Contributors xi
Preface xix
Evolution of acute medicine: the development of ambulatory emergency care xxi
Section 1 Presentations in Acute Medicine 1
General 2
1. The critically ill patient 3
2. Hypotension and shock 9
3. Reduced conscious level 16
4. Delirium 23
5. Falls in older people 30
Cardiorespiratory 34
6. Cardiac arrest in hospital 35
7. Acute chest pain 46
8. Palpitations 53
9. Transient loss of consciousness 60
10. Acute breathlessness 68
11. Acute respiratory failure 73
12. Pleural effusion 79
13. Cough and haemoptysis 85
Neurological 91
14. Neurological diagnosis in acute medicine 92
15. Acute headache 98
16. Seizures and epilepsy 103
17. Weakness and paralysis 110
18. Acute sensor/symptoms 117
19. Loss of vision 123
Abdominal 132
20. Acute vomiting 133
21. Acute abdominal pain 138
22. Acute diarrhoea 144
23. Acute jaundice 150
24. Ascites 155
25. Acute kidney injury 160
Skin and Musculoskeletal 170
26. Acute rash 171
27. Urticaria and angioedema 177
28. Acute arthritis 183
29. Acute spinal pain 187
30. Acute limb pain 190
Miscellaneous 194
31. Comprehensive geriatric assessment 195
32. Acute medical problems in pregnancy 199
33. Fever on return from abroad 207
34. Acute medical problems in the HIV-positive patient 215
Section 2 Syndrome and Disorders 223
General 224
35. Sepsis 225
36. Poisoning 233
37. Acid-base disorders 246
38. Anaphylaxis 252
Cardiovascular 258
39. Acute arrhythmias: general principles of management 259
40. Regular broad complex tachycardia 263
41. Irregular broad complex tachycardia 268
42. Narrow complex tachycardia 272
43. Atrial fibrillation and flutter 279
44. Bradycardia and atrioventricular block 283
45. Acute coronary syndromes (1): ST-segment elevation 289
46. Acute coronary syndromes (2): Non-ST-segment elevation 298
47. Acute pulmonary oedema 305
48. Acute heart failure and decompensated chronic heart failure 311
49. Cardiogenic shock 317
50. Aortic dissection and other acute aortic syndromes 321
51. Heart valve disease and prosthetic heart valves 328
52. Infective endocarditis 333
53. Acute pericarditis 340
54. Cardiac tamponade 344
55. Severe hypertension 347
56. Deep vein thrombosis 353
57. Pulmonary embolism 358
58. Problems with pacemakers and other cardiac devices 366
Respiratory 371
59. Upper airway obstruction 372
60. Acute asthma 378
61. Exacerbation of chronic obstructive pulmonary disease (COPD) 384
62. Community-acquired pneumonia 390
63. Hospital-acquired pneumonia 396
64. Pneumothorax 399
Neurological 402
65. Stroke 403
66. Transient ischaemic attack 412
67. Subarachnoid haemorrhage 418
68. Bacterial meningitis 422
69. Encephalitis 428
70. Spinal cord compression 432
71. Guillain-Barré syndrome 436
72. Raised intracranial pressure 442
Abdominal 446
73. Acute upper gastrointestinal bleeding 447
74. Acute lower gastrointestinal bleeding 455
75. Acute oesophageal disorders 459
76. Inflammatory bowel disease flare 462
77. Acute liver failure and decompensated chronic liver disease 467
78. Alcoholic hepatitis 476
79. Biliary tract disorders and acute pancreatitis 478
80. Urinary tract infection 481
Metabolic 487
81. Hypoglycaemia 488
82. Hyperglycaemic states 491
83. Diabetic ketoacidosis 495
84. Hyperasmolat hyperglycemic state 499
85. Disorders of plasma sodium concentration 501
86. Disorders of plasma potassium concentration 508
87. Disorders of plasma calcium concentration 514
88. Disorders of plasma magnesium concentration 518
89. Disorders of plasma phosphate concentration 521
90. Acute adrenal insufficiency 525
91. Thyrotoxic storm 530
92. Myxoedema coma 534
93. Pituitary apoplexy 537
94. Paraganglioma (phaeochromocytoma) crisis 540
Skin and Musculoskeletal 543
95. Cellulitis and necrotizing fasciitis 544
96. Erythroderma and toxic epidermal necrolysis 549
97. Acute gout and pseudogout 555
98. Septic arthritis 558
99. Acute vasculitis 561
Haematology and Miscellaneous 568
100. Interpretation of full blood count and film 569
101. Pancytopenia and febrile neutropenia 577
102. Bleeding disorders 584
103. Management of anticoagulation 589
104. Acute painful sickle cell crisis 601
105. Complications of cancer 605
106. Alcohol-related problems in acute medicine 612
107. Hypothermia 615
108. Drowning 619
109. Electrical injury 623
110. Palliative and end-of-life care 625
111. Medicolegal issues in acute medicine 632
Section 3 Techniques and Procedures in Acute Medicine 639
112. Airway management 641
113. Non-invasive ventilation 646
114. Ultrasonography in acute medicine 651
115. Reading a chest X-ray 657
116. Central vein cannulation 665
117. Arterial blood sampling and cannulation 673
118. Arterial blood gases, oxygen saturation and oxygen therapy 677
119. Temporary cardiac pacing 681
120. Pericardial aspiration (pericardiocentesis) 687
121. DC cardioversion 692
122. Insertion of an intercostal chest drain 696
123. Lumbar puncture 704
124. Aspiration of the knee joint 709
125. Insertion of a Sengstaken-Blakemore tube 712
Index 715