응급의학 er-manual

목차

*** ATLS : 개요 : 강의록
*** face injury 일반 : 응급구조학과 강의록
201 ocular emergency
202 Otolaryngologic emergency
203 Nasal emergency
212 Initail approach to the trauma Pt
213 Pediatric trauma
214 Grriatric injury
215 Head trauma
*** Brain Edema
216 spinal injury
217 penetrating & blunt Neck trauma
*** Chest X-ray
218 Thoracic trauma
219 Abd trauma
221 Trauma to the GUT
223 Early Mx of Fx & D/L
227 trauma to the pelvis, hip & femur
228 Knee injury
229 leg injury
231 foot injury
232 Neck pain
233 Thoracic & lumbar pain syndrome
234 shoulder pain
235 Overuse synd
236 muscle ruptures
237 compartment synd
238 Rheumaic disorders in adults
240 soft tissue problems of the foot
241 Behavior disorders : clinical feature
242 Behavioral disorders : emergency assessment & stabililzation
243 Psyco tropic medication
248 Emergency evaluation of Presoner & Substance abuse
251 Sexual vilolence
252 Domestic violence
253 abuse in the elderly and impaired
254 Violence in the ED
256 Echocardiography
258 Pelvic U/S

본문내용

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Schizophrenia, mania or Other Psychosis
1. Lorazepam 2-4 mg IM c Haloperidol 5 mg IM or thiothixene 10 mg IM
or, RT c antipsychosis alone
2. 1) Thioxene(Navane) 10 mg IM or 20 mg concentrate.
2) Haloperidol (haldol) 5 mg IM or 10 mg concentrate
3) Loxapine (Loxitane) 10 mg IM or 25 mg concentrate PO
Personality disorder
Lorazepam(Ativan) 1-2 mg PO q 1-2 h or 2 mg IM (0.05mg/kg) q 1-2 h
Alcohol withdrawal state
1. For agitation, tremors, or change V/S : Chlordiazepoxide 25-50 mg PO q 4-6 h
2. For elderly or liver disease Pt : Lorazepam 2 mg PO q 2 h
3. For Extreme agitation : Lorazepam 2-4 mg IM q 1 h
Cocaine & amphetamine intoxication.
1. For mild to moderate agitation : diazepam 10 mg PO q 8 h
2. For severe Agitation : Thiothixene 20 mg concentrate or 10 mg IM,
Haloperidol 10 mg concentrate or 5mg IM
Phenylcylidine intoxication
1. For Hyperactivity, mild agitation, tension, anxiety, excitement :
Diazepam 10-30 mg PO or Lorazepam 2-4 mg IM ( 0.05 mg/kg)
2. For severe agitation & Excitement c hallucinations, delusion, bizarre behavior :
Haloperidol 5-10 mg IM q 30-60 min.
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Prevention
Visitor ID badges
Hx of Pt
Interview : a safe calm environment
Seclusion room :
Solid walls c sturdy, heavy furniture.
Lightening to be dimmed or brightened depending on the circumstance.
Exit - clear of obstruction & readily available to the interviewer.
Large enough for a team of security.
Weapons of any type are not permitted.
Trained hospital security personnel visible to everyone entering the ED.
Metal detectors & x-ray machines
Monitors & alarm button.
256 Echocardiography
1. The main function of Doppler ultrasound
1.blood flow velocity
2.방향 (Direction)
3.Turbulance
2. 주요 심질환의 Echo 소견
CATHETRIZATION
1. Describe 3 indications for cardiac catheterization
1. conform of Dx of certain disease
2. anatomic involvement, physiologic degree 를 확인 하고자 할때
3. therapeutic effect 를 평가 활때
2. PCWP와 LA pressure 가 일치하지 않는 이유
1. mitral insufficience 와 mitral stenosis 가 같이 있을때
2. pulmonary embolism시
258. PELVIC ULTRASONOGRAPHY
NOAMAL EARLY PREGNANCY
. sonofinding : basis of accurate gestational dating criteria
. implantation of embryo : 5days after fertilization
. cardiac activity : 6weeks after of LMP
. crown-rump length : fetal age within 4days up to 12weeks
FAILING EARLY PREGNANCY
. nonspecific symptom : low abdominal pain, vaginal bleeding etc.
. classification : intrauterine
extrauterine
. correlation of history with sonographic, clinical, laboratory finding
1. Intrauterine
. gestation sac : first major sonographic sign
visible in preg. 5weeks - round or oval
if gestation sac is grossly distorted( irregular and enlongated)
suggests abnormal findings.
. size of gestation sac : abdominal U.S : detect in 2.5cm or greater
vaginal U.S : detect at least 1.8cm
. yolk sac : first sonographic appearance at about 5.5weeks

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