Table of Contents

1.0 SIGNS, SYMPTOMS, AND PRESENTATIONS 1.1 Abnormal Vital Sign Physiology 1.1.1 Hypothermia 1.1.2 Fever 1.1.3 Bradycardia 1.1.4 Tachycardia 1.1.5 Apnea 1.1.6 Tachypnea 1.1.7 Hypoxia 1.1.8 Hypotension 1.1.9 Hypertension 1.2 Pain 1.2.1 Pain (unspecified) 1.2.2 Headache (See 12.3) 1.2.3 Eye pain 1.2.4 Chest pain 1.2.5 Abdominal pain 1.2.6 Pelvic pain 1.2.7 Back pain 1.3 General 1.3.1 Altered mental status 1.3.2 Anuria 1.3.3 Anxiety 1.3.4 Ascites 1.3.5 Ataxia 1.3.6 Auditory disturbances 1.3.7 Bleeding 1.3.8 Congestion/Rhinorrhea 1.3.9 Constipation 1.3.10 Cough 1.3.11 Crying/Fussiness 1.3.12 Cyanosis 1.3.13 Dehydration 1.3.14 Diarrhea 1.3.15 Dysmenorrhea 1.3.16 Dysphagia 1.3.17 Dysuria 1.3.18 Edema 1.3.19 Failure to thrive 1.3.20 Fatigue/Malaise 1.3.21 Feeding problems 1.3.22 Hematemesis 1.3.23 Hematuria 1.3.24 Hemoptysis 1.3.25 Hiccup 1.3.26 Jaundice 1.3.27 Joint swelling 1.3.28 Lethargy 1.3.29 Lightheadedness/Dizziness 1.3.30 Limp 1.3.31 Lymphadenopathy 1.3.32 Mechanical and indwelling devices, complications 1.3.33 Nausea/Vomiting 1.3.34 Occupational exposure 1.3.35 Palpitations 1.3.36 Paralysis 1.3.37 Paresthesia/Dysesthesia 1.3.38 Poisoning 1.3.39 Pruritus 1.3.40 Rash 1.3.41 Rectal bleeding 1.3.42 Shock 1.3.43 Shortness of breath 1.3.44 Sore throat 1.3.45 Stridor 1.3.46 Syncope 1.3.47 Tinnitus 1.3.48 Tremor 1.3.49 Urinary incontinence 1.3.50 Urinary retention 1.3.51 Vaginal bleeding 1.3.52 Vaginal discharge 1.3.53 Vertigo 1.3.54 Visual disturbances 1.3.55 Weakness 1.3.56 Wheezing 2.0 ABDOMINAL AND GASTROINTESTINAL DISORDERS 2.1 Abdominal Wall 2.1.1 Hernias 2.2 Esophagus 2.2.1 Infectious disorders 2.2.1.1 Candida (See 4.4.2.1, 7.5.7) 2.2.1.2 Viral esophagitis 2.2.2 Inflammatory disorders 2.2.2.1 Esophagitis 2.2.2.2 Gastroesophageal reflux (GERD) 2.2.2.3 Toxic effects of caustic (See 17.1.14) 2.2.2.3.1 Acid 2.2.2.3.2 Alkali 2.2.3 Motor abnormalities 2.2.3.1 Spasms 2.2.4 Structural disorders 2.2.4.1 Boerhaave’s syndrome 2.2.4.2 Diverticula 2.2.4.3 Foreign body 2.2.4.4 Hernias 2.2.4.5 Mallory-Weiss syndrome 2.2.4.6 Stricture and stenosis 2.2.4.7 Tracheoesophageal fistula 2.2.4.8 Varices 2.2.5 Tumors 2.3 Liver 2.3.1 Cirrhosis 2.3.1.1 Alcoholic 2.3.1.2 Biliary obstructive 2.3.1.3 Drug-induced 2.3.2 Hepatorenal failure 2.3.3 Infectious disorders 2.3.3.1 Abscess 2.3.3.2 Hepatitis 2.3.3.2.1 Acute 2.3.3.2.2 Chronic 2.3.4 Tumors 2.4 Gall Bladder and Biliary Tract 2.4.1 Cholangitis 2.4.2 Cholecystitis 2.4.3 Cholelithiasis/Choledocholithiasis 2.4.4 Tumors 2.5 Pancreas 2.5.1 Pancreatitis 2.5.2 Tumors 2.6 Peritoneum 2.6.1 Spontaneous bacterial peritonitis 2.7 Stomach 2.7.1 Infectious disorders 2.7.2 Inflammatory disorders 2.7.2.1 Gastritis 2.7.3 Peptic ulcer disease 2.7.3.1 Hemorrhage 2.7.3.2 Perforation 2.7.4 Structural disorders 2.7.4.1 Congenital hypertrophic pyloric stenosis 2.7.4.2 Foreign body 2.7.5 Tumors 2.8 Small Bowel 2.8.1 Infectious disorders 2.8.2 Inflammatory disorders 2.8.2.1 Regional enteritis/Crohn’s disease 2.8.3 Motor abnormalities 2.8.3.1 Obstruction 2.8.3.2 Paralytic ileus 2.8.4 Structural disorders 2.8.4.1 Aortoenteric fistula 2.8.4.2 Congenital anomalies 2.8.4.3 Intestinal malabsorption 2.8.4.4 Meckel's diverticulum 2.8.5 Tumors 2.8.6 Vascular insufficiency 2.9 Large Bowel 2.9.1 Infectious disorders 2.9.1.1 Antibiotic-associated 2.9.1.2 Bacterial 2.9.1.3 Parasitic 2.9.1.4 Viral 2.9.2 Inflammatory disorders 2.9.2.1 Appendicitis 2.9.2.2 Necrotizing enterocolitis (NEC) 2.9.2.3 Radiation colitis 2.9.2.4 Ulcerative colitis 2.9.3 Motor abnormalities 2.9.3.1 Hirschsprung’s disease 2.9.3.2 Irritable bowel 2.9.3.3 Obstruction 2.9.4 Structural disorders 2.9.4.1 Congenital anomalies 2.9.4.2 Diverticula 2.9.4.3 Intussusception 2.9.4.4 Volvulus 2.9.5 Tumors 2.10 Rectum and Anus 2.10.1 Infectious disorders 2.10.1.1 Perianal/Anal abscess 2.10.1.2 Perirectal abscess 2.10.1.3 Pilonidal cyst and abscess 2.10.2 Inflammatory disorders 2.10.2.1 Proctitis 2.10.3 Structural disorders 2.10.3.1 Anal fissure 2.10.3.2 Anal fistula 2.10.3.3 Congenital anomalies 2.10.3.4 Foreign body 2.10.3.5 Hemorrhoids 2.10.3.6 Rectal prolapse 2.10.4 Tumors 2.11 Spleen 2.11.1 Asplenism 2.11.2 Splenomegaly 2.11.3 Vascular insufficiency/Infarction 3.0 CARDIOVASCULAR DISORDERS 3.1 Cardiopulmonary Arrest 3.1.1 Sudden unexpected infant death (SUID) 3.1.2 Pulseless electrical activity 3.2 Congenital Abnormalities of the Cardiovascular System 3.3 Disorders of Circulation 3.3.1 Arterial 3.3.1.1 Aneurysm 3.3.1.2 Aortic dissection 3.3.1.3 Thromboembolism 3.3.2 Venous 3.3.2.1 Thromboembolism (See 16.6.2) 3.4 Disturbances of Cardiac Rhythm 3.4.1 Cardiac dysrhythmias 3.4.1.1 Ventricular 3.4.1.2 Supraventricular 3.4.2 Conduction disorders 3.5 Diseases of the Myocardium, Acquired 3.5.1 Cardiac failure 3.5.1.1 Cor pulmonale 3.5.1.2 High output 3.5.1.3 Low output 3.5.2 Cardiomyopathy 3.5.2.1 Hypertrophic 3.5.3 Congestive heart failure 3.5.4 Coronary syndromes 3.5.5 Ischemic heart disease 3.5.6 Myocardial infarction 3.5.7 Myocarditis 3.5.8 Ventricular aneurysm 3.6 Diseases of the Pericardium 3.6.1 Pericardial tamponade (See 18.1.2.6) 3.6.2 Pericarditis 3.7 Endocarditis 3.8 Hypertension 3.9 Tumors 3.10 Valvular Disorders 4.0 CUTANEOUS DISORDERS 4.1 Cancers of the Skin 4.1.1 Basal cell 4.1.2 Kaposi's sarcoma 4.1.3 Melanoma 4.1.4 Squamous cell 4.2 Ulcerative Lesions 4.2.1 Decubitus 4.2.2 Venous stasis 4.3 Dermatitis 4.3.1 Atopic 4.3.2 Contact 4.3.3 Eczema 4.3.4 Psoriasis 4.3.5 Seborrhea 4.4 Infections 4.4.1 Bacterial 4.4.1.1 Abscess 4.4.1.2 Cellulitis 4.4.1.3 Erysipelas 4.4.1.4 Impetigo 4.4.1.5 Necrotizing infection 4.4.2 Fungal 4.4.2.1 Candida (See 2.2.1.1, 7.5.7) 4.4.2.2 Dermatophytes 4.4.3 Ectoparasites 4.4.4 Viral 4.4.4.1 Aphthous ulcers 4.4.4.2 Childhood exanthems (See 10.6.8, 10.6.9) 4.4.4.3 Herpes simplex (See 10.6.4, 13.1.3.1) 4.4.4.4 Herpes zoster (See 10.6.5) 4.4.4.5 Human papillomavirus (HPV) (See 13.1.3.2) 4.4.4.6 Molluscum contagiosum 4.5 Maculopapular Lesions 4.5.1 Erythema multiforme 4.5.2 Erythema nodosum 4.5.3 Henoch-Schönlein purpura (HSP) 4.5.4 Pityriasis rosea 4.5.5 Purpura 4.5.6 Urticaria 4.6 Papular/Nodular Lesions 4.6.1 Hemangioma/Lymphangioma 4.6.2 Lipoma 4.6.3 Sebaceous cyst 4.7 Vesicular/Bullous Lesions 4.7.1 Pemphigus 4.7.2 Staphylococcal scalded skin syndrome 4.7.3 Stevens-Johnson syndrome 4.7.4 Toxic epidermal necrolysis 4.7.5 Bullous pemphigoid 5.0 ENDOCRINE, METABOLIC, AND NUTRITIONAL DISORDERS 5.1.1.1 Acidosis 5.1 Acid-base Disturbances 5.1.1 Metabolic or respiratory 5.2.1 Corticoadrenal insufficiency 5.3 Fluid and Electrolyte Disturbances 5.3.1 Calcium metabolism 5.3.2 Fluid overload/Volume depletion 5.1.1.2 Alkalosis 5.1.2 Mixed acid-base balance disorder 5.2 Adrenal Disease 5.2.2 Cushing’s syndrome 5.3.3 Potassium metabolism 5.3.4 Sodium metabolism 5.3.5 Magnesium metabolism 5.3.6 Phosphorus metabolism 5.4 Glucose Metabolism 5.4.1 Diabetes mellitus 5.4.1.1 Type I 5.4.1.2 Type II 5.4.1.3 Complications in glucose metabolism 5.4.1.3.1 Diabetic ketoacidosis (DKA) 5.4.1.3.2 Hyperglycemia 5.4.1.3.3 Hyperosmolar hyperglycemic state 5.4.1.3.4 Hypoglycemia 5.5 Nutritional Disorders 5.5.1 Vitamin deficiencies 5.5.2 Wernicke-Korsakoff syndrome 5.5.3 Malabsorption 5.6 Parathyroid Disease 5.7 Pituitary Disorders 5.7.1 Panhypopituitarism 5.8 Thyroid Disorders 5.8.1 Hyperthyroidism 5.8.2 Hypothyroidism 5.8.3 Thyroiditis 5.9 Tumors of Endocrine Glands 5.9.1 Adrenal 5.9.1.1 Pheochromocytoma 5.9.2 Pituitary 5.9.3 Thyroid 6.0 ENVIRONMENTAL DISORDERS 6.1 Bites and Envenomation (See 18.1.3.2) 6.1.1 Arthropods 6.1.1.1 Insects 6.1.1.2 Arachnida 6.1.2 Mammals 6.1.3 Marine organisms (See 17.1.28) 6.1.4 Reptiles 6.2 Dysbarism 6.2.1 Air embolism 6.2.2 Barotrauma 6.2.3 Decompression syndrome 6.3 Electrical Injury (See 18.1.3.3.1) 6.3.1 Lightning 6.4 High-altitude Illness 6.4.1 Acute mountain sickness 6.4.2 Barotrauma of ascent 6.4.3 High-altitude cerebral edema 6.4.4 High-altitude pulmonary edema 6.5 Submersion Incidents 6.5.1 Cold water immersion 6.5.2 Near drowning 6.6 Temperature-related Illness 6.6.1 Heat 6.6.1.1 Heat exhaustion 6.6.1.2 Heat stroke 6.6.2 Cold 6.6.2.1 Frostbite 6.6.2.2 Hypothermia 6.7 Radiation Emergencies 7.0 HEAD, EAR, EYE, NOSE, THROAT DISORDERS 7.1 Ear 7.1.1 Foreign body 7.1.2 Labyrinthitis 7.1.3 Mastoiditis 7.1.4 Ménière’s disease 7.1.5 Otitis externa 7.1.5.1 Infective 7.1.5.1.1 7.1.1.1 Impacted cerumen 7.1.6 Otitis media 7.1.7 Perforated tympanic membrane (See 18.1.11.2) 7.1.8 Perichondritis 7.2 Eye 7.2.1 External eye 7.2.1.1 Blepharitis 7.2.1.2 Burn confined to eye (See 18.1.10.2) 7.2.1.3 Conjunctivitis 7.2.1.4 Corneal abrasions (See 18.1.10.1) 7.2.1.5 Dacryocystitis 7.2.1.6 Disorders of lacrimal system 7.2.1.7 Foreign body 7.2.1.8 Inflammation of the eyelids 7.2.1.8.1 Chalazion 7.2.1.8.2 Hordeolum 7.2.1.9 Keratitis 7.2.2 Anterior pole 7.2.2.1 Glaucoma 7.2.2.2 Hyphema (See 18.1.10.5) 7.2.2.3 Iritis (See 18.1.10.9) 7.2.2.4 Hypopyon 7.2.3 Posterior pole 7.2.3.1 Choroiditis/Chorioretinitis 7.2.3.2 Optic neuritis 7.2.3.3 Papilledema 7.2.3.4 Retinal detachments and defects (See 18.1.10.8) 7.2.3.5 Retinal vascular occlusion 7.2.4 Orbit 7.2.4.1 Cellulitis 7.2.4.1.1 Preseptal 7.2.4.1.2 Postseptal 7.2.4.2 Purulent endophthalmitis 7.3 Cerebral Venous Sinus Thrombosis 7.3.1 Cavernous sinus thrombosis 7.4 Nose 7.4.1 Epistaxis 7.4.2 Foreign body 7.4.3 Rhinitis 7.4.4 Sinusitis 7.5 Oropharynx/Throat 7.5.1 Dentalgia 7.5.2 Diseases of the oral soft tissue 7.5.2.1 Ludwig's angina 7.5.2.2 Stomatitis 7.5.3 Diseases of the salivary glands 7.5.3.1 Sialolithiasis 7.5.3.2 Suppurative parotitis 7.5.4 Foreign body 7.5.5 Gingival and periodontal disorders 7.5.5.1 Gingivostomatitis Larynx/Trachea 7.5.6 Larynx/Trachea 7.5.6.1 Epiglottitis (See 16.1.1.2) 7.5.6.2 Laryngitis 7.5.6.3 Tracheitis 7.5.7 Oral candidiasis (See 2.2.1.1, 4.4.2.1) 7.5.8 Dental abscess 7.5.9 Peritonsillar abscess 7.5.10 Pharyngitis/Tonsillitis 7.5.11 Retropharyngeal abscess 7.5.12 Temporomandibular joint disorders 7.6 Tumors 8.0 HEMATOLOGIC DISORDERS 8.1 Blood Transfusion 8.1.1 Complications 8.2 Hemostatic Disorders 8.2.1 Coagulation defects 8.2.1.1 Acquired 8.2.1.2 Hemophilias 8.2.2 Disseminated intravascular coagulation 8.2.3 Platelet disorders 8.2.3.1 Thrombocytopenia 8.3 Lymphomas 8.4 Pancytopenia 8.5 Red Blood Cell Disorders 8.5.1 Anemias 8.5.1.1 Aplastic 8.5.1.2 Hemoglobinopathies 8.5.1.2.1 Sickle cell disease 8.5.1.3 Hemolytic 8.5.1.4 Hypochromic 8.5.1.4.1 Iron deficiency 8.5.1.5 Megaloblastic 8.5.2 Polycythemia 8.5.3 Methemoglobinemia (See 17.1.29) 8.6 White Blood Cell Disorders 8.6.1 Leukemia 8.6.2 Multiple myeloma 8.6.3 Leukopenia 9.0 IMMUNE SYSTEM DISORDERS 9.1 Collagen Vascular Disease 9.1.1 Raynaud’s disease 9.1.2 Reiter’s syndrome 9.1.3 Rheumatoid arthritis (See 11.3.1.3) 9.1.4 Scleroderma 9.1.5 Systemic lupus erythematosus 9.1.6 Vasculitis 9.2 Hypersensitivity 9.2.1 Allergic reaction 9.2.2 Anaphylaxis 9.2.3 Angioedema 9.2.4 Drug allergies 9.3 Transplant-related Problems 9.3.1 Immunosuppression 9.3.2 Rejection 9.4 Immune Complex Disorders 9.4.1 Kawasaki syndrome 9.4.2 Rheumatic fever 9.4.3 Sarcoidosis 9.4.4 Post-streptococcal glomerulonephritis (See 15.3.1) 10.0 SYSTEMIC INFECTIOUS DISORDERS 10.1 Bacterial 10.1.1 Bacterial food poisoning 10.1.1.1 Botulism 10.1.2 Chlamydia 10.1.3 Gonococcus 10.1.4 Meningococcus 10.1.5 Mycobacterium 10.1.5.1 Atypical mycobacteria 10.1.5.2 Tuberculosis 10.1.6 Other bacterial diseases 10.1.6.1 Gas gangrene (See 11.6.3) 10.1.7 Sepsis/Bacteremia 10.1.7.1 Shock 10.1.7.2 Systemic inflammatory response syndrome (SIRS) 10.1.7.3 Toxic shock syndrome 10.1.8 Spirochetes 10.1.8.1 Syphilis 10.1.9 Tetanus 10.2 Biological Warfare Agents 10.3 Fungal Infections 10.4 Protozoan/Parasites 10.4.1 Malaria 10.4.2 Toxoplasmosis 10.5 Tick-Borne 10.5.1 Ehrlichiosis 10.5.2 Lyme disease 10.5.3 Rocky Mountain spotted fever 10.6 Viral 10.6.1 Infectious mononucleosis 10.6.2 Influenza/Parainfluenza 10.6.3 Hantavirus 10.6.4 Herpes simplex (See 4.4.4.3, 13.1.3.1) 10.6.5 Herpes zoster/Varicella (See 4.4.4.4) 10.6.6 HIV/AIDS 10.6.7 Rabies 10.6.8 Roseola (See 4.4.4.2) 10.6.9 Rubella (See 4.4.4.2) 10.7 Emerging Infections, Pandemics, and Drug Resistance 11.0 MUSCULOSKELETAL DISORDERS (NONTRAUMATIC) 11.1 Bony Abnormalities 11.1.1 Aseptic/Avascular necrosis 11.1.2 Osteomyelitis 11.1.3 Tumors 11.2 Disorders of the Spine 11.2.1 Disc disorders 11.2.2 Inflammatory spondylopathies 11.2.3 Low back pain 11.2.3.1 Cauda equina syndrome (See 18.1.15.1) 11.2.3.2 Sacroiliitis 11.2.3.3 Sprains/Strains 11.3 Joint Abnormalities 11.3.1 Arthritis 11.3.1.1 Septic 11.3.1.2 Crystal arthropathies 11.3.1.3 Rheumatoid (See 9.1.3) 11.3.1.4 Juvenile 11.3.1.5 Osteoarthrosis 11.3.2 Congenital dislocation of the hip 11.3.3 Slipped capital femoral epiphysis 11.4 Muscle Abnormalities 11.4.1 Myositis 11.4.2 Rhabdomyolysis 11.5 Overuse Syndromes 11.5.1 Bursitis 11.5.2 Muscle strains 11.5.3 Peripheral nerve syndrome 11.5.3.1 Carpal tunnel syndrome 11.5.4 Tendonitis 11.6 Soft Tissue Infections 11.6.1 Fasciitis 11.6.2 Felon 11.6.3 Gangrene (See 10.1.6.1) 11.6.4 Paronychia 11.6.5 Synovitis/Tenosynovitis 12.0 NERVOUS SYSTEM DISORDERS 12.1 Cranial Nerve Disorders 12.1.1 Idiopathic facial nerve paralysis (Bell’s palsy) 12.1.2 Trigeminal neuralgia 12.2 Demyelinating Disorders 12.2.1 Multiple sclerosis 12.3 Headache (See 1.2.2) 12.3.1 Tension 12.3.2 Vascular 12.3.3 Cluster 12.4 Hydrocephalus 12.4.1 Normal pressure 12.4.2 VP shunt 12.5 Infections/Inflammatory Disorders 12.5.1 Encephalitis 12.5.2 Intracranial and intraspinal abscess 12.5.3 Meningitis 12.5.3.1 Bacterial 12.5.3.2 Viral 12.5.4 Myelitis 12.5.5 Neuritis 12.6 Movement Disorders 12.6.1 Dystonic reaction 12.6.2 Chorea/Choreiform 12.6.3 Tardive dyskinesia 12.7 Neuromuscular Disorders 12.7.1 Guillain-Barré syndrome 12.7.2 Myasthenia gravis 12.7.3 Peripheral neuropathy 12.8 Other Conditions of the Brain 12.8.1 Dementia (See 14.5.3) 12.8.2 Parkinson’s disease 12.8.3 Pseudotumor cerebri 12.9 Seizure Disorders 12.9.1 Febrile 12.9.2 Neonatal 12.9.3 Status epilepticus 12.9.3.1 Nonconvulsive 12.10 Spinal Cord Compression 12.11 Stroke 12.11.1 Hemorrhagic 12.11.1.1 Intracerebral 12.11.1.2 Subarachnoid 12.11.2 Ischemic 12.11.2.1 Embolic 12.11.2.2 Thrombotic 12.12 Transient Cerebral Ischemia 12.13 Tumors 13.0 OBSTETRICS AND GYNECOLOGY 13.1 Female Genital Tract 13.1.1 Cervix 13.1.1.1 Cervicitis and endocervicitis 13.1.1.2 Tumors 13.1.2 Infectious disorders 13.1.2.1 Pelvic inflammatory disease 13.1.2.1.1 Fitz-Hugh-Curtis syndrome 13.1.2.1.2 Tuboovarian abscess 13.1.2.2 Urethritis 13.1.3 Lesions 13.1.3.1 Herpes simplex (See 4.4.4.3, 10.6.4) 13.1.3.2 Human papillomavirus (HPV) (See 4.4.4.5) 13.1.4 Ovary 13.1.4.1 Cyst 13.1.4.2 Torsion 13.1.4.3 Tumors 13.1.5 Uterus 13.1.5.1 Dysfunctional bleeding 13.1.5.2 Endometriosis 13.1.5.3 Prolapse 13.1.5.4 Tumors 13.1.5.4.1 Gestational trophoblastic disease 13.1.5.4.2 Leiomyoma 13.1.6 V agina and vulva 13.1.6.1 Bartholin’s cyst 13.1.6.2 Foreign body 13.1.6.3 Vaginitis/Vulvovaginitis 13.2 Normal Pregnancy 13.3 Complications of Pregnancy 13.3.1 Abortion 13.3.2 Ectopic pregnancy 13.3.3 Hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome 13.3.4 Hemorrhage, antepartum 13.3.4.1 Abruptio placentae (See 18.2.1) 13.3.4.2 Placenta previa 13.3.5 Hyperemesis gravidarum 13.3.6 Gestational hypertension 13.3.6.1 Eclampsia 13.3.6.2 Preeclampsia 13.3.7 Infections 13.3.8 Rh isoimmunization 13.3.9 First trimester bleeding 13.3.10 Gestational diabetes 13.4 High-risk Pregnancy 13.4.1 Assisted reproductive therapies 13.5 Normal Labor and Delivery 13.6 Complications of Labor 13.6.1 Fetal distress 13.6.2 Premature labor (See 18.2.3) 13.6.3 Premature rupture of membranes 13.6.4 Rupture of uterus (See 18.2.4) 13.7 Complications of Delivery 13.7.1 Malposition of fetus 13.7.2 Nuchal cord 13.7.3 Prolapse of cord 13.8 Postpartum Complications 13.8.1 Endometritis 13.8.2 Hemorrhage 13.8.3 Mastitis 13.8.4 Pituitary infarction 13.9 Contraception

14.0 PSYCHOBEHAVIORAL DISORDERS 14.1 Addictive Behavior 14.1.1 Alcohol dependence 14.1.2 Drug dependence 14.1.3 Eating disorders 14.1.4 Substance abuse 14.1.5 Tobacco dependence 14.2 Mood Disorders and Thought Disorders 14.2.1 Acute psychosis 14.2.2 Bipolar disorder 14.2.3 Depression 14.2.3.1 Suicidal risk 14.2.4 Grief reaction 14.2.5 Schizophrenia 14.3 Factitious Disorders 14.3.1 Drug-diversion behavior 14.3.2 Munchausen syndrome/Munchausen by proxy 14.4 Neurotic Disorders 14.4.1 Anxiety/Panic 14.4.2 Obsessive compulsive 14.4.3 Phobic 14.4.4 Post-traumatic stress 14.5 Organic Psychoses 14.5.1 Chronic organic psychotic conditions 14.5.1.1 Alcoholic psychoses 14.5.1.2 Drug psychoses 14.5.2 Delirium 14.5.3 Dementia (See 12.8.1) 14.5.4 Intoxication and/or withdrawal 14.5.4.1 Alcohol (See 17.1.2) 14.5.4.2 Hallucinogens (See 17.1.17) 14.5.4.3 Opioids (See 17.1.1.3) 14.5.4.4 Sedatives/Hypnotics/Anxiolytics (See 17.1.35) 14.5.4.5 Sympathomimetics and cocaine (See 17.1.36;17.1.15) 14.5.4.6 Anticholinergic (See 17.1.4) 14.6 Patterns of Violence/Abuse/Neglect 14.6.1 Interpersonal violence 14.6.1.1 Child, intimate partner, elder 14.6.2 Homicidal Risk 14.6.3 Sexual assault 14.6.4 Staff/Patient safety 14.7 Personality Disorders 14.8 Psychosomatic Disorders 14.8.1 Hypochondriasis 14.8.2 Hysteria/Conversion 15.0 RENAL AND UROGENITAL DISORDERS 15.1 Acute and Chronic Renal Failure 15.2 Complications of Renal Dialysis 15.3 Glomerular Disorders 15.3.1 Glomerulonephritis (See 9.4.4) 15.3.2 Nephrotic syndrome 15.4 Infection 15.4.1 Cystitis 15.4.2 Pyelonephritis 15.5 Male Genital Tract 15.5.1 Genital lesions 15.5.2 Hernias 15.5.3 Inflammation/Infection 15.5.3.1 Balanitis/Balanoposthitis 15.5.3.2 Epididymitis/Orchitis 15.5.3.3 Gangrene of the scrotum (Fournier's gangrene) 15.5.3.4 Prostatitis 15.5.3.5 Urethritis 15.5.4 Structural 15.5.4.1 Paraphimosis/Phimosis 15.5.4.2 Priapism 15.5.4.3 Prostatic hypertrophy (BPH) 15.5.4.4 Torsion 15.5.5 Testicular masses 15.5.6 Tumors 15.5.6.1 Prostate 15.5.6.2 Testis 15.6 Nephritis 15.6.1 Hemolytic uremic syndrome 15.7 Structural Disorders 15.7.1 Calculus of urinary tract 15.7.2 Obstructive uropathy 15.7.3 Polycystic kidney disease 15.8 Tumors 16.0 THORACIC-RESPIRATORY DISORDERS 16.1 Acute Upper Airway Disorders 16.1.1 Infections 16.1.1.1 Croup 16.1.3 Tracheostomy/Complications 16.2 Disorders of Pleura, Mediastinum, and Chest Wall 16.2.1 Costochondritis 16.1.1.2 Epiglottitis (See 7.5.6.1) 16.1.2 Obstruction 16.2.2 Mediastinitis 16.2.3 Pleural effusion 16.2.4 Pleuritis 16.2.5 Pneumomediastinum 16.2.6 Pneumothorax (See 18.1.2.7) 16.2.6.1 Simple 16.2.6.2 Tension 16.2.6.3 Open 16.2.7 Empyema 16.3 Noncardiogenic Pulmonary Edema 16.4 Obstructive/Restrictive Lung Disease 16.4.1 Asthma/Reactive airway disease 16.4.2 Bronchitis and bronchiolitis 16.4.3 Bronchopulmonary dysplasia 16.4.4 Chronic obstructive pulmonary disease 16.4.5 Cystic fibrosis 16.4.6 Environmental/Industrial exposure 16.4.7 Foreign body 16.5 Physical and Chemical Irritants/Insults 16.5.1 Pneumoconiosis 16.5.2 Toxic effects of gases, fumes, vapors (See 18.1.3.3.2) 16.6 Pulmonary Embolism/Infarct 16.6.1 Septic emboli 16.6.2 Venous thromboembolism (See 3.3.2.1) 16.6.3 Fat emboli 16.7 Pulmonary Infections 16.7.1 Lung abscess 16.7.2 Pneumonia 16.7.2.1 Aspiration 16.7.2.2 Community-acquired 16.7.2.3 Health care-associated 16.7.3 Pulmonary tuberculosis 16.7.4 Respiratory syncytial virus (RSV) 16.7.5 Pertussis 16.8 Tumors 16.8.1 Breast 16.8.2 Pulmonary 16.9 Pulmonary Hypertension 17.0 TOXICOLOGIC DISORDERS 17.1 Drug and Chemical Classes 17.1.1 Analgesics 17.1.1.1 Acetaminophen 17.1.2 Alcohol (See 14.5.4.1) 17.1.2.1 Ethanol 17.1.2.2 Glycol 17.1.2.3 Isopropyl 17.1.1.2 Nonsteroidal anti-inflammatories (NSAIDS) 17.1.1.3 Opiates and related narcotics (See 14.5.4.3) 17.1.1.4 Salicylates 17.1.2.4 Methanol 17.1.3 Anesthetics 17.1.4 Anticholinergics/Cholinergics (See 14.5.4.6) 17.1.5 Anticoagulants/Antithrombotics 17.1.6 Anticonvulsants 17.1.7 Antidepressants 17.1.8 Antiparkinsonism drugs 17.1.9 Antihistamines and antiemetics 17.1.10 Antipsychotics 17.1.11 Bronchodilators 17.1.12 Carbon monoxide 17.1.13 Cardiovascular drugs 17.1.13.1 Antiarrhythmics 17.1.13.1.1 Digitalis 17.1.13.2 Antihypertensives 17.1.13.3 Beta blockers 17.1.13.4 Calcium channel blockers 17.1.14 Caustic agents (See 2.2.2.3) 17.1.14.1 Acid 17.1.14.2 Alkali 17.1.15 Cocaine (See 14.5.4.5) 17.1.16 Cyanides, hydrogen sulfide 17.1.17 Hallucinogens (See 14.5.4.2) 17.1.18 Hazardous materials 17.1.19 Heavy metals 17.1.20 Herbicides, insecticides, and rodenticides 17.1.21 Household/Industrial chemicals 17.1.22 Hormones/Steroids 17.1.23 Hydrocarbons 17.1.24 Hypoglycemics/Insulin 17.1.25 Inhaled toxins 17.1.26 Iron 17.1.27 Isoniazid 17.1.28 Marine toxins (See 6.1.3) 17.1.29 Methemoglobinemia (See 8.5.3) 17.1.30 Mushrooms/Poisonous plants 17.1.31 Neuroleptics 17.1.32 Non-prescription drugs 17.1.33 Organophosphates 17.1.34 Recreational drugs 17.1.35 Sedatives/Hypnotics (See 14.5.4.4) 17.1.36 Stimulants/Sympathomimetics (See 14.5.4.5) 17.1.37 Strychnine 17.1.38 Lithium 17.1.39 Nutritional supplements 17.1.40 Chemical warfare agents 17.1.41 Antibiotics 17.1.42 Antiretrovirals 18.0 TRAUMATIC DISORDERS 18.1.1.1 Diaphragm 18.1 Trauma 18.1.1 Abdominal trauma 18.1.1.2 Hollow viscus 18.1.1.3 Penetrating 18.1.1.4 Retroperitoneum 18.1.1.5 Solid organ 18.1.1.6 Vascular 18.1.2 Chest trauma 18.1.2.1 Aortic dissection/Disruption 18.1.2.2 Contusion 18.1.2.2.1 Cardiac 18.1.2.2.2 Pulmonary 18.1.2.3 Fracture 18.1.2.3.1 Clavicle 18.1.2.3.2 Ribs/Flail chest 18.1.2.3.3 Sternum 18.1.2.4 Hemothorax 18.1.2.5 Penetrating chest trauma 18.1.2.6 Pericardial tamponade (See 3.6.1) 18.1.2.7 Pneumothorax (See 16.2.6) 18.1.2.7.1 Simple 18.1.2.7.2 Tension 18.1.2.7.3 Open 18.1.3 Cutaneous injuries 18.1.3.1 Avulsions 18.1.3.2 Bite wounds (See 6.1) 18.1.3.3 Burns 18.1.3.3.1 Electrical (See 6.3) 18.1.3.3.2 Chemical (See 16.5.2) 18.1.3.3.3 Thermal 18.1.3.4 Lacerations 18.1.3.5 Puncture wounds 18.1.4 Facial fractures 18.1.5.1 Bladder 18.1.5.2 External genitalia 18.1.4.1 Dental 18.1.4.2 Le Fort 18.1.4.3 Mandibular 18.1.4.4 Orbital 18.1.4.5 Nasal 18.1.4.5.1 Septal hematoma 18.1.4.6 Zygomatic arch 18.1.5 Genitourinary trauma 18.1.5.1 Bladder 18.1.5.2 External Genitalia 18.1.5.3 Renal 18.1.5.4 Ureteral 18.1.5.5 Urethral 18.1.6.1 Intracranial injury 18.1.6 Head trauma 18.1.6.2 Scalp lacerations/Avulsions 18.1.6.3 Skull fractures 18.1.7 Injuries of the spine 18.1.7.1 Dislocations/Subluxations 18.1.7.2 Fractures 18.1.7.3 Sprains/Strains 18.1.8 Extremity bony trauma 18.1.8.1 Dislocations/Subluxations 18.1.8.2 Fractures (open and closed) 18.1.9 Neck trauma 18.1.9.1 Laryngotracheal injuries 18.1.9.2 Penetrating neck trauma 18.1.9.3 Vascular injuries 18.1.9.3.1 Carotid artery 18.1.9.3.2 Jugular vein 18.1.9.4 Strangulation 18.1.10 Ophthalmologic trauma 18.1.10.1 Corneal abrasions/Lacerations (See 7.2.1.4) 18.1.10.2 Corneal burns (See 7.2.1.2) 18.1.10.2.1 Acid 18.1.10.2.2 Alkali 18.1.10.2.3 Ultraviolet 18.1.10.3 Eyelid lacerations 18.1.10.4 Foreign body (See 19.4.4.8) 18.1.10.5 Hyphema (See 7.2.2.2) 18.1.10.6 Lacrimal duct injuries 18.1.10.7 Penetrating globe injuries 18.1.10.8 Retinal detachments (See 7.2.3.4) 18.1.10.9 Traumatic iritis (See 7.2.2.3) 18.1.10.10 Retrobulbar hematoma 18.1.11 Otologic trauma 18.1.11.1 Hematoma 18.1.11.2 Perforated tympanic membrane (See 7.1.7) 18.1.12 Pediatric fractures 18.1.12.1 Epiphyseal 18.1.12.1.1 Salter-Harris classification 18.1.12.2 Greenstick 18.1.12.3 Torus 18.1.13 Pelvic fracture 18.1.14 Soft-tissue extremity injuries 18.1.14.1 Amputations/Replantation 18.1.14.2 Compartment syndromes 18.1.14.3 High-pressure injection 18.1.14.4 Injuries to joints 18.1.14.5 Penetrating trauma 18.1.14.6 Periarticular 18.1.14.7 Sprains/Strains 18.1.14.8 Tendon injuries 18.1.14.8.1 Lacerations/Transections 18.1.14.8.2 Ruptures 18.1.14.8.2.1 Achilles tendon 18.1.14.8.2.2 Patellar tendon 18.1.14.9 Vascular injuries 18.1.15 Spinal cord and nervous system trauma 18.1.15.1 Cauda equina syndrome (See 12.2.3.1) 18.1.15.2 Injury to nerve roots 18.1.15.3 Peripheral nerve injury 18.1.15.4 Spinal cord injury 18.1.15.4.1 Spinal cord injury without radiologic abnormality (SCIWORA) 18.2 Trauma in Pregnancy 18.2.1 Abruptio placentae (See 13.3.4.1) 18.2.2 Perimortem C-section (See 19.4.8.2) 18.2.3 Premature labor (See 13.6.2) 18.2.4 Rupture of uterus (See 13.6.4) 18.3 Multi-system Trauma 18.3.1 Blast injury 19.0 PROCEDURES AND SKILLS INTEGRAL TO THE PRACTICE OF EMERGENCY MEDICINE 19.1 Airway Techniques 19.1.1 Intubation 19.1.2 Airway adjuncts 19.1.3 Surgical airway 19.1.4 Mechanical ventilation 19.1.5 Non-invasive ventilatory management 19.1.6 Ventilatory monitoring 19.2 Resuscitation 19.2.1 Cardiopulmonary resuscitation 19.2.2 Neonatal resuscitation 19.2.3 Pediatric resuscitation 19.2.4 Post-resuscitative care 19.2.5 Blood, fluid, and component therapy 19.2.6 Arterial catheter insertion 19.2.7 Central venous access 19.2.8 Intraosseous infusion 19.2.9 Defibrillation 19.2.10 Thoracotomy 19.3 Anesthesia and Acute Pain Management 19.3.1 Local anesthesia 19.3.2 Regional nerve block 19.3.3 Procedural sedation and analgesia 19.4 Diagnostic and Therapeutic Procedures 19.4.1 Abdominal and gastrointestinal 19.4.1.1 Anoscopy 19.4.1.2 Excision of thrombosed hemorrhoid 19.4.1.3 Gastric lavage 19.4.1.4 Gastrostomy tube replacement 19.4.1.5 Nasogastric tube 19.4.1.6 Paracentesis 19.4.2 Cardiovascular and Thoracic 19.4.2.1 Cardiac pacing 19.4.2.2 Cardioversion 19.4.2.3 ECG interpretation 19.4.2.4 Pericardiocentesis 19.4.2.5 Thoracentesis 19.4.2.6 Thoracostomy 19.4.3 Cutaneous 19.4.3.1 Escharotomy 19.4.3.2 Incision and drainage 19.4.3.3 Trephination, nails 19.4.3.4 Wound closure techniques 19.4.3.5 Wound management 19.4.4 Head, ear, eye, nose, and throat 19.4.4.1 Control of epistaxis 19.4.4.2 Drainage of peritonsillar abscess 19.4.4.3 Laryngoscopy 19.4.4.4 Lateral canthotomy 19.4.4.5 Slit lamp examination 19.4.4.6 Tonometry 19.4.4.7 Tooth stabilization 19.4.4.8 Corneal foreign body removal (See 18.1.10.4) 19.4.4.9 Drainage of hematoma 19.4.5 Systemic infectious 19.4.5.1 Personal protection (equipment and techniques) 19.4.5.2 Universal precautions and exposure management 19.4.6 Musculoskeletal 19.4.6.1 Arthrocentesis 19.4.6.2 Compartment pressure measurement 19.4.6.3 Fracture/Dislocation immobilization techniques 19.4.6.4 Fracture/Dislocation reduction techniques 19.4.6.5 Spine immobilization techniques 19.4.6.6 Fasciotomy 19.4.7 Nervous system 19.4.7.1 Lumbar puncture 19.4.8 Obstetrics and gynecology 19.4.8.1 Delivery of newborn 19.4.8.2 Perimortem c-section (See 18.2.2) 19.4.8.3 Sexual assault examination 19.4.9 Psychobehavioral 19.4.9.1 Psychiatric screening examination 19.4.9.2 Violent patient management/Restraint 19.4.10 Renal and urogenital 19.4.10.1 Bladder catheterization 19.4.10.1.1 Urethral catheter 19.4.10.1.2 Suprapubic catheter 19.4.10.2 Cystourethrogram 19.4.10.3 Testicular detorsion 19.4.11 Toxicologic 19.4.11.1 Decontamination 19.5 Other Diagnostic and Therapeutic Procedures 19.5.1 Foreign body removal 19.5.2 Collection and handling of forensic material 19.5.3 Ultrasound 19.5.3.1 Diagnostic 19.5.3.2 Procedural 20.0 OTHER CORE COMPETENCIES OF THE PRACTICE OF EMERGENCY MEDICINE 20.1 Interpersonal and Communication Skills 0.1.1 Interpersonal skills 20.1.1.1 Inter-departmental and medical staff relations 20.1.1.2 Intra-departmental relations, teamwork, and collaboration skills 20.1.1.3 Patient and family experience of care 20.1.2 Communication skills 20.1.2.1 Complaint management and service recovery 20.1.2.2 Conflict management 20.1.2.3 Crisis resource management 20.1.2.4 Delivering bad news 20.1.2.5 Multicultural approach to the ED patient 20.1.2.6 Negotiation skills 20.2 Practice-based Learning and Improvement 20.2.1 Performance improvement and lifelong learning 20.2.1.1 Evidence-based medicine 20.2.1.2 Interpretation of medical literature 20.2.1.3 Knowledge translation 20.2.1.4 Patient safety and medical errors 20.2.1.5 Performance evaluation and feedback 20.2.1.6 Research 20.2.2 Practice guidelines 20.2.3 Education 20.2.3.1 Patient and family 20.2.3.2 Provider 20.2.4 Principles of quality improvement 20.3 Professionalism 20.3.1 Advocacy 20.3.1.1 Patient 20.3.1.2 Professional 20.3.2 Ethical principles 20.3.2.1 Conflicts of interest 20.3.2.2 Diversity awareness 20.3.2.3 Electronic communications/Social media 20.3.2.4 Medical ethics 20.3.3 Leadership and management principles 20.3.4 Well-being 20.3.4.1 Fatigue and impairment 20.3.4.2 Time management/Organizational skills 20.3.4.3 Work/Life balance 20.3.4.4 Work dysphoria (burn-out) 20.4 Systems-based Practice 20.4.1 Clinical informatics 20.4.1.1 Computerized order entry 20.4.1.2 Clinical decision support 20.4.1.3 Electronic health record 20.4.1.4 Health information integration 20.4.2 ED Administration 20.4.2.1 Contracts and practice models 20.4.2.2 Patient flow and throughput 20.4.2.2.1 Patient triage and classification 20.4.2.2.2 Hospital crowding and diversion 20.4.2.2.3 Observation and rapid treatment units 20.4.2.3 Financial principles 20.4.2.3.1 Billing and coding 20.4.2.3.2 Cost-effective care and resource utilization 20.4.2.3.3 Reimbursement issues 20.4.2.4 Human resource management 20.4.2.4.1 Allied health professionals 20.4.2.4.2 Recruitment, credentialing, and orientation 20.4.3 ED operations 20.4.3.1 Policies and procedures 20.4.3.2 ED data acquisition and operational metrics 20.4.3.3 Safety, security, and violence in the ED 20.4.4 Health care coordination 20.4.4.1 End-of-life and palliative care/Advance directives 20.4.4.2 Placement options 20.4.4.3 Outpatient services 20.4.5 Regulatory/Legal 20.4.5.1 Accreditation 20.4.5.2 Compliance and reporting requirements 20.4.5.3 Confidentiality and HIPAA 20.4.5.4 Consent, capacity, and refusal of care 20.4.5.5 Emergency Medical Treatment and Active Labor Act (EMTALA) 20.4.5.6 External quality metrics 20.4.6 Risk management 20.4.6.1 Liability and litigation 20.4.6.2 Professional liability insurance 20.4.6.3 Risk mitigation 20.4.7 Evolving trends in health care delivery 20.4.7.1 Public policy 20.4.8 Regionalization of emergency care