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This well-illustrated book provides detailed guidance on all aspects of physical examination in patients requiring emergency or intensive care. After an introductory section covering basic principles and the recognition of pre-terminal signs, the approach to examination of individual organ systems is clearly explained. Examination schemes are then presented for particular conditions or settings, including respiratory distress, shock, neurological disease, trauma, suspected infection, and cardiac arrest. The skill of physical examination has become the forgotten art of medicine in both undergraduate and postgraduate studies. Furthermore, most books on the topic have so far focused on examination practices applicable to non-critically ill patients. In emergency and intensive care medicine, however, a different approach and sometimes also different examination techniques are required due to the life-threatening disease process. In summarizing knowledge and providing guidance on physical examination in this specific subgroup of patients, this book will meet the needs of all physicians and allied health care professionals involved in the care of critically ill patients.
The ultimate guide to the evidence-based clinical encounter "This book is an excellent source of supported evidence that provides useful and clinically relevant information for the busy practitioner, student, resident, or educator who wants to hone skills of physical diagnosis. It provides a tool to improve patient care by using the history and physical examination items that have the most reliability and efficiency."--Annals of Internal Medicine "The evidence-based examination techniques put forth by Rational Clinical Examination is the sort that can be brought to bear on a daily basis – to save time, increase confidence in medical decisions, and help decrease unnecessary testing for conditions that do not require absolute diagnostic certainty. In the end, the whole of this book is greater than its parts and can serve as a worthy companion to a traditional manual of physical examination."--Baylor University Medical Center (BUMC)Proceedings 5 STAR DOODY'S REVIEW! "Physical diagnosis has been taught to every medical student but this evidence-based approach now shows us why, presenting one of medicine's most basic tenets in a new and challenging light. The format is extraordinary, taking previously published material and updating the pertinent evidence since the initial publication, affirming or questioning or refining the conclusions drawn from the data. "This is a book for everyone who has studied medicine and found themselves doubting what they have been taught over the years, not that they have been deluded, but that medical traditions have been unquestionably believed because there was no evidence to believe otherwise. The authors have uncovered the truth. "This extraordinary, one-of-a-kind book is a valuable addition to every medical library."--Doody's Review Service Completely updated with new literature analyses, here is a uniquely practical, clinically relevant approach to the use of evidence in the content of physical examination. Going far beyond the scope of traditional physical examination texts, this invaluable resource compiles and presents the evidence-based meanings of signs, symptoms, and results from physical examination maneuvers and other diagnostic studies. Page after page, you'll find a focus on actual clinical questions and presentations, making it an incomparably practical resource that you'll turn to again and again. Importantly, the high-yield content of The Rational Clinical Examination is significantly expanded and updated from the original JAMA articles, much of it published here for the first time. It all adds up to a definitive, ready-to-use clinical exam sourcebook that no student or clinician should be without. FEATURES Packed with updated, new, and previously unpublished information from the original JAMA articles Standardized template for every issue covered, including: Case Presentation; Why the Issue Is Clinically Important; Research and Statistical Methods Used to Find the Evidence Presented; The Sensitivity and Specificity of Each Key Result; Resolution of the Case Presentation; and the Clinical Bottom Line Completely updated with all-new literature searches and appraisals supplementing each chapter Full-color format with dynamic clinical illustrations and images Real-world focus on a specific clinical question in each chapter, reflecting the way clinicians approach the practice of evidence-based medicine More than 50 complete chapters on common and challenging clinical questions and patient presentations Also available: JAMAevidence.com, a new interactive database for the best practice of evidence based medicine
Critical care medicine is a dynamic and exciting arena where complex pathophysiologic states require extensive knowledge and up-to-date clinical information. An extensive kno- edge of basic pathophysiology, as well as awareness of the appropriate diagnostic tests and treatments that are used to optimize care in the critically ill is essential. Since our frst edition 7 years ago, new information crucial to the care and understanding of the critically ill patient has rapidly accumulated. Because this knowledge base crosses many different disciplines, a comprehensive multidisciplinary approach presenting the information is essential, similar to the multidisciplinary approach that is used to care for the critically ill patient. We have strived to provide this content in an easily digestible format that uses a variety of teaching tools to facilitate understanding of the presented concepts and to enhance information retention. To meet the demand to provide comprehensive and diverse education in order to und- stand the pathogenesis and optimum care of a variety of critical illnesses, we have subst- tially revised the prior topics in the frst edition with updated information. We have also markedly expanded the number of topics covered to include acute lung injury and the acute respiratory distress syndrome, an expanded discussion of the physiology and operation of mechanical ventilation, obstetrical care in the ICU, neurosurgical emergencies, acute co- nary syndromes, cardiac arrhythmias, role of whole body rehabilitation in the ICU, ethical conduct of human research in the ICU, and nursing care of the ICU patient.
The “essential” companion to the landmark Users' Guides to the Medical Literature - completely revised and updated! 5 STAR DOODY'S REVIEW! "This second edition is even better than the original. Information is easier to find and the additional resources that will be available at www.JAMAevidence.com will provide readers with a one-stop source for evidence-based medicine."--Doody's Review Service Evidence-based medicine involves the careful interpretation of medical studies and its clinical application. And no resource helps you do it better-and faster-than Users' Guides to the Medical Literature: Essentials of Evidence-Based Clinical Practice. This streamlined reference distills the most clinically-relevant coverage from the parent Users' Guide Manual into one highly-focused, portable resource. Praised for its clear explanations of detailed statistical and mathematical principles, The Essentials concisely covers all the basic concepts of evidence-based medicine--everything you need to deliver optimal patient care. It's a perfect at-a-glance source for busy clinicians and students, helping you distinguish between solid medical evidence and poor medical evidence, tailor evidence-based medicine for each patient, and much more. Now in its second edition, this carry-along quick reference is more clinically relevant--and more essential--than ever! FEATURES Completely revised and updated with all new coverage of the basic issues in evidence-based medicine in patient care Abundant real-world examples drawn from the medical literature are woven throughout, and include important related principles and pitfalls in using clinical research in patient care decisions Edited by over 60 internationally recognized editors and contributors from around the globe Also look for JAMAevidence.com, a new interactive database for the best practice of evidence based medicine.
The fully updated second edition of this popular handbook concisely summarises all current knowledge about delirium in critically ill patients and describes simple tools the bedside clinician can use to prevent, diagnose and manage delirium. Chapters discuss new developments in assessing risk and diagnosis, crucial discoveries regarding delirium and long-term cognitive outcomes, and dangers of sedation and death. Updated management advice reflects new evidence about antipsychotics and delirium. This book explains how to minimise the risks of delirium, drugs to avoid, drugs to use and when to use them, as well as current theories regarding pathophysiology, different motoric subtypes leading to missed diagnosis, and the adverse impact of delirium on patient outcomes. While there are still unanswered questions, this edition contains all the available answers. Illustrated with real-life case reports, Delirium in Critical Care is essential reading for trainees, consultants and nurses in the ICU and emergency department.
A guide to the techniques and analysis of clinical data. Each of the seventeen sections begins with a drawing and biographical sketch of a seminal contributor to the discipline. After an introduction and historical survey of clinical methods, the next fifteen sections are organized by body system. Each contains clinical data items from the history, physical examination, and laboratory investigations that are generally included in a comprehensive patient evaluation. Annotation copyrighted by Book News, Inc., Portland, OR
The first book to teach physical assessment techniques based on evidence and clinical relevance. Grounded in an empirical approach to history-taking and physical assessment techniques, this text for healthcare clinicians and students focuses on patient well-being and health promotion. It is based on an analysis of current evidence, up-to-date guidelines, and best-practice recommendations. It underscores the evidence, acceptability, and clinical relevance behind physical assessment techniques. Evidence-Based Physical Examination offers the unique perspective of teaching both a holistic and a scientific approach to assessment. Chapters are consistently structured for ease of use and include anatomy and physiology, key history questions and considerations, physical examination, laboratory considerations, imaging considerations, evidence-based practice recommendations, and differential diagnoses related to normal and abnormal findings. Case studies, clinical pearls, and key takeaways aid retention, while abundant illustrations, photographic images, and videos demonstrate history-taking and assessment techniques. Instructor resources include PowerPoint slides, a test bank with multiple-choice questions and essay questions, and an image bank. This is the physical assessment text of the future. Key Features: Delivers the evidence, acceptability, and clinical relevance behind history-taking and assessment techniques Eschews “traditional” techniques that do not demonstrate evidence-based reliability Focuses on the most current clinical guidelines and recommendations from resources such as the U.S. Preventive Services Task Force Focuses on the use of modern technology for assessment Aids retention through case studies, clinical pearls, and key takeaways Demonstrates techniques with abundant illustrations, photographic images, and videos Includes robust instructor resources: PowerPoint slides, a test bank with multiple-choice questions and essay questions, and an image bank Purchase includes digital access for use on most mobile devices or computers
Written specifically for non-infectious disease specialists in both inpatient and outpatient settings, A Rational Approach to Clinical Infectious Diseases provides concise, practical guidance that mimics the decision-making process and reasoning employed by an ID physician. Using clear, understandable language, Dr. Zelalem Temesgen and his esteemed colleagues at the Mayo Clinic present the art and the context of infectious diseases together with the science, helping non-specialists apply a rational approach to the diagnosis and treatment of infectious conditions. Clearly explains the rationale of opting for one particular treatment or length of course over another in order to arrange appropriate management and follow-up. Provides focused ID decision support to questions such as: What diagnostic test should I order? What is the correct antibiotic for this patient/geographical region? Are IV or oral antibiotics most appropriate? How long should the antibiotic course be and when should it be de-escalated? What special considerations should be taken in immunocompromised patients? How often should complex infections be followed up? Uses a succinct, easy-to-read writing style, following a consistent format: Important characteristics/epidemiology; Clinical related data; Rash characteristics; Ancillary diagnostic studies; Treatment; and Other. Provides visual and quick-reference support with dozens of figures and tables throughout the text. Contains invaluable guidance to help non-specialists provide the best care for patients, stem antibiotic misuse and resistance, avoid adverse drug events, and avoid unnecessary costs.