Dedication |
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Preface |
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Acknowledgements |
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Section I GENERAL MEDICAL EMERGENCIES |
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Cardiopulmonary Resuscitation |
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2 | |
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13 | |
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14 | |
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ST elevation myocardial infarction |
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14 | |
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Non-ST elevation myocardial infarction, unstable angina and non-cardiac chest pain |
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18 | |
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Venous thromboembolism with pulmonary embolus |
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22 | |
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Venous thromboembolism with deep vein thrombosis |
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26 | |
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28 | |
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29 | |
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30 | |
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Abdominal causes of chest pain |
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30 | |
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Musculoskeletal and chest wall pain |
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31 | |
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31 | |
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36 | |
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36 | |
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Community-acquired pneumonia |
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39 | |
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Chronic obstructive pulmonary disease |
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41 | |
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42 | |
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45 | |
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45 | |
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Acute upper airway obstruction |
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47 | |
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Upper Gastrointestinal Haemorrhage |
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50 | |
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Diabetic Coma and Pre-coma |
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51 | |
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52 | |
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Hyperglycaemic, hyperosmolar non-ketotic syndrome |
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53 | |
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The Patient with an Altered Conscious Level |
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54 | |
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The collapsed or unconscious patient |
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54 | |
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58 | |
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Alcohol-related medical problems |
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62 | |
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The patient with an altered conscious level and smelling of alcohol |
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63 | |
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64 | |
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Acute Neurological Conditions |
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65 | |
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65 | |
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67 | |
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Generalized convulsive status epilepticus |
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69 | |
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Transient ischaemic attack |
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71 | |
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73 | |
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75 | |
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75 | |
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77 | |
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78 | |
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78 | |
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Acute narrow-angle glaucoma |
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79 | |
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Hypertensive encephalopathy |
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79 | |
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80 | |
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Tension (muscle contraction) headache |
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81 | |
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82 | |
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Disease in other cranial structures |
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82 | |
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82 | |
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83 | |
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83 | |
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84 | |
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84 | |
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85 | |
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85 | |
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86 | |
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87 | |
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87 | |
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Allergic or Immunological Conditions |
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87 | |
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87 | |
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88 | |
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89 | |
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91 | |
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Blistering (vesicobullous) conditions |
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91 | |
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Pruritus (itching conditions) |
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93 | |
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94 | |
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97 | |
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97 | |
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98 | |
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Disordered behaviour in the elderly |
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99 | |
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100 | |
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102 | |
Section II ACIDBASE, ELECTROLYTE AND RENAL EMERGENCIES |
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106 | |
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Arterial blood gas interpretation |
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106 | |
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108 | |
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110 | |
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112 | |
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113 | |
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114 | |
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115 | |
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117 | |
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118 | |
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119 | |
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121 | |
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122 | |
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123 | |
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124 | |
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125 | |
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127 | |
Section III INFECTIOUS DISEASE AND FOREIGN TRAVEL EMERGENCIES |
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Febrile Neutropenic Patient |
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130 | |
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131 | |
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Gastrointestinal Tract Infection |
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132 | |
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Sexually Transmitted Diseases |
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134 | |
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Human Immunodeficiency Virus (HIV) Infection |
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135 | |
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Needlestick and Sharps Incidents |
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138 | |
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Inoculation Incident with HIV Risk |
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138 | |
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Inoculation Incident with Hepatitis B Risk |
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139 | |
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Common Imported Diseases of Travellers |
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140 | |
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141 | |
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142 | |
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143 | |
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143 | |
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144 | |
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SARS and bird 'flu (avian influenza) |
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144 | |
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145 | |
Section IV TOXICOLOGY |
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Acute Poisoning: General Principles |
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148 | |
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152 | |
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152 | |
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155 | |
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Tricyclic antidepressants |
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157 | |
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158 | |
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159 | |
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160 | |
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161 | |
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163 | |
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164 | |
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166 | |
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Calcium-channel blocking drugs |
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166 | |
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167 | |
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169 | |
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169 | |
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170 | |
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171 | |
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172 | |
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173 | |
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174 | |
Section V TOXINOLOGY EMERGENCIES |
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178 | |
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Viper (adder) snake bites |
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178 | |
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179 | |
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182 | |
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183 | |
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185 | |
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186 | |
Section VI ENVIRONMENTAL EMERGENCIES |
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188 | |
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188 | |
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189 | |
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191 | |
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193 | |
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193 | |
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Decompression illness with barotrauma |
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194 | |
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Electrical Burns, Electrocution and Lightning Strike |
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196 | |
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197 | |
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Low-voltage electrocution |
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197 | |
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High-voltage electrocution |
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198 | |
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199 | |
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201 | |
Section VII SURGICAL EMERGENCIES |
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204 | |
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210 | |
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211 | |
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211 | |
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216 | |
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Vascular injury in the neck |
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216 | |
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217 | |
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217 | |
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217 | |
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218 | |
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218 | |
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219 | |
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Rib and sternum fractures |
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219 | |
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220 | |
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222 | |
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223 | |
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224 | |
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Penetrating chest injuries |
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224 | |
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Abdominal and Pelvic Trauma |
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226 | |
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226 | |
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Penetrating abdominal trauma |
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228 | |
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229 | |
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231 | |
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Penetrating renal injuries |
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232 | |
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Bladder and urethral injuries |
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232 | |
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Additional Orthopaedic Injuries in Multiple Trauma |
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233 | |
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233 | |
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Thoracic and lumbosacral spine injury |
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233 | |
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235 | |
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236 | |
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236 | |
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242 | |
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245 | |
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245 | |
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249 | |
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251 | |
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251 | |
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252 | |
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252 | |
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|
252 | |
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The stable patient with an acute abdomen |
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253 | |
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Causes of acute abdominal pain |
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255 | |
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255 | |
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257 | |
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258 | |
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258 | |
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259 | |
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Inflammatory bowel disease |
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|
259 | |
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260 | |
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260 | |
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Ruptured abdominal aortic aneurysm |
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261 | |
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262 | |
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263 | |
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263 | |
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264 | |
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265 | |
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266 | |
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267 | |
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267 | |
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268 | |
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269 | |
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Retroperitoneal haemorrhage |
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|
269 | |
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|
269 | |
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Medical disorders presenting with acute abdominal pain |
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|
270 | |
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|
271 | |
Section VIII ORTHOPAEDIC EMERGENCIES |
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Injuries to the Shoulder and Upper Arm |
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|
274 | |
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Fractures of the clavicle |
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|
274 | |
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Acromioclavicular dislocation |
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|
274 | |
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Sternoclavicular dislocation |
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|
275 | |
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|
276 | |
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Anterior dislocation of the shoulder |
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|
276 | |
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Posterior dislocation of the shoulder |
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|
278 | |
|
Fractures of the upper humerus |
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|
279 | |
|
Fractures of the shaft of the humerus |
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|
280 | |
|
Injuries to the Elbow and Forearm |
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|
281 | |
|
Supracondylar fracture of the humerus |
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|
281 | |
|
Condylar and epicondylar fractures of the humerus |
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|
282 | |
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|
283 | |
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|
284 | |
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Fractures of the olecranon |
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|
284 | |
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Fractures of the radial head |
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|
285 | |
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Fractures of the radial and ulnar shafts |
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|
286 | |
|
Injuries to the Wrist and Hand |
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|
286 | |
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|
286 | |
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|
290 | |
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Barton's fracturedislocation |
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|
291 | |
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Distal radial fractures in children |
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|
291 | |
|
Fractures of the scaphoid |
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|
292 | |
|
Dislocations of the carpus |
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|
293 | |
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Fractures of the other carpal bones |
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|
294 | |
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Fractures of the thumb metacarpal |
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|
295 | |
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Dislocation of the thumb metacarpal |
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|
296 | |
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Rupture of the ulnar collateral ligament |
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|
296 | |
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Fractures of the other metacarpals |
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|
297 | |
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Fractures of the proximal and middle phalanges |
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|
298 | |
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Fractures of the distal phalanges |
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|
298 | |
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Dislocation of the phalanges |
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|
299 | |
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Flexor tendon injuries in the hand |
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|
300 | |
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Extensor tendon injuries in the hand |
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|
300 | |
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301 | |
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301 | |
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|
302 | |
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Thoracic and Lumbar Spine Injuries |
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|
302 | |
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|
302 | |
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Injuries to the Hip and Upper Femur |
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|
302 | |
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|
302 | |
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Fractures of the neck of the femur |
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|
303 | |
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Fractures of the shaft of the femur |
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|
304 | |
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Injuries to the Lower Femur, Knee and Upper Tibia |
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|
305 | |
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Supracondylar and condylar fractures of the femur |
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|
305 | |
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Fractures of the patella and injury to the quadriceps apparatus |
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|
306 | |
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Dislocation of the patella |
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|
307 | |
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Soft-tissue injuries of the knee |
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|
308 | |
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|
310 | |
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Fractures of the tibial condyles |
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|
310 | |
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Injuries to the Lower Tibia, Ankle and Foot |
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|
310 | |
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Fractures of the shaft of the tibia |
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|
310 | |
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Isolated fracture of the fibula |
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|
311 | |
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312 | |
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313 | |
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|
314 | |
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Fractures and dislocation of the talus |
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|
314 | |
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Fractures of the calcaneus |
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|
315 | |
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Rupture of the tendo Achillis |
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|
316 | |
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|
316 | |
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Metatarsal injuries and tarsometatarsal dislocations |
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|
317 | |
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Fractures of the phalanges of the foot |
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|
317 | |
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Dislocations of the phalanges of the foot |
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|
318 | |
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|
318 | |
Section IX MUSCULOSKELETAL AND SOFT-TISSUE EMERGENCIES |
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|
320 | |
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|
323 | |
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Crush injuries and compartment syndrome |
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|
326 | |
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|
327 | |
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328 | |
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329 | |
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329 | |
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330 | |
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330 | |
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331 | |
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Rotator cuff tear: supraspinatus rupture |
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332 | |
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332 | |
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|
333 | |
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Tennis and golfer's elbow |
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333 | |
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333 | |
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De Quervain's stenosing tenosynovitis |
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333 | |
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334 | |
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334 | |
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335 | |
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335 | |
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Mechanical (indirect) back trauma |
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|
335 | |
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Severe or atypical, non-traumatic back pain |
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|
336 | |
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Mild to moderate, non-traumatic back pain |
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|
337 | |
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|
338 | |
Section X PAEDIATRIC EMERGENCIES |
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|
340 | |
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Cardiopulmonary Resuscitation |
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|
343 | |
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|
350 | |
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|
351 | |
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|
352 | |
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353 | |
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354 | |
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|
356 | |
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Croup (acute laryngotracheobronchitis) |
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|
356 | |
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Epiglottitis (supraglottitis) |
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|
357 | |
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|
358 | |
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Abdominal Pain, Diarrhoea and Vomiting |
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|
359 | |
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|
359 | |
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Diarrhoea, vomiting and dehydration |
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|
360 | |
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365 | |
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Seizures and Febrile Convulsions |
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|
367 | |
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367 | |
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369 | |
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|
370 | |
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|
372 | |
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Cot Death and Sudden Infant Death Syndrome (SIDS) |
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|
373 | |
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Child Abuse (Non-accidental Injury) |
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|
375 | |
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|
377 | |
Section XI OBSTETRIC AND GYNAECOLOGICAL EMERGENCIES |
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Gynaecological Assessment and Management |
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|
380 | |
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|
380 | |
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Gynaecological Causes of Acute Abdominal Pain |
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|
380 | |
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Ruptured ectopic pregnancy |
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|
381 | |
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Pelvic inflammatory disease (acute salpingitis) |
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|
383 | |
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|
384 | |
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Torsion of an ovarian tumour |
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|
385 | |
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|
385 | |
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Bleeding in Early Pregnancy |
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|
385 | |
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|
385 | |
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|
387 | |
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Conditions in Late Pregnancy |
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|
388 | |
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|
388 | |
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|
388 | |
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Pre-eclampsia and eclampsia |
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|
389 | |
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|
390 | |
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|
391 | |
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Cardiopulmonary resuscitation in late pregnancy |
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|
393 | |
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|
394 | |
|
Post-coital contraception |
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|
394 | |
|
Missed oral contraceptive pill |
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|
395 | |
|
Domestic violence to females |
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|
396 | |
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|
397 | |
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|
398 | |
Section XII ENT EMERGENCIES |
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Traumatic Conditions of the Ear |
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|
402 | |
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Subperichondrial haematoma |
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|
402 | |
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|
402 | |
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Foreign body in the external ear |
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|
403 | |
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|
403 | |
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|
403 | |
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Non-traumatic Conditions of the Ear |
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|
404 | |
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|
404 | |
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Furunculosis of the external ear |
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|
405 | |
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|
405 | |
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|
406 | |
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|
406 | |
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|
407 | |
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Traumatic Conditions of the Nose |
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|
408 | |
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|
408 | |
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|
408 | |
|
Non-traumatic Conditions of the Nose |
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|
409 | |
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|
409 | |
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Traumatic Conditions of the Throat |
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|
411 | |
|
Non-traumatic Conditions of the Throat |
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|
412 | |
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|
412 | |
|
Quinsy (peritonsillar abscess) |
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|
412 | |
|
Foreign body in the pharynx |
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|
412 | |
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|
413 | |
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|
414 | |
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|
414 | |
Section XIII OPHTHALMIC EMERGENCIES |
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|
416 | |
|
Topical Ophthalmic Preparations |
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|
416 | |
|
Traumatic Conditions of the Eye |
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|
417 | |
|
Periorbital haematoma ('black eye') |
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|
417 | |
|
Subconjunctival haematoma |
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|
418 | |
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|
418 | |
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|
418 | |
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Chemical burns to the eye |
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|
419 | |
|
Conjunctival foreign body |
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|
419 | |
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|
420 | |
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|
421 | |
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|
421 | |
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|
421 | |
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Penetrating trauma to the eye |
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|
422 | |
|
Conditions Affecting the Eyelids |
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|
423 | |
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|
423 | |
|
External stye (hordeolum) |
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|
424 | |
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|
424 | |
|
Meibomian cyst (chalazion) |
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|
424 | |
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|
424 | |
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|
425 | |
|
Basal cell carcinoma (rodent ulcer) |
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|
425 | |
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Ophthalmic shingles (herpes zoster ophthalmicus) |
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|
425 | |
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|
426 | |
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|
426 | |
|
Acute episcleritis and scleritis |
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|
427 | |
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|
428 | |
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|
428 | |
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|
429 | |
|
Sudden Loss of Vision in the Uninflamed Eye |
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|
429 | |
|
Central retinal artery occlusion |
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|
430 | |
|
Central retinal vein occlusion |
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|
431 | |
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|
431 | |
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|
431 | |
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|
432 | |
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|
432 | |
Section XIV MAXILLOFACIAL AND DENTAL EMERGENCIES |
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|
Traumatic Conditions of the Face and Mouth |
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|
434 | |
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|
434 | |
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|
434 | |
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|
436 | |
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|
436 | |
|
Fracture of the zygomatic or malar complex |
|
|
437 | |
|
'Blow-out' fracture of the orbital floor |
|
|
438 | |
|
Middle-third of face fractures |
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|
439 | |
|
Non-traumatic Conditions of the Mouth |
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|
440 | |
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|
440 | |
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|
440 | |
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|
441 | |
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|
441 | |
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|
442 | |
Section XV PSYCHIATRIC EMERGENCIES |
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|
444 | |
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|
445 | |
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Alcohol and Drug Dependency and Abuse |
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|
447 | |
|
Alcohol and drug withdrawal |
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|
447 | |
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|
447 | |
|
Opiate and intravenous drug addiction |
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|
448 | |
|
Benzodiazepine, barbiturate and solvent addiction |
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|
449 | |
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|
450 | |
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|
451 | |
Section XVI ADMINISTRATIVE AND LEGAL ISSUES |
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|
Excellent Habits of the Good Emergency Department Doctor |
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|
454 | |
|
The excellent Emergency Department doctor |
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|
454 | |
|
Emergency Department medical records |
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|
454 | |
|
Communicating with the general practitioner |
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|
456 | |
|
Risk management and incident reporting |
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|
456 | |
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|
458 | |
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|
459 | |
|
Consent, Competence and Refusal of Treatment |
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|
460 | |
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|
460 | |
|
Refusal of treatment and discharge against medical advice |
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|
461 | |
|
The Police, Coroner and Attending Court |
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|
462 | |
|
Police request for patient information |
|
|
462 | |
|
Police request to interview a patient |
|
|
462 | |
|
Police request for an alcohol breath test or blood sample |
|
|
463 | |
|
Request for a police medical statement |
|
|
463 | |
|
|
464 | |
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|
464 | |
|
Retrieval and Inter-hospital Transfer |
|
|
465 | |
|
Mass Casualty Disaster and the Major Incident |
|
|
466 | |
|
|
469 | |
Glossary |
|
471 | |
Appendix: Critical care areas drug infusion guideline |
|
477 | |
Index |
|
485 | |