About the Book

The popular handbook.
Fully revised and updated.
Presents all aspects of emergency situations.
Covers topics on pediatrics, dermatology, ENT, ophthalmology, gynecology, psychiatry, gastroenterology, respiratory and cardiovascular, neurology, hematology, urology, immunology, oncology, forensic and community medicine, and surgery.
Must-have reference for Family Physician and Hospital Residents on emergency duty.

About the Author

Aspi F Golwalla MD FACC FCPs FCCP Sharukh A Golwalla md(Med) DM(Card) FCCP

Table of Contents:
Contents 1. Pediatric Emergencies 1 • Neonatal Emergencies 1 • General Pediatric Emergencies 22 • Accidental Poisoning in Children 45 • Neonatal Critical Care 46 • Neonatal Jaundice 47 • Kala-azar (Visceral Leishmaniasis) 49 • Dengue Illness 50 2. Dermatologic Emergencies 53 • Infections 54 • Autoimmune Disorders 58 • Toxic Disorders 62 • Allergic Reactions Anaphylaxis and Angioedema 68 • Drug Reactions 69 3. Emergencies in Ear, Nose and Throat 73 • Foreign Bodies in the External Auditory Canal 73 • Furunculosis of the External Auditory Canal 74 • Malignant Otitis Externa 76 • Traumatic Perforation of the Ear Drum 77 • Bleeding from the Ear 78 • Acute Otitis Media 78 • Acute Mastoiditis and Mastoid Abscess 79 • Earache 80 • Sudden Deafness 80 • Meniere’s Disease 82 • Epistaxis 83 • Foreign Body in the Nose 84 • Cerebrospinal Fluid Rhinorrhoea 85 • Fracture of Nasal Bone 86 • Laryngeal Emergencies 87 Prelims.indd 9 18-05-2015 11:19:06 x A Handbook of Emergencies • Cafe Coronary 88 • Foreign Body in the Bronchus 88 • Burns due to Acid or Alkali Ingestion 89 • Foreign Body in the Pharynx 89 • Foreign Body in Oesophagus 90 • Temporomandibular Joint Dislocation 91 • Trismus (Not Due to Tetanus) 92 4. Ophthalmic Emergencies 93 • Sudden Loss of Vision 93 • Painful Ophthalmic Emergencies 94 • Acute Conjunctivitis 94 • Panophthalmitis 95 • Trachoma 96 • Ophthalmia Neonatorum 96 • Corneal Ulcer 97 • Iridocyclitis 98 • Episcleritis and Scleritis 100 • Acute Orbital Cellulitis 102 • Cavernous Sinus Thrombosis 102 • Acute Dacryocystitis 103 • Vitreous Haemorrhage 103 • Central Retinal Artery Occlusion 104 • Retinoblastoma (Glioma) 105 • Optic Neuritis 106 • Malignant Exophthalmos 107 • Detachment of the Retina 107 • Foreign Bodies (Extraocular) 108 • Intraocular Foreign Body 109 • Chemical Injury and Burns of the Cornea and Conjunctiva 110 • Perforating Injuries 111 • Effects of Contusions 112 • Hyphaema (Blood in the Anterior Chamber) 113 • Acute Congestive Glaucoma 114 • Lens-induced Glaucoma 115 Prelims.indd 10 18-05-2015 11:19:06 Contents xi 5. Emergencies in Gynaecology 116 • Emergencies with Profuse External Haemorrhage 116 • Injuries of the Vulva, Vagina and Perineum 120 • Haemorrhage from Tumours of Uterus and Ovaries 121 • Emergencies with Obvious Severe Intraperitoneal Haemorrhage 123 • Emergencies Associated with Obvious Infection 128 • Rupture of a Pyosalpinx, Tubo-ovarian Abscess or an Infected Ovarian Cyst 130 • Emergencies with Acute Abdominal Conditions of Doubtful Etiology 132 • Dysmenorrhoea 134 • Torsion of an Ovarian Tumour, Hydrosalpinx or Subserous Fibroid 135 • Rupture of a Chocolate Cyst of Ovary 136 • Rupture of an Ovarian Tumour 137 • Red Degeneration of Fibroid of the Uterus 138 • Acute Retention of Urine 139 6. Psychiatric Emergencies 141 • Violence 142 • Suicidal Behaviour 145 • Victims of Disaster 146 • Grief 147 • Rape Survivor 148 • Anxiety and Panic Disorders 149 • Stupor 151 • Emergencies Associated with Substance Use Disorders 152 • Alcohol 153 • Opioids 155 • Sedatives and Hypnotics (Barbiturates, Benzodiazepines, Methaqualone, etc.) 157 • Cannabinoids 159 • Central Nervous System Stimulants 160 • Hallucinogens 161 • Psychiatric Manifestations of Physical Disorders 163 Prelims.indd 11 18-05-2015 11:19:06 xii A Handbook of Emergencies 7. Gastrointestinal, Liver and Biliary Tract Emergencies 165 • Oesophageal Disorders 165 • Acute Gatsrointestinal Bleeding (Haematemesis and Melaena) 166 • Acute Lower GI Haemorrhage 171 • Acute Abdominal Pain 173 • Acute Appendicitis 174 • Acute Diverticulitis 175 • Perforated Peptic Ulcer 176 • Acute Severe Ulcerative Colitis 176 • Acute Pancreatitis 177 • Acute GI Vascular Disorders 179 • Acute Non-specific Mesenteric Lymphadenitis 181 • Tuberculous Lymphadenitis 181 • Abdominal Distension 182 • Intestinal Obstruction 183 • Emergencies in Diseases of the Biliary Tract 184 • Liver Disorders 186 • Acute Liver Failure 190 8. Respiratory Emergencies 195 • Massive Haemoptysis 195 • Acute Severe Asthma 197 • Acute Respiratory Failure 200 • Acute Lung Injury (ALI) and Acute Respiratory Distress Syndrome (ARDS) 202 • Acute Exacerbation of COPD 206 • Pneumonia 210 • Massive Pulmonary Collapse 212 • Spontaneous Pneumothorax 213 • Massive Pleural Effusion 214 • Acute Laryngeal Obstruction 215 9. Cardiovascular Emergencies 218 • Cardiac Arrest 218 • Unstable Angina/Nstemi 223 • ST Elevation Myocardial Infarction 226 Prelims.indd 12 18-05-2015 11:19:06 Contents xiii • Cardiac Arrhythmias 230 • Bradyarrhythmias 235 • Acute Left Ventricular Failure with Pulmonary Oedema 237 • Hypertensive Crises 238 • Acute Massive Pulmonary Embolism 239 • Cardiac Tamponade 241 • Acute Aortic Regurgitation 243 • Peripheral Vascular Emergencies 243 • Severe Primary Antiphospholipid Syndrome 246 • Syncope 246 10. Neurological Emergencies 249 • Raised Intracranial Pressure 249 • Ischaemic Cerebrovascular Disease 253 • Intracerebral Haemorrhage (ICH) 261 • Acute Subarachnoid Hemorrhage (SAH) 262 • Status Epilepticus (SE) 265 • Antiepileptic Drugs (AEDs) 268 • Intracranial Infections 269 • Acute Neuromuscular Emergencies 277 • Acute Spinal Cord Disturbance (Myelopathy) 293 11. Emergencies in Haematology 296 • Anaemia 296 • Haemoglobinuria 298 • Sickle Cell Crisis 299 • Bleeding Disorders 300 • Disseminated Intravascular Coagulation (DIC) 302 • Transfusion Reactions 303 • Bone Marrow Failure 305 • Neutropenia (Agranulocytosis) 307 • Pure Red Cell Aplasia 308 12. Endocrine Emergencies 309 • Thyroid Crisis (Thyroid Storm) 309 • Gastrointestinal Bleeding and Cold Exposure 310 • Myxoedema Coma 311 • Acute Adrenal Insufficiency 313 Prelims.indd 13 18-05-2015 11:19:06 xiv A Handbook of Emergencies • Diabetic Ketoacidosis 314 • Lactic Acidosis in a Diabetic 317 • Hypoglycemia 317 • Hypercalcemic Crisis 319 • Hypocalcemic Tetany 320 • Pituitary Apoplexy 321 • Cranial Diabetes Insipidus 322 • Hypertensive Crisis in Pheochromocytoma 323 • Pituitary Crisis or Coma 323 • Hyponatremia Secondary to SIADH 324 13. Emergencies in Urogenital Diseases 326 • Hematuria 326 • Renal Colic 328 • Acute Retention of Urine 330 • Scrotal Pain 333 • Paraphimosis 334 • Acute Nephritic Syndrome 335 • Rapidly Progressive Renal Failure 336 • Acute Renal Failure 337 14. Emergencies in Tropical and Infectious Diseases 341 • Malaria 341 • Typhoid Fever 344 • Fulminant Amoebic Infection 345 • Acute Bacillary Dysentery 347 • Cholera 348 • Acute Gastroenteritis (Food Poisoning) 350 • Clostridium difficile Infection 351 • Tetanus 352 • Leptospirosis 355 • Dengue 356 • Chickungunya Fever 357 • Effects of Heat 358 • Rabies 359 • Measles 359 • Chickenpox 361 • Whooping Cough 362 Prelims.indd 14 18-05-2015 11:19:06 Contents xv • Mumps 363 • Diphtheria 364 • Infectious Mononucleosis 365 • Acute Disseminated Miliary Tuberculosis 367 15. Shock 368 • Hypovolemic Shock 368 • Cardiogenic Shock 369 • Obstructive Shock 371 • Septic Shock 371 • Systemic Inflammatory Response Syndrome 374 • Anaphylactic Shock 375 16. Rheumatological Emergencies 377 • Emergencies Involving Disease Processes 377 • Emergencies Involving Specific Organs 379 • Emergencies Due to Drugs 381 17. Febrile Emergencies 383 • Sepsis Syndrome 383 • Febrile Neutropenia 383 • Fever in Immunocompromised Host 384 • Thyroid Storm 384 • Pheochromocytoma 385 • Heat Stroke 385 • Cerebral Hemorrhage 387 18. Emergencies in HIV Infection 388 • Emergencies due to Opportunistic Infections (OI) 388 • Emergencies due to Antiretroviral Therapy 391 19. Emergencies Due to Fluid and Electrolyte and Acid-Base Disturbances 393 • Disorders of Water and Electrolyte Metabolism 393 • Water 393 • Sodium 394 • Potassium 396 • Calcium 398 Prelims.indd 15 18-05-2015 11:19:06 xvi A Handbook of Emergencies • Magnesium 399 • Acid-Base Disturbances 400 20. Acute Poisoning 403 • Approach to a Case of Poisoning 403 • Poisonous Substances 413 21. Venomous Bites and Stings 453 • Snake Bite 453 • Scorpion Stings 457 • Spider Bites 458 • Bee and Wasp Stings 458 • Fish Stings 459 22. Emergencies Due to Physical Causes 461 • Heat Illness 461 • Cold-induced Illness 461 • High Altitude-induced illness 464 • Drowning and Near-Drowning 465 • Diving and Dysbaric Emergencies 468 • Electrical Injuries and Lightning 470 23. Emergency Management in Burns 473 • Causes of Burn 473 • Pathophysiology 474 • Treatment 475 • Management 478 24. Infections in the Immunocompromised Patient 485 • Main Groups at Risk of Infection 485 • Factors Associated with Increased Risk of Infection 485 • Diagnosis 486 • Investigations 487 • Management of Infection 487 • HIV Infection 488 25. Emergencies in Cancer 491 • Spinal Cord Compression 491 • Superior Vena Caval Syndrome 492 Prelims.indd 16 18-05-2015 11:19:06 Contents xvii • Cardiac Tamponade 492 • Pulmonary Complications 493 • Infections 494 • Metabolic Complications 494 • Haemorrhage 495 • Renal Failure 495 • GI Complications 496 26. Postoperative Medical Emergencies 497 • Fever 497 • Wound Infection 499 • Intra-abdominal Sepsis 500 • Urinary Tract Infection 502 27. Emergencies in Industrial Medicine 504 • Chemical Hazards 504 • Acute Allergic Episodes 509 28. Medical Emergencies in the Air 512 • Effects of Altitude 512 • Medical Fitness to Fly 514 29. Emergency Medical Procedures 517 • Venous Cutdown 517 • Insertion of Nasogastric Tube 518 • Lumbar Puncture 519 • Use of Self-retaining Foley Urinary Catheter 521 • Tracheostomy 523 Appendix 525 • Normal Values of CSF 525 • Normal Haematological Values 525 • Coagulation Tests 525 • Serum Levels of Common Emergency Drugs 526 Index 539 Prelims.indd 17 18-05-2015 11:19:06