Author: WikEM

Tintinalli’s Emergency Medicine (7th Edition)

SECTION 25: ABUSE AND ASSAULT

Chapter 290: Child Abuse and Neglect

Chapter 291: Female and Male Sexual Assault

Chapter 292: Intimate Partner Violence and Abuse

Chapter 293: Abuse of the Elderly and Impaired

Pages 1975 – 1990

WikEM articles:

• http://www.wikem.org/wiki/Geriatrics_(Main_Page)
• http://www.wikem.org/wiki/Pediatric_Common_Problems
• http://www.wikem.org/wiki/Sexual_Assault

Reading Selection

Chapter 100: Abdominal and Pelvic Pain in the Nonpregnant Female

Pages 672 – 676 (Tintinalli’s Emergency Medicine, 7th Edition)

Key Points and Pearls

• The bimanual exam is of limited value given its lack of accuracy and reproducibility for complaints such as CMT, adnexal tenderness or masses
• Ovarian cysts may cause pain when they rupture, precipitate ovarian torsion, or become large enough to cause pressure on adjacent structures
• Hormonal contraception is used to prevent cysts from forming (rather than to treat persistent functional cysts)
• Risk factors for torsion include ovarian cysts, tumors, pregnancy, and chemical induction of ovulation
• PID treatment includes ceftriaxone 250mg IM x 1 + doxycycline 100mg PO BID x 14 days + metronidazole 500mg PO BID x

Reading Selection

Chapter 39: Pain Management in Infants and Children

Tintinalli’s Emergency Medicine (7th Edition) pages 265 – 270

Key Points and Pearls

• Pediatric procedures should be performed with pharmacological and nonpharmacological adjuncts to minimize pain (analgesia), decrease anxiety (anxiolysis), and provide sedation.
• Fasting status has no correlation with aspiration. Preprocedural fasting is not required and only prevents a theoretical risk of aspiration, though no evidence supports this risk.

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