Details

<p>About the Authors xi</p> <p>Foreword xv</p> <p>Preface xvii</p> <p>Acknowledgments xix</p> <p>Section 1: The Science of Diagnostic Testing and Clinical Decision Rules</p> <p>1 Diagnostic Testing in Emergency Care 3</p> <p>2 Evidence-Based Medicine: The Process 11</p> <p>3 The Epidemiology and Statistics of Diagnostic Testing 19</p> <p>4 Clinical Decision Rules 36</p> <p>5 Appropriate Testing in an Era of Limited Resources: Practice and Policy Considerations 44</p> <p>6 Understanding Bias in Diagnostic Research 54</p> <p>Section 2: Trauma</p> <p>7 Cervical Spine Fractures 67</p> <p>8 Cervical Spine Fractures in Children 80</p> <p>9 Cervical Spine Fractures in Older Adults 86</p> <p>10 Blunt Abdominal Trauma 92</p> <p>11 Acute Knee Injuries 97</p> <p>12 Acute Ankle and Foot Injuries 102</p> <p>13 Blunt Head Injury in Children 107</p> <p>14 Blunt Head Injury 117</p> <p>15 Blunt Chest Trauma 128</p> <p>16 Occult Hip Fracture 135</p> <p>17 Blunt Soft Tissue Neck Trauma 141</p> <p>18 Occult Scaphoid Fractures 147</p> <p>19 Penetrating Abdominal Trauma 153</p> <p>20 Penetrating Trauma to the Extremities and Vascular Injuries 162</p> <p>Section 3: Cardiology</p> <p>21 Heart Failure 173</p> <p>22 Syncope 181</p> <p>23 Acute Coronary Syndrome 189</p> <p>24 Palpitations 205</p> <p>Section 4: Infectious Disease</p> <p>25 Bacterial Meningitis in Children 219</p> <p>26 Serious Bacterial Infections in Children Aged 1–3 Months 223</p> <p>27 Necrotizing Fasciitis 227</p> <p>28 Infective Endocarditis 232</p> <p>29 Pharyngitis 238</p> <p>30 Rhinosinusitis 243</p> <p>31 Pneumonia 248</p> <p>32 Urinary Tract Infection 255</p> <p>33 Sepsis 259</p> <p>34 Septic Arthritis 270</p> <p>35 Osteomyelitis 278</p> <p>36 Sexually Transmitted Diseases (STDs) 288</p> <p>37 Influenza 295</p> <p>38 Pediatric Fever in Children Aged 3-36 Months 303</p> <p>Section 5: Surgical and Abdominal Complaints</p> <p>39 Acute Nonspecific Nontraumatic Abdominal Pain 309</p> <p>40 Small Bowel Obstruction 317</p> <p>41 Acute Pancreatitis 324</p> <p>42 Acute Appendicitis 330</p> <p>43 Acute Cholecystitis 340</p> <p>44 Aortic Emergencies 347</p> <p>45 Ovarian Torsion 351</p> <p>Section 6: Urology</p> <p>46 Nephrolithiasis 359</p> <p>47 Testicular Torsion 365</p> <p>Section 7: Neurology</p> <p>48 Nontraumatic Subarachnoid Hemorrhage 375</p> <p>49 Acute Stroke 381</p> <p>50 Transient Ischemic Attack 387</p> <p>51 Seizure 394</p> <p>Section 8: Miscellaneous: Hematology Ophthalmology Pulmonology Rheumatology and Geriatrics</p> <p>52 Venous Thromboembolism 403</p> <p>53 Temporal Arteritis 415</p> <p>54 Intraocular Pressure 421</p> <p>55 Asthma 430</p> <p>56 Nontraumatic Back Pain 441</p> <p>57 Intravascular Volume Status 450</p> <p>58 Geriatric Syndromes 457</p> <p>Index 471</p>

<p>“One of the things I enjoyed most about this book was being able to examine actual sensitivities, specificities, and likelihood ratios of various decision instruments and diagnostic tests that I use daily. It was also  enlightening to learn several diagnostic strategies and decision instruments that I previously had not used.”  (<i>Annals of Emergency Medicine</i>, 1 August 2013)</p> <p>“This is an excellent resource for clinicians seeking to provide evidence-based care in emergency medicine. It is a comprehensive and reliable resource that helps reach a balance between overuse and underuse of diagnostic testing. The information is presented in a concise format that can be used during clinical encounters or for more exhaustive reviews of the literature surrounding a clinical question. As evidence-based emergency medicine is a rapidly changing and advancing field, this updated edition is certainly justified.”  (<i>Doody’s</i>, 7 June 2013)</p> <p> </p>

<p><strong>Jesse M. Pines</strong>, MD, MBA; Director, Center for Health Care Quality, Associate Professor Emergency Medicine and Health Policy, George Washington University, Washington, D.C., USA

The ability to differentiate patients who need emergent treatment from those who do not is a vital skill in Emergency Medicine. Solid history-taking, a thorough physical examination, appropriate use of laboratory tests and imaging, and sound clinical judgement are all keys to making these decisions. <p>However, determining which elements of the patient history, findings on the physical exam, and laboratory and imaging results to use can be challenging for emergency physicians and other providers in acute care settings. <i>Evidence-Based Emergency Care: Diagnostic Testing and Clinical Decision Rules</i> will equip you with the information you need to:</p> <ul> <li>Interpret and draw practical conclusions from published studies</li> <li>Understand both bottom-line conclusions and limitations of the various studies on diagnostic testing and clinical decision rules</li> <li>Learn how to make the best decision for your patient based on up-to-date evidence</li> </ul> <p>Part I provides an overview of the science of diagnostic testing, reviewing the process behind<br />the development of clinical decision rules and exploring the increasing pressures to improve the efficiency of diagnostic test utilization faced by emergency practitioners.</p> <p>Subsequent chapters focus on practical questions that have been addressed through original research studies. The authors provide a review of the current literature on a specific question, an interpretation of the clinical question in the context of the literature (focusing on the actual data behind the studies being referenced) and, finally, how the evidence can be most appropriately applied to the care of emergency patients. <br /><br />More than ever, you need <i>Evidence-Based Emergency Care: Diagnostic Testing and Clinical Decision Rules</i>, a trusted guide to the evidence on diagnostic testing in the emergency setting that will help you make</p>

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