Roberts and Hedges’ Clinical Procedures in Emergency Medicine and Acute Care
- 7th Edition - December 12, 2017
- Imprint: Elsevier
- Author: James R. Roberts
- Language: English
- Hardback ISBN:9 7 8 - 0 - 3 2 3 - 3 5 4 7 8 - 3
- eBook ISBN:9 7 8 - 0 - 3 2 3 - 5 4 7 9 4 - 9
Comprehensive, detailed, and up to date, Roberts and & Hedges’ Clinical Procedures in Emergency Medicine and Acute Care, 7th Edition, provides highly visual coverage of… Read more
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Request a sales quoteComprehensive, detailed, and up to date, Roberts and & Hedges’ Clinical Procedures in Emergency Medicine and Acute Care, 7th Edition, provides highly visual coverage of both common and uncommon procedures encountered in emergency medicine and acute care practice. It clearly describes the ins and outs of every procedure you're likely to consider, such as how, why, when to, and when not to perform them, and recommends other emergency or acute care procedures that may be an option. Thoroughly revised and updated throughout, the 7th Edition remains the most well-known and trusted procedures manual in its field.
- Provides clear, detailed information for practitioners at all levels of experience, – from trainees who are unfamiliar with a specific procedure to those with experience in the technique.
- Cover image
- Title Page
- Table of Contents
- Associate Editors
- Copyright
- Dedication
- How this Medical Textbook Should be Viewed by the Practicing Clinician and the Judicial System
- Contributors
- Preface
- Foreword
- Acknowledgments
- Video Contents
- Supplementary Videos
- Section I Vital Signs and Patient Monitoring Techniques
- 1 Vital Signs Measurement
- Abstract
- Background
- Normal Values
- Respiration
- Pulse
- Arterial Blood Pressure
- Doppler Ultrasound for Evaluation of Pulse and Blood Pressure
- Vital Sign Determination of Volume Status
- Orthostatic Vital Signs Measurement
- Capillary Refill
- Temperature
- Pain as a Vital Sign
- References
- 2 Devices for Assessing Oxygenation and Ventilation
- Spirometry
- Noninvasive Oxygenation Monitoring: Pulse Oximetry
- CO2 Monitoring
- Conclusion
- References
- Section II Respiratory Procedures
- 3 Basic Airway Management and Decision Making
- Abstract
- The Challenge of Emergency Airway Management
- Basic Airway Management Techniques
- Oxygen Therapy
- Bag-Mask Ventilation
- Extraglottic Airway Devices
- Conclusion
- References
- 4 Tracheal Intubation
- Abstract
- General Approach to Emergency Intubation
- Airway Anatomy
- Preparation
- Preoxygenation
- Assessing for a Difficult Airway
- Emergency Airway Decision Making
- Direct Laryngoscopy (DL)
- Video and Optical Laryngoscopes
- Flexible Endoscopic Intubation
- Optical and Video Intubating Stylets
- Orotracheal Intubation With a King Laryngeal Tube (LT) or Combitube in Place
- Blind Nasotracheal (NT) Intubation
- Digital Intubation
- Retrograde Intubation
- Changing Tracheal Tubes
- Preventing Unplanned Extubation
- Conclusion
- References
- 5 Pharmacologic Adjuncts to Intubation
- Abstract
- Overview of RSI
- Pretreatment: Preventing the Complications of Intubation
- Induction Agents
- Neuromuscular Blocking Agents
- The “Sedated Look” Evaluation of the Airway Before RSI
- Awake Intubation
- Acknowledgment
- References
- 6 Cricothyrotomy and Percutaneous Translaryngeal Ventilation
- Abstract
- Anatomy
- Surgical Cricothyrotomy
- Percutaneous Translaryngeal Ventilation
- Conclusion
- References
- 7 Tracheostomy Care
- Abstract
- Introduction
- Background
- Tracheal Anatomy and Physiology
- Evaluation of Tracheostomy Patients
- General Equipment for Tracheostomy Patients
- Routine Tracheostomy Maintenance
- Ventilating Tracheostomy Patients
- Tracheal Suctioning
- Changing a Tracheostomy Tube
- Complications of Tracheostomy
- Transesophageal Puncture for Voice Restoration
- Transtracheal Oxygen Delivery Systems
- Special Populations
- Conclusion
- References
- 8 Mechanical Ventilation
- Abstract
- Introduction
- Basic Physiology
- Indications for MV
- Equipment—Standard Options
- Modes of Ventilation
- Neuromuscular Blockade/Paralyzing Agent for Mechanically Ventilated Patients
- Sedation
- Specific Disease Processes
- Complications of MV
- Troubleshooting
- Special Scenarios
- Liberation From the Ventilator
- Conclusion
- References
- 9 Thoracentesis
- Abstract
- Anatomy
- Etiology of Pleural Effusions
- Clinical Presentation
- Radiologic Diagnosis
- Indications
- Contraindications
- Technique
- Pediatric Patients
- Postprocedure Evaluation
- Pleural Fluid Analysis
- Complications
- References
- 10 Tube Thoracostomy
- Abstract
- Pathophysiology
- Diagnosis
- References:
- Indications for Tube Thoracostomy
- Contraindications
- Treatment
- Procedure
- Other Techniques
- Tube Thoracostomy in Pediatric Patients
- Complications
- References
- Section III Cardiac Procedures
- 11 Techniques for Supraventricular Tachycardias
- Abstract
- Introduction
- Overview/Significance: Anatomy and Physiology of Supraventricular Tachycardia
- Conclusion
- References
- 12 Defibrillation and Cardioversion
- Abstract
- Introduction
- Principles of Resuscitation
- Anatomy, Physiology, and Pathophysiology
- Indications for and Contraindications to Defibrillation
- Conductive Material
- Procedure
- Pediatric Defibrillation
- Cardioversion
- Acknowledgment
- References
- 13 Assessment of Implantable Devices
- Abstract
- Pacemaker Characteristics
- Indications for Placement of Implantable Pacemakers and Aicds
- Pacemaker and AICD Response to Magnet Placement
- Clinical Evaluation of Patients With Implanted Pacemakers and Aicds
- Complications and Malfunction of Implanted Pacemakers
- Diagnosis of Acute Myocardial Infarction in the Presence of a Paced Cardiac Rhythm
- Automatic Implantable Cardioverter Defibrillators—Unique Malfunctions
- References
- 14 Basic Electrocardiographic Techniques
- Abstract
- Introduction
- Background
- Indications
- Basic Equipment
- Features of the ECG
- Additional Electrocardiographic Leads
- Prehospital ECG
- Alternative Techniques for Assessment of Rhythm
- Electrode Misplacement and Misconnection
- Artifact
- References
- 15 Emergency Cardiac Pacing
- Abstract
- Emergency Transvenous Cardiac Pacing
- References
- Emergency TCP
- References
- 16 Pericardiocentesis
- Definition
- Anatomy and Physiology
- Epidemiology
- Causes of Pericardial Effusion (Box 16.1)
- Diagnosing Cardiac Tamponade
- References
- Indications for Pericardiocentesis
- Contraindications
- Overview of Techniques and Equipment
- Procedure
- Complications
- References
- 17 Cardiopulmonary Resuscitation and Artificial Perfusion During Cardiac Arrest
- Abstract
- Conventional CPR
- Adjuncts to Improve the Quality of CPR
- Monitoring During CPR
- Conclusion
- References
- 18 Resuscitative Thoracotomy
- Indications and Contraindications
- Air Embolism
- Equipment
- Procedure
- Interpretation and Hemodynamic Monitoring
- EDT in Children
- Complications
- Acknowledgment
- References
- Section IV Vascular Techniques and Volume Support
- 19 Pediatric Vascular Access and Blood Sampling Techniques
- Abstract
- Patient Preparation and Restraint
- Blood Sampling Techniques
- Vascular Line Placement: Venous and Arterial
- Rehydration Techniques in Infants and Children
- References
- 20 Arterial Puncture and Cannulation
- Abstract
- Indications and Contraindications
- Equipment: Arterial Puncture
- Site Selection
- Techniques
- Percutaneous Technique for Arterial Cannulation
- Selection of Arteries for Cannulation
- Complications of Arterial Cannulation
- Interpretation
- Conclusion
- Acknowledgment
- References
- 21 Peripheral Intravenous Access
- Abstract
- Introduction
- Historical Perspective
- Indications and Contraindications
- Ultrasound Guidance and Transillumination
- Anatomy
- Preparation
- Complications
- Extravasation of Medications and Vasopressors
- References
- References
- 22 Central Venous Catheterization and Central Venous Pressure Monitoring
- Abstract
- Historical Perspective
- Anatomy
- Indications
- Contraindications
- Procedure
- Equipment
- Technique
- Site Selection
- Specific Vessel Access Techniques
- Anchoring the Central Line
- Special Considerations for Other Vessels
- CVP Monitoring
- Complications
- Training and Simulation
- References
- 23 Venous Cutdown
- Abstract
- Indications
- Contraindications
- Anatomy and Selection of the Site
- Equipment
- Technique
- Complications
- Acknowledgment
- References
- 24 Indwelling Vascular Access Devices
- Abstract
- Historical Perspective
- Indwelling Vascular Access Devices (IVADs)
- Accessing Ivads in the ED
- Complications of Ivads
- Aftercare Instructions
- References
- 25 Intraosseous Infusion
- Abstract
- Historical Perspective
- Anatomy and Physiology
- Indications
- Contraindications
- Equipment and Setup
- Procedure
- Use of Specific IO Devices
- Complications
- Training
- Duration of Use
- References
- 26 Alternative Methods of Drug Administration
- Abstract
- Endotracheal (ET) Administration of Medication
- Intranasal Administration of Medication
- Rectal Administration of Medication
- Other Alternate Routes of Administration of Medication
- References
- 27 Autotransfusion
- Abstract
- Introduction
- Background
- Anatomy
- Pathophysiology
- Advantages
- Indications
- Contraindications
- Equipment and Material
- Procedure for Autotransfusion
- Complications
- Resources
- References
- 28 Transfusion Therapy
- Abstract
- Background
- Other Blood Products
- Collection and Storage of Blood Products
- Ordering of Blood
- Administration of Blood Products
- Acknowledgments
- References
- Section V Anesthetic and Analgesic Techniques
- 29 Local and Topical Anesthesia
- Abstract
- Background
- Pharmacology and Physiology
- Topical Anesthesia
- Infiltration Anesthesia
- Special Considerations
- Complications
- Summary
- References
- 30 Regional Anesthesia of the Head and Neck
- Abstract
- Anatomy of the Trigeminal Nerve (Cranial Nerve V)
- Equipment for Facial Nerve Blocks
- General Recommendations
- Conclusion
- References
- 31 Regional Anesthesia of the Thorax and Extremities
- Abstract
- General Concepts
- Specific Nerve Blocks
- Reference:
- References
- 32 Intravenous Regional Anesthesia*
- Indications and Contraindications
- Equipment
- Procedure
- Mechanism of Action
- Procedural Points
- Complications
- References
- 33 Systemic Analgesia and Sedation for Procedures
- Abstract
- Terminology
- PSA Guidelines
- Evaluation Before PSA
- Personnel and Interactive Monitoring
- Equipment and Mechanical Monitoring
- Supplemental Oxygen
- Discharge Criteria
- General Principles
- Routes of Administration
- Drug Selection Strategies
- Pharmacopeia
- Acknowledgement
- References
- Section VI Soft Tissue Procedures
- 34 Principles of Wound Management
- Abstract
- Background: Wound Healing
- Initial Evaluation
- Cleaning
- Closure
- Protection
- Patient Instructions
- Secondary Wound Care
- Complications
- References
- 35 Methods of Wound Closure
- Abstract
- Wound Tape
- Tissue Adhesive (Tissue Glue)
- Wound Staples
- Sutures
- Distally and Proximally Based Flap Lacerations
- References
- 36 Foreign Body Removal
- Abstract
- Evaluation and Diagnosis
- References
- FB Removal
- Disposition Management
- Acknowledgment
- References
- 37 Incision and Drainage
- Abstract
- Abscess Etiology and Pathogenesis
- MRSA
- Manifestations of Cutaneous Abscesses
- Imaging
- References:
- Laboratory Findings
- Indications for and Contraindications to I&D
- Prophylactic and Therapeutic Antibiotic Therapy
- Recurrent Infections
- I&D Procedure
- Follow-Up Examination
- Specific Abscess Therapy
- Acknowledgments
- References
- 38 Burn Care Procedures
- Abstract
- Wound Evaluation
- Histopathology of Burns
- Outpatient Versus Inpatient Care
- Procedure
- Follow-Up Care of Minor Burns
- Special Minor Burn Care Circumstances
- Specific Burning Agents
- Emergency Escharotomy
- Conclusion
- Acknowledgments
- References
- Section VII Gastrointestinal Procedures
- 39 Esophageal Foreign Bodies
- Abstract
- General Features
- Radiology of Esophageal Foreign Bodies
- Visualization of Esophageal and Pharyngeal Fbs
- Esophagoscopy
- Esophageal Pharmacologic Maneuvers
- Removal of Esophageal Fbs in the ED
- Special Situations
- References
- 40 Nasogastric and Feeding Tube Placement
- Abstract
- Properties of NG and Feeding Tubes
- NG Tube Placement
- Replacement of Nasoenteric Feeding Tubes
- Pharyngostomy and Esophagostomy Feeding Tubes
- Gastroenterostomy and Jejunostomy Tubes
- Clogged Feeding Tubes
- References
- 41 Balloon Tamponade of Gastroesophageal Varices
- Introduction
- Background
- Indications
- Contraindications
- Procedure
- Aftercare
- Complications
- Conclusion
- References
- 42 Decontamination of the Poisoned Patient
- Abstract
- Introduction
- Gastric Decontamination
- Dermal Decontamination
- References
- 43 Peritoneal Procedures
- Abstract
- DPL
- Paracentesis
- References
- 44 Abdominal Hernia Reduction
- Abstract
- Background
- Classification
- Diagnosis
- Reduction
- Potential Complications
- Interpretation
- References
- 45 Anorectal Procedures
- Abstract
- Anatomy
- Digital Rectal Exam (DRE)
- Anoscopy
- Management of Hemorrhoids
- Management of Anorectal Abscess and Pilonidal Cyst and Abscess
- Management of Rectal Fbs
- Management of Rectal Prolapse
- Anal Fissure
- References
- Section VIII Musculoskeletal Procedures
- 46 Prehospital Immobilization
- Abstract
- Spinal Motion Restriction
- Extremity Immobilization
- Pelvic Immobilization
- Removal of Helmets and Protective Equipment
- References
- 47 Management of Amputations
- Abstract
- Background
- Indications
- Contraindications
- General Considerations
- Patient Assessment and Management
- Care of the Stump and Amputated Part
- Special Considerations
- Complications
- Field Amputations
- References
- 48 Extensor and Flexor Tendon Injuries in the Hand, Wrist, and Foot
- Abstract
- Extensor Tendons
- Extensor Tendon Injuries of the Foot
- Flexor Tendon Injuries
- Achilles Tendon Rupture
- Knee Extensor Tendon Rupture
- References
- 49 Management of Common Dislocations
- Abstract
- Preparation of the Patient
- General Principles
- Shoulder Dislocations
- AC Joint Subluxation and Dislocation
- Sternoclavicular Dislocations
- Elbow Dislocations
- Radial Head Subluxation (Nursemaid's Elbow)
- Hand Injuries
- Hip Dislocations
- Knee (Femur, Tibia) Dislocations
- Dislocations of the Fibular Head
- Patellar Dislocation
- Ankle Dislocations
- Dislocations of the Foot
- Conclusion
- References
- 50 Splinting Techniques
- Indications and Contraindications
- Equipment (See Review Box 50.1)
- General Procedure of Custom Splint Application
- Upper Extremity Splints
- Lower Extremity Splints
- Complications of Splints
- Conclusion
- References
- 51 Podiatric Procedures
- Common Nontraumatic Conditions of the Foot
- Traumatic Conditions of the Foot
- Ingrown Toenail
- References
- 52 Treatment of Bursitis, Tendinitis, and Trigger Points
- Abstract
- General Anatomic Considerations
- Rationale for Injection Therapy
- Indications and Contraindications
- Hazards and Complications
- Corticosteroid Preparations
- Dosage and Administration
- Preparation of the Site
- Techniques
- Acknowledgments
- References
- 53 Arthrocentesis
- Abstract
- Background
- Indications and Contraindications
- Equipment
- General Arthrocentesis Technique
- Specific Arthrocentesis Techniques
- Synovial Fluid Interpretation
- Joint Arthrography
- References
- 54 Compartment Syndrome Evaluation
- Abstract
- Background
- Pathophysiology
- Clinical Features
- Diagnosis
- Ancillary Studies
- Invasive Compartment Pressure Monitoring
- Needle Placement Techniques for Specific Compartments
- Interpretation of Compartment Pressure Measurements
- Complications
- Acknowledgments
- References
- Section IX Genitourinary, Obstetric, and Gynecologic Procedures
- 55 Urologic Procedures
- Abstract
- Introduction
- Testicular Torsion
- Priapism
- Paraphimosis
- Phimosis
- Urethral Catheterization
- Suprapubic Aspiration
- Suprapubic Cystostomy
- Lower Genitourinary Tract Imaging
- Upper Genitourinary Tract Imaging
- Acknowledgments
- References
- 56 Emergency Childbirth
- Abstract
- Background
- Anatomy and Physiology
- Identification of Labor
- Evaluation of Labor
- Labor Movements: Vertex Presentation
- Labor Movements: Breech Presentation
- Vaginal Examination
- Fetal Well-Being
- Vaginal Bleeding During the Third Trimester
- Procedure
- Complications
- Perimortem Cesarean Section
- The Newborn
- Acknowledgments
- Selected Readings
- References
- 57 Gynecologic Procedures
- Abstract
- Pelvic Examination
- Common Causes of Vaginal Bleeding in Adult Women
- Culdocentesis
- References
- 58 Examination of the Sexual Assault Victim
- Abstract
- Definitions
- Evaluation and Treatment of Patients Suffering From Sexual Assault
- Treatment
- Specific Populations
- Legal Issues
- SARTs
- Acknowledgment
- References
- Section X Neurologic Procedures
- 59 Management of Increased Intracranial Pressure and Intracranial Shunts
- Abstract
- Pathophysiology of ICP
- Signs and Symptoms
- Medical Treatment of Increased ICP
- Intracranial Shunts
- Acknowledgments
- References
- 60 Spinal Puncture and Cerebrospinal Fluid Examination
- Abstract
- Historical Perspective
- Anatomy and Physiology
- Indications for Spinal Puncture
- Contraindications to Spinal Puncture
- Equipment
- Procedure
- Complications
- Interpretation
- Acknowledgments
- References
- 61 Special Neurologic Tests and Procedures
- Abstract
- Evaluation of the Comatose Patient
- Procedures to Evaluate and Treat Vertigo
- Evaluation of Weakness
- Acknowledgments
- References
- Section XI Ophthalmologic, Otolaryngologic, and Dental Procedures
- 62 Ophthalmologic Procedures
- Abstract
- Assessment of Visual Acuity
- Use of Ophthalmic Anesthetic and Analgesic Agents
- Dilating the Eye
- The Fluorescein Examination
- Eye Irrigation
- Globe Protection and Evaluation
- Bedside ED Ocular Ultrasound
- Ocular FB Removal
- Eye Patching
- Contact Lens Procedures
- Bandage Contact Lenses for Treatment of Corneal Abrasions
- Infectious Keratitis
- Tonometry
- Slit Lamp Examination
- Unilateral Loss of Vision
- Reduction of Globe Luxation
- Stye
- APD or Marcus Gunn Pupil
- Subconjunctival Hemorrhage
- Acknowledgment
- References
- 63 Otolaryngologic Procedures
- Abstract
- Pharynx and Larynx
- Tonsil: Peritonsillar Abscess
- Ear
- Nose
- References
- 64 Emergency Dental Procedures
- Abstract
- Teeth
- The Periodontium
- Acute Toothache in the ED
- Dentoalveolar Trauma
- Oral Hemorrhage
- Alveolar Osteitis (Dry Socket)
- Dentoalveolar Infections
- Dental Material
- Intraoral Piercing
- Acknowledgments
- References
- Section XII Special Procedures
- 65 Procedures Pertaining to Hypothermia and Hyperthermia
- Abstract
- Procedures Pertaining to Hypothermia
- Procedures Pertaining to Hyperthermia
- Acknowledgments
- References
- 66 Ultrasound
- Abstract
- Physics
- Indications and Contraindications
- Equipment
- General Approach
- Complications
- Fast, E-Fast, and Rush Exams
- References
- 67 Bedside Laboratory and Microbiologic Procedures
- Abstract
- Assessment of Urine
- Testing for Pregnancy
- Blood Cultures in the ED
- Principles and Pitfalls in Phlebotomy for Blood Testing
- Bedside Tests for Gastrointestinal Hemorrhage
- Blood Glucose Meters
- Diagnostic and Therapeutic Toxicologic Bedside Procedures
- References
- 68 Standard Precautions and Infectious Exposure Management
- Guidelines for Standard Precautions
- Occupational Disease Exposure
- References
- 69 Physical and Chemical Restraint
- Abstract
- Background
- Excited Delirium Syndrome (ExDS)
- Medicolegal Concerns
- Patient Assessment
- De-Escalation Techniques
- Types of Patient Restraint
- Acknowledgment
- References
- 70 Noncardiac Implantable Devices
- Abstract
- Insulin Infusion Devices
- Intrathecal Drug Delivery Systems
- Vagal Nerve Stimulators
- Other Implantable Devices
- MRI and Implantable Devices
- References
- 71 Radiation in Pregnancy and Clinical Issues of Radiocontrast Agents
- Abstract
- Types of Radiation
- Radiobiology and Radiophysics
- Effects of Radiation
- Nuclear Medicine Studies
- Diagnosis of PE
- Diagnosis of Appendicitis
- Diagnosis of Pregnancy and Consent
- Patient Counseling
- Nonionizing Radiation
- Ultrasonography
- Summary
- Clinical Use of Radiocontrast Material
- References
- 72 Procedures in the Setting of Anticoagulation
- Abstract
- Introduction
- Assessing Risk of Bleeding and Thrombosis
- Management of Anticoagulant Associated Bleeding
- Summary
- References
- Appendix Commonly Used Formulas and Calculations
- Introduction
- English-to-Metric Conversions
- Mean Arterial Pressure
- QT and QTC Intervals
- Predicted Peak Expiratory Flow Rate
- Endotracheal Tube Size
- Ventilator Settings
- Ideal Body Weight
- Absolute Neutrophil Count
- White Blood Cell Correction in Cerebrospinal Fluid
- Renal Function
- Fractional Excretion of Sodium
- Sodium Deficit
- Sodium Correction
- Hypernatremia
- Potassium
- Calcium
- Maintenance IV Fluid Rate
- Fluid Resuscitation of Burned Patients
- Anion Gap
- Osmolal Gap
- Acid-Base Balance
- Winter's Formula
- Glasgow Coma Scale
- National Institutes of Health Stroke Score
- Diagnostic Probability
- Acknowledgment
- Index
- Instructions for online access
- Edition: 7
- Published: December 12, 2017
- Imprint: Elsevier
- No. of pages: 1500
- Language: English
- Hardback ISBN: 9780323354783
- eBook ISBN: 9780323547949
JR
James R. Roberts
Dr. Roberts’ research is interdisciplinary and involves fundamental, clinical, behavioral and epidemiological studies. He has been involved in several seminal studies of preeclampsia including the recognition of preeclampsia as involving endothelial dysfunction and being more than hypertension in pregnancy. He currently is involved in global health research and is on the Management Committee of the Bill and Melinda Gates funded study, Preeclampsia and Eclampsia monitoring prevention and treatment (PRE-EMPT0. He also heads the Global Pregnancy Collaboration, a consortium of 34 centers world-wide that facilitates collaborative research. He is a co-investigator on studies in Brazil and South Africas.
Affiliations and expertise
Professor of Emergency Medicine, Vice Chair, Department of Emergency Medicine, Senior Consultant, Division of Toxicology, The Drexel University College of Medicine; Chairman, Department of Emergency Medicine, Director, Division of Medical Toxicology, Mercy Catholic Medical Center, Philadelphia, Pennsylvania