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Chapter 1 – Preparedness for Pediatric Emergencies |
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Introduction |
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Emergency Department Preparedness |
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Triage |
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Child-Friendly Area |
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Staffing |
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Interface With Out-of-Hospital Care |
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Equipment and Supplies |
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Other Preparedness Issues |
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Interpersonal Violence |
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Parental Presence |
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Transfer to a Higher Level of Care |
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Disasters |
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Chapter Review |
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Chapter 2 – Pediatric Assessment |
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Introduction |
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Developing a General Impression: The Pediatric Assessment Triangle |
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Assessing the Pediatric ABCDEs |
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Summary of Initial Assessment |
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Focused History and Physical Examination |
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Ongoing Assessment |
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Chapter Review |
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Chapter 3 – The Pediatric Airway in Health and Disease |
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Introduction |
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Anatomic and Physiologic Responses to Airway Maneuvers |
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General Approach to Airway Emergencies |
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Upper Airway Obstruction |
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Croup |
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Foreign Body Aspiration |
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Retropharyngeal Abscess |
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Epiglottitis |
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Anaphylaxis |
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Lower Airway Obstruction |
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Bronchiolitis |
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Asthma |
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Disease of Oxygenation and Ventilation and Disease of the Lungs |
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Bronchopulmonary Dysplasia |
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Cystic Fibrosis |
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Pneumonia |
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Respiratory Failure |
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Chapter Review |
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Chapter 4 – Cardiovascular System |
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Introduction |
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Congenital Heart Disease |
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Cyanotic Heart Disease |
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Noncyanotic Heart Disease |
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Congestive Heart Failure |
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Acquired Heart Disease |
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Myocarditis |
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Acute Rheumatic Fever |
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Pericarditis |
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Bacterial Endocarditis |
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Kawasaki Disease |
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Rhythm Disturbances |
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Pulseless Arrest Rhythms |
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Cardiomyopathy |
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Postsurgical Complications |
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Shock |
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Hypovolemic Shock |
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Cardiogenic Shock |
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Distributive Shock |
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Chapter Review |
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Chapter 5 – Central Nervous System |
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Altered Level of Consciousness |
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Meningitis |
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Encephalitis |
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Headache |
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Weakness |
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Seizures |
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Febrile Seizures |
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Afebrile Seizures |
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Status Epilepticus |
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Chapter Review |
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Chapter 6 – Metabolic Disease |
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Introduction |
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Diabetic Ketoacidosis |
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Hypoglycemia in Diabetic Children |
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Hypoglycemia in Nondiabetic Children |
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Adrenal Insufficiency/Congenital Adrenal Hyperplasia |
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Diabetes Insipidus |
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Syndrome of Inappropriate Secretion of Antidiuretic Hormone |
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Water Intoxication |
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Metabolic Disease of the Newborn and Young Child |
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Chapter Review |
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Chapter 7 – Environmental Emergencies |
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Introduction |
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Envenomations |
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Snake Bites |
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Spider Bites |
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Body Temperature Disturbances |
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Minor Heat Illnesses |
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Major Heat Illnesses |
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Hypothermia |
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Submersion Injury |
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Chapter Review |
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Chapter 8 – Toxicology: Ingestions and Smoke Inhalation |
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General Evaluation and Management of Ingestions |
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Specific Ingestions |
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Acetaminophen |
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Ethanol |
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Methanol and Ethylene Glycol |
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Anticholinergic Agents |
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Caustics |
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Clonidine |
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Cyanide |
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Cyclic Antidepressants |
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Hydrocarbons |
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Iron |
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Opioids |
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Organophosphates |
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Salicylates |
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Selective Serotonin Reuptake Inhibitors |
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γ-Hydroxybutyrate |
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Ecstasy |
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Overall Management Issues |
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Additional Routes of Exposure |
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Smoke Inhalation |
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Chapter Review |
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Chapter 9 – Trauma |
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Introduction |
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Pathophysiologic and Anatomic Considerations |
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Assessment and Management |
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Primary and Secondary Surveys |
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Central Nervous System Injuries |
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Cranial and Intracranial Injuries |
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Seizures |
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Extracranial Head Injuries |
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Spinal Injuries |
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Chest Injuries |
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Abdominal Injuries |
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Burns |
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Electrical Trauma |
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Other Burns |
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Summary |
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Chapter Review |
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Chapter 10 – Child Maltreatment |
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Introduction |
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Physical Abuse |
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Bruises and Bites |
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Burns |
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Head Injuries |
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Abdominal Injuries |
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Skeletal Injury |
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Sexual Abuse |
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Acute Sexual Assault |
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Neglect |
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Münchausen Syndrome By Proxy |
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Summary |
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Chapter Review |
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Chapter 11 – Nontraumatic Surgical Emergencies |
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Necrotizing Enterocolitis |
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Malrotation and Midgut Volvulus |
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Pyloric Stenosis |
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Intussusception |
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Meckel Diverticulum |
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Testicular Torsion |
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Pediatric Inguinal Hernia |
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Appendicitis |
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Chapter Review |
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Chapter 12 – Nontraumatic Orthopedic Emergencies |
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Development Dysplasia of the Hip |
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Rotational Deformities |
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Metatarsus Adductus |
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Internal Tibial Torsion |
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Excessive Femoral Anteversion |
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Angular Deformities |
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Blount Disease |
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Radial Head Subluxation |
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Legg-Calvé-Perthes Disease |
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Slipped Capital Femoral Epiphysis |
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Acute Septic Arthritis |
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Osgood-Schlatter Disease |
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Summary |
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Chapter Review |
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Chapter 13 – Medical Emergencies |
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Introduction |
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Sepsis |
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Fever in Children at Risk for Sepsis |
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Sickle Cell Disease |
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Dermatologic Emergencies |
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Epididymitis |
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Balanitis/Balanoposthitis |
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Urinary Tract Infections—Cystitis and Pyelonephritis |
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Hypertension |
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Acute Glomerulonephritis |
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Nephrotic Syndrome |
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Syncope |
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Chapter Review |
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Chapter 14 – Neonatal Emergencies |
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Introduction |
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Resuscitation of the Newly Born |
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Fever |
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Bacterial Sepsis |
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Lethargy |
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Irritability |
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Apnea |
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Cyanosis |
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Congenital Heart Disease |
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Grunting |
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Vomiting |
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Constipation |
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Diarrhea |
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Seizures |
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Withdrawal |
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Gastrointestinal Bleeding |
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Umbilical Problems |
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Hyperbilirubinemia |
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Chapter Review |
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Chapter 15 – Procedural Sedation and Analgesia |
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Introduction |
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Pain Assessment |
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Medications Used in Analgesia and Sedation |
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Medication Selections |
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Summary |
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Chapter Review |
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Chapter 16 – Interface With EMS |
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Introduction |
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Origin of EMS Systems |
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Federal EMSC Program |
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EMSC Landmarks |
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Physician’s Role in EMSC |
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Future of EMSC |
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Chapter Review |
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Chapter 17 – Disaster Management |
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Introduction |
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Emergency Management Process |
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Children and Disaster Planning |
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Planning by Community Medical Practitioners |
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Planning by EMS Agencies |
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Planning by Hospitals |
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Planning by Community Agencies |
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Planning by Community Emergency Management |
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Response and Recovery Phases |
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Mitigation Phase |
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Pediatric Medical Issues After Community-wide Disasters |
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Pediatric Mental Health Issues After Disasters |
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Summary |
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Chapter Review |
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Chapter 18 - Preparedness for Acts of Nuclear, Biological, and Chemical Terrorism |
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Introduction |
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Major Biological Agents |
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Anthrax |
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Smallpox |
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Plague |
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Botulism |
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Tularemia |
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Viral Hemorrhagic Fevers |
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Chemical Agents |
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Nerve Agents |
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Vesicant Agents |
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Cyanide |
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Radiation Exposure |
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Early Recognition |
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Chapter Review |
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Chapter 19 – Children With Special Health Care Needs |
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Introduction |
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Tracheostomies and Home Ventilation |
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Feeding Tubes and Gastrostomy Tubes |
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Central Venous Catheters |
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Dialysis Shunts and Peritoneal Dialysis Catheters |
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Ventriculoperitoneal Shunts |
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Chapter Review |
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Chapter 20 – Medical-Legal Considerations |
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Introduction |
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Medical Malpractice and the ED |
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Statute of Limitations |
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High-Risk Cases in Pediatric Emergency Medicine |
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Documentation |
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Communication |
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Consultants |
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Issues of Consent |
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Refusal of Care |
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Transfer of Care |
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Family Presence |
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Death and Dying |
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Organ Donation |
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The Medical Examiner |
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Chapter Review |
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Chapter 21 – Office-Based Emergencies |
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Section 1. General Office Preparedness |
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1.1 Telephone Triage |
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1.2 Monitoring the Waiting Area |
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1.3 Staff Education |
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1.4 Equipment and Medications |
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1.5 Emergency Transport |
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1.6 Patient and Parent Education |
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Section 2. Trauma |
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2.1 Major Trauma |
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2.2 Minor Trauma |
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2.3 Minor Head Trauma |
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2.4 Minor Torso Trauma |
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2.5 Soft Tissue Injuries |
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2.6 Lacerations |
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2.7 Suturing |
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2.8 Staples |
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2.9 Tissue Adhesive Application |
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2.10 Human and Animal Bites |
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Section 3. Foreign Bodies |
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3.1 Subcutaneous Foreign Body Removal |
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3.2 Nail Bed Splinter Removal |
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3.3 Ocular Foreign Body Removal |
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3.4 Cerumen/Aural Foreign Body Removal |
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3.5 Nasal Foreign Body Removal |
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Section 4. Minor Burns |
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4.1 Minor Burns |
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Section 5. Miscellaneous Procedures |
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5.1 Subungual Hematoma Drainage |
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5.2 Paronychia |
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5.3 Skin Abscess Drainage |
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5.4 Fish Hook Removal |
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5.5 Ring Removal |
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5.6 Contact Lens Removal |
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5.7 Eye Patching |
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5.8 Tooth Reimplantation and Stabilization |
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5.9 Management of Penile Zipper Injury |
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5.10 Reduction of Inguinal Hernia |
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5.11 Reduction of Paraphimosis |
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5.12 Reduction of Rectal Prolapse |
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Chapter Review |
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Chapter 22 – Critical Procedures |
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Introduction |
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Section 1: Pediatric Length-Based Resuscitation Tape |
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Section 2: Cervical Spine Immobilization |
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Section 3: Monitoring |
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3.1 ECG Monitoring |
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3.2 Impedance Pneumatography |
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3.3 Blood Pressure Monitors |
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3.4 Pulse Oximetry |
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3.5 Exhaled CO2 Monitors |
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Section 4: Oxygen Administration |
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4.1 Nasal Cannula |
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4.2 Oxygen Mask |
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4.3 Nonrebreathing Masks |
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4.4 Oxygen Hoods |
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Section 5. Suction |
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Section 6: Opening the Airway |
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6.1 Chin-Lift Maneuver |
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6.2 Jaw-Thrust Maneuver |
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Section 7: Airway Adjuncts |
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7.1 Oropharyngeal Airways |
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7.2 Nasopharyngeal Airways |
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Section 8: Bag-Mask Ventilation |
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Section 9: Management of Upper Airway Foreign Bodies With Magill Forceps |
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Section 10: Emergent Intubation |
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10.1 Endotracheal Intubation |
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10.2 Rapid Sequence Intubation |
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Section 11: Rescue Airway Techniques |
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11.1 Supraglottic Devices |
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11.1A Laryngeal Mask Airway |
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11.1B Combitube |
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11.2 Specialized Laryngoscopes |
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11.2A Fiberoptic Scopes |
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11.3 Laryngoscopes With Special Blades |
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11.3A Lighted Stylet |
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11.4 Tracheal Guides |
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Section 12: Surgical Airway Techniques |
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12.1 Needle Cricothyrotomy |
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12.2 Retrograde Intubation |
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12.3 Wire-Guided Cricothyrotomy |
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12.4 Surgical Cricothyrotomy |
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12.5 Tracheostomy Management |
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Section 13: Cardioversion and Defibrillation |
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13.1 Cardioversion and Defibrillation |
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13.2 Automated External Defibrillator |
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Section 14: Vascular Access |
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14.1 Peripheral Venous Catheter Placement |
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14.2 External Jugular Vein Cannulation |
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14.3 Central Venous Catheter Placement |
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14.4 Umbilical Vein Catheterization |
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14.5 Intraosseous Needle Placement |
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14.6 Venous Cutdown |
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Section 15: Thoracic Procedures |
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15.1 Needle Thoracostomy (Thoracentesis) |
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15.2 Tube Thoracostomy |
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15.3 Emergency Thoracotomy |
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15.4 Pericardiocentesis |
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Section 16: Miscellaneous Procedures |
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16.1 Nasogastric/Orogastric Intubation |
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16.2 Catheterization of the Bladder |
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Section 17: Orthopedic Procedures |
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17.1 Compartment Syndrome |
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17.2 Dislocations |
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17.3 Shoulder Dislocation |
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17.4 Elbow Dislocation |
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17.5 Knee Dislocation |
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17.6 Hip Dislocation |
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17.7 Splinting |
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17.7A Volar Arm Splint |
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17.7B Sugar-Tong Splint (Forearm) |
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17.7C Ulnar Gutter Splint |
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17.7D Thumb Spica Splint |
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17.7E Sugar-Tong Splint (Upper Extremity) |
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17.7F Finger Splints |
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17.7G Posterior Splint (Lower Extremity) |
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17.7H Sugar-Tong Splint (Lower Extremity) |
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17.8 Crutch Walking |
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Appendix A: Check Your Knowledge Answers |
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Index |
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Additional Credits |