Download Common Simple Emergencies (Brady's series in emergency by Philip M. Buttaravoli PDF

By Philip M. Buttaravoli

Emergency medication

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If the test is negative or unavailable and you have a high clinical suspicion that this is a viral pharyngitis, provide symptomatic treatment (below), send a culture, and hold antibiotics pending results. For reistant or recurrent infections with possible beta-lactamase- producing co-pathogens, consider instead 10 days of cephalexin (Keflex), cefadroxil (Duricef, Ultracef), cefaclor (Ceclor), or cefurooxime (Ceftin, Zinacef). If you suspect mononucleosis, draw blood for atypical lymphocytes and a heterophile or monospot to confirm the diagnosis (see below).

Inject directly into the palpable depression left by the displaced condyle. After reducing the dislocation it will be comforting to apply a soft cervical collar to reduce the range of motion at the temperomandibular joint (TMJ). Recommend a soft diet and instruct thepatient to refrain from opening his mouth too widely. Prescribe analgesics if needed. If reduction cannot be obtained using the above techniques, then consider admission for reduction under general anesthesia. What not to do: Try not to get your thumbs bitten when the jaw snaps back into position.

Discussion Most otitis is caused by a viral infection, and most patients do well regardless of the antibiotic chosen. Despite the increase in antimicrobial resistance of community-acquired Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis and the plethora of alternative antibiotics available, amoxicillin remains the drug of choice, because it concentrates in middle ear fluid. References: Niemela M, Uhari M, Jounio-Ervasti K et al: Lack of specific symptomology in children with acute otitis media.

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