Harwood-Nuss
CLINICAL PRACTICE OF
EMERGENCY MEDICINE
SIXTH EDITION
Editor-in-Chief
...............................................
Allan B. Wolfson, MD
Professor and Vice Chair for Education
Department of Emergency Medicine
University of Pittsburgh
Program Director
University of Pittsburgh Emergency Medicine Residency
Pittsburgh, Pennsylvania
Associate Editors
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Robert L. Cloutier, MD, MCR
Associate Professor of Emergency Medicine and Pediatrics
Co-Director, Pediatric Emergency Medicine Fellowship
Assistant Program Director, Emergency Medicine Training Program
Oregon Health and Science University
Portland, Oregon
Gregory W. Hendey, MD
Professor and Chief of Emergency Medicine
UCSF Fresno Medical Education Program
Community Regional Medical Center
Fresno, California
Louis J. Ling, MD
Professor of Emergency Medicine
University of Minnesota Medical School
Medical Toxicologist
Hennepin Regional Poison Center
Minneapolis, Minnesota
Senior Vice President for Hospital-based Accreditation
Accreditation Council for Graduate Medical Education
Chicago, Illinois
Carlo L. Rosen, MD
Associate Professor
Harvard Medical School
Program Director and Vice Chair for Education
Department of Emergency Medicine
Associate Director of Graduate Medical Education
Beth Israel Deaconess Medical Center
Boston, Massachusetts
Jeffrey J. Schaider, MD
Professor, Department of Emergency Medicine
Rush Medical College
Chairman, Department of Emergency Medicine
Cook County Health and Hospital System
Chicago, Illinois
Acquisitions Editor: Jamie M. Elfrank
Product Development Editor: Ashley Fischer
Editorial Assistant: Brian Convery
Production Project Manager: David Orzechowski
Design Coordinator: Holly McLaughlin
Manufacturing Coordinator: Beth Welsh
Marketing Manager: Stephanie Kindlick
Prepress Vendor: Aptara, Inc.
6th edition
Copyright 2015 Wolters Kluwer
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Printed in the United States of America
ISBN 13: 978-1-4511-8881-3
ISBN 10: 1-4511-8881-1
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To my family, friends, mentors, and colleagues, and to the many residents and students who continue to teach me so much.
Allan B. Wolfson, MD
To my wife Nicola and my children, Jared and Joanna, for their patience and support of my time-consuming endeavors; and to my parents, Rene and Charlotte, for their earliest support of my career aspirations.
Robert L. Cloutier, MD, MCR
To Lisa, Eric, and Adam for the love and support they continue to give me. And to the residents and faculty at UCSF Fresno for making my job so much fun for so many years.
Gregory W. Hendey, MD
Thanks to the authors for sharing their valuable insight and wisdom; to Beth, Eric, Ali and Amanda for their never-ending understanding and love; and to the faculty and residents at Hennepin County Medical Center who have taught me so much. Special thanks to Ann for picking me for her program, not so many years ago.
Louis J. Ling, MD
To Cathy, Sofia, and Sam for being so supportive. And to the memory of my father, John F. Rosen, MD. And to the residents and faculty at Beth Israel Deaconess Medical Center with whom I am proud to work.
Carlo L. Rosen, MD
This book is dedicated to my wife Anna and my children, Jacob and Isaac. Without their support and love, nothing would be possible.
Jeffrey J. Schaider, MD
Contributors
Janak Acharya, MD
Assistant Professor
Department of Emergency Medicine
University of California, San Francisco
San Francisco, California
Attending Physician
Department of Emergency Medicine
Fresno Community Hospital
Fresno, California