.Lumbarpuncture

Background

Indications

Contraindications

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