This book will help to

care for patients in the first critical 24 hours of admission
manage patients using the most up-to-date evidence based approach
understand the most common emergency medical conditions and their underlying disease mechanisms
handle the patient’s assessment , understand the observations and manage their disease
easily obtain clear practical advice
know what to tell the patient and relatives using jargon-free language
access information on SARS, avian influenza and bio-terrorism

Contents:
Abbreviations

Introduction: Immediate assessment of the critically ill
ABCDE: Immediate assessment and intervention

Early warning: Track and Trigger

National Early Warning Score

Communication – NEWS and SBAR

Cardiology
Acute severe breathlessness

Cardiac failure

Heart muscle damage

Valvular disease

Rhythm disturbance

Types of heart failure

Left heart failure

Right heart failure

Congestive cardiac failure

Right heart failure and COPD

Diastolic heart failure

Clinical features and management of cardiac failure

Acute left ventricular failure

Acute on chronic congestive cardiac failure

Ischaemic heart disease

Chest pain

Acute coronary syndromes, NSTEMIs and Unstable Angina

Sudden cardiac death

Atrial fibrillation and arterial emboli

Causes of atrial fibrillation

Importance of atrial fibrillation

Complications of atrial fibrillation

Diagnosis of atrial fibrillation

Management of atrial fibrillation

Infective endocarditis

Drugs in the management of acute heart disease

Respiratory medicine
The breathless patient: the general approach

Respiratory failure

Type I and Type II respiratory failure

Principles of treatment

Acute severe asthma

Mechanisms

Assessment of acute severe asthma

Management of acute severe asthma

Chronic obstructive pulmonary disease

Mechanisms

Management of acute exacerbations of COPD

Non-invasive ventilation

Pneumonia

Assessment

The severity score in pneumonia: CURB-65

Management of pneumonia

Antibiotics

Spontaneous pneumothorax

Nursing the patient with a chest drain

Acute neurological problems
Ensuring the safety of the patient

Prioritising the initial management: GCS and ABCDE

Managing ‘medical’ and ‘neurological’ coma

Responding to neurological deterioration

Stroke and stroke-like emergencies

Cerebral infarction

Transient ischaemic attacks

Intracerebral haemorrhage

Subarachnoid haemorrhage

Subdural haemorrhage

Extradural haemorrhage

Nursing the patient with a stroke: the first 24 h

Meningococcal meningitis

Acute severe headache

Subarachnoid haemorrhage

Lumbar puncture

Sudden loss of consciousness: faints and fits

The basic mechanisms: syncope

The basic mechanisms: epileptic seizures

Pseudoseizures (non-epileptic seizures)

Acute paralysis of the lower limbs

Spinal cord compression

Guillain–Barré syndrome

Gastroenterology
Nausea and vomiting underlying mechanisms

Nausea and vomiting in acute medical conditions

Acute upper gastrointestinal haemorrhage

Management of upper gastrointestinal haemorrhage

Portal hypertension and the management of oesophageal varices

Acute liver failure and hepatic encephalopathy

Acute jaundice

Acute abdominal pain

Acute diarrhoea: sources and courses

Infective diarrhoea

Clostridium difficile diarrhoea

Infective diarrhoea versus acute ulcerative colitis

Medical conditions presenting with gastrointestinal symptoms

Diabetic complications
Diabetes on the Acute Medical Unit: the general approach

Normal blood sugar control and the nature of diabetes

An overview of Type I and Type II diabetes

Acute medical conditions associated with diabetes

Diabetic renal disease

Diabetic neuropathy

Cardiovascular disease

Cerebrovascular disease

Peripheral vascular disease

Blood sugar control in adverse medical situations

Variable Rate Intravenous Insulin Infusion (VRIII) or GKI

DIGAMI regimen

Diabetic Keto Acidosis (DKA)

Hyperosmolar non-ketotic diabetic coma (HONK)

Hypoglycaemia

Infective complications in diabetes: the acute diabetic foot

Thromboembolic disease
Thrombosis and thromboembolisation

Mechanisms

Superficial thrombophlebitis

Deep vein thrombosis

Pulmonary thromboembolism

Tests to identify thromboembolic disease

Management of pulmonary thromboembolism

Nursing the patient with a suspected DVT

Other causes of a swollen painful leg

Cellulitis

Necrotising fasciitis

Management of a DVT

Anticoagulation therapy

Deliberate self-harm, alcohol and substance abuse
Deliberate self-harm

General principles

Care of the unconscious patient: ABCDE

The patient who refuses treatment

Specific overdoses

Benzodiazepines

Paracetamol poisoning

Antidepressant overdose

Carbon monoxide poisoning

Alcohol abuse

Acute alcohol-withdrawal syndrome

Cocaine 303 Ecstasy

Heroin abuse

Needle stick injuries

Hospital-acquired methicillin-resistant Staphylococcus aureus infections

Violent incidents

The ‘social admission’
Common errors and omissions in the admission of elderly patients

Taking a history from the patient

Taking a history from a third party

Falls

The cause of falls

Assessment after a fall

Immobility

Immediate safety of the patient: ABCDE

Assessing the cause: establish the full history

Delirium

Dementia

Nursing home admissions

Ethical issues and the elderly sick

The emergency admission of patients with a terminal disease

Multisystem failure
Shock: the basic mechanisms

Cardiogenic shock

Hypovolaemic shock

Redistributive (low-resistance) shock

Acute severe hypotensive collapse

The importance of immediate resuscitation

Ensuring adequate oxygen delivery to vital organs

Oxygen therapy

The blood pressure

Inserting a CVP line

Fluid challenge

This updated edition

contains improved sections on stroke care, diabetes and sepsis,
introduces the NEWS 2 observation chart
has revised its case histories in line with current practice