EMERGENCY MANAGEMENT OF THE HI-TECH PATIENT IN ACUTE AND CRITICAL CARE

Emergency Management of the Hi-Tech Patient in Acute and Critical Care helps practitioners stabilize and care for pediatric and adult patients who have specialized medical devices such as prosthetic valves, cochlear transplants, insulin pumps, orthopedic hardware, and ventriculoperitoneal (VP) shunts. Using a step-by-step approach to acute presentations of patients with clinical hardware, this concise yet comprehensive guide provides specific instructions for the initial evaluation and management of numerous clinical scenarios including device malfunctions, infections, trauma, surgical complications, and more.

Encompassing management of both the patient and the device, the guide enables emergency and critical care clinicians to rapidly make appropriate treatment decisions without the immediate need for extensive research, extended discussions with subspecialists, or recalling complex diagnostic and therapeutic algorithms. Clear, concise, and easy-to-follow chapters—written by a panel of highly experienced experts across specialties—include numerous algorithms, figures, tables, diagrams, and color illustrations and clinical images. An invaluable resource for improving the quality of care for the unique hi-tech patient population, this advanced practical manual:

• Provides algorithms for the most common clinical scenarios of device malfunction and related complications
• Covers management of patients who have undergone major operations such as organ transplantation or complex congenital heart disease repair
• Presents detailed management plans for a wide range of hardware types and medical conditions
• Offers expert guidance to practitioners in settings where not all specialties are readily available, such as rural and remote areas or community hospitals
• Features contributions from a team of experts in various areas of adult and pediatric emergency and critical care medicine

Emergency Management of the Hi-Tech Patient in Acute and Critical Care is a must-have clinical reference and guide for pediatric and adult emergency medicine physicians, general pediatricians, internists, general practitioners, critical care specialists, and allied health practitioners.

List of Contributors ix

Preface xv

Acknowledgments xvii

Section I Gastro-intestinal Devices 1

1 Using and Troubleshooting Enteral Feeding Devices 3
Courtney E. Nelson and Thane A. Blinman

2 Gastrointestinal Diversions: Colostomies, Ileostomies, Mucous Fistulas, and Spit Fistulas 21
Ellen G. Szydlowski and Peter Mattei

3 Management of the Bariatric Surgery Patient in the Emergency Department 27
Megan Lavoie and Joy Collins

4 Transjugular Intrahepatic Portosystemic Shunt 37
Heather House and Anne Marie Cahill

Section II Central Catheters 43

5 Indwelling Central Venous Catheter Devices 45
Anna Weiss

6 Vascular Access for Hemodialysis 57
Sarah Fesnak, Xenia Morgan, and Kimberly Windt

7 Peritoneal Dialysis Catheters 63
Jamie Lovell

Section III ENT and OMFS Devices 71

8 Orthopedic Devices 73
Carmelle Wallace, Andrew Tyler, and Keith D. Baldwin

9 Spine Devices 95
Susan E. Nelson and Keith D. Baldwin

10 Facial Distractors: Cranial Vault, Midface, and Mandibular 109
Francesca Drake and Phuong D. Nguyen

11 Management of Facial Fractures in Adults and Children 117
Sameer Shakir and Phuong D. Nguyen

12 Cranial Orthotics and Ear Molding 129
Meg Ann Maguire and Phuong D. Nguyen

13 Ear, Nose, and Throat Devices 137
Eva Delgado and Adva Buzi

Section IV CNS Devices 157

14 Cerebral-ventricular Shunts 159
Panagiotis Kratimenos, Angela Burd, and Chima Oluigbo

15 Initial Evaluation and Management of Patients with Neurosurgical Devices 169
Peter J. Madsen, Chariton Moschopoulos, and Benjamin C. Kennedy

Section V Miscellaneous Devices 183

16 Ophthalmic Devices 185
Marlet Bazemore and William P. Madigan

17 Breast Implants 189
R. Jason VonDerHaar and Liza C. Wu

18 Cutaneous Delivery Systems/Patches 203
Desiree M. Seeyave

19 Dental Emergencies Involving Oral Hardware 209
Chisom O.A. Agbim and Ioannis Koutroulis

Section VI Wound Management Devices 215

20 Emergency Management of Patients with Negative Pressure Wound Therapy Devices (NPWTD) 217
David Yamane and Tenagne Haile-Mariam

21 Emergency Management of Patients with Wound Infections 233
David Yamane and Tenagne Haile-Mariam

Section VII GU Devices 235

22 Emergency Management of Patients with Genitourinary Prostheses 237
Katie Wagner, Michael Phillips, and Kelly Chiles

Section VIII Cardiac Devices 245

23 Management of Prosthetic Valve Complications 247
Massoud Kazzi and Guenevere V. Burke

24 Emergency Management of Patients with Vascular Occlusion Devices, Stents, or Filters 257
Amy Caggiula

25 The Emergency Department Approach to the Patient with an Implantable Mechanical Circulatory Support Device 267
Robert Shesser

26 Emergency Management of the Patient with an Implantable Pacemaker or Defibrillator 277
Michael J. O’Neal

Section IX Pulmonary Devices 289

27 Invasive Ventilation: A Discussion of Equipment and Troubleshooting 291
Pelton A. Phinizy, Joseph J. Bolton, and John F. Tamasitis

28 Respiratory Medication Devices 313
Natalie Napolitano and James B. Fink

29 Secretion Clearance Devices 325
Amanda J. Nickel, Daniel Dawson, and Oscar H. Mayer

30 Non-invasive Ventilation 337
Oscar H. Mayer and Anthony Mozzone

31 Tracheostomy Tubes 347
Joanne Stow, Allison E. Boyd, and Jerry Cabrera

Index 373

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