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 Inflammatory 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 abnormalities
    
  • 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 Acid-base Disturbances

• 5.1.1 Metabolic or respiratory
  
  • 5.1.1.1 Acidosis
    
  • 5.1.1.2 Alkalosis
    
• 5.1.2 Mixed acid-base balance disorder
  

5.2 Adrenal Disease

• 5.2.1 Corticoadrenal insufficiency
  
• 5.2.2 Cushing's syndrome
  

5.3 Fluid and Electrolyte Disturbances

• 5.3.1 Calcium metabolism
  
• 5.3.2 Fluid overload/Volume depletion
  
• 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
20.1.1 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