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The Gist of Emergency Medicine - part 8

các thuốc giảm đau prn, kháng sinh, và theo dõi. Đối với viêm xoang cấp tính sử dụng một chế độ tương tự, cộng với các thuốc thông mũi tại chỗ / hệ thống X 2 3 ngày. Xem thêm chú thích (†), p. 98. → được cảnh báo cho các biến chứng của viêm tai giữa / viêm xoang | The Gist of Emergency Medicine 134 E Acute otitis media bacterial L decongestants prn analgesics prn antibiotics and follow-up. For acute sinusitis use a similar regime plus topical systemic decongestants X 2-3days. See also footnote Ỷ p. 98. be on the alert for the complications of otitis sinusitis e.g. mastoiditis meningitis brain abscess orbital cellulitis cavernous sinus syndrome sepsis. prophylaxis for recurrent otitis media L zithromax 10mg kg weekly. 3 THREE A Only avulsed permanent teeth can be reimplanted. B Dental infections with visible facial edema L penicillin and flagyl or clindamycin alone. give initial dose s I.V. depending on the severity. C Post-dental extraction pain dry socket try sprinkling clindamycin on the site from an open capsule followed by moist packing. Dental consult prn. 4 Erythema multiforme may progress to Steven-Johnson syndrome erythema multiforme major . L ABC s treat the underlying cause discontinue possible causative drugs steroids prn antibiotics prn biopsy prn to burn centre prn Steven-Johnson syndrome . See also Urticaria 7 C p. 136. 5 FIVE A Toxic epidermal necrolysis children usually less than 6 years more superficial due to staph toxin adults deeper usually due to a drug biopsy L ABC s discontinue possible causative drugs antibiotics prn treat as 2nd degree burns to burn center prn application of a temporary skin substitute . EENT - Skin - Joints - Allergy The Gist of Emergency Medicine 135 B Poison ivy L ABC s prednisone 50-60mg OD tapered over 2-3 weeks Burow s solution compresses prn. C Pityriasis Rosea L ABC s symptomatic treatment prednisone prn. 6 Joints Caution an acute inflammatory monoarthritis is infection until proven otherwise overlying cellulitis . The presence of crystals or a negative gram stain does not exclude a septic joint. Err on the side of I.V. antibiotics with staph coverage plus an orthopedic consult . quick joint assessment hand grip scratch back cross legs knees ankles gait. Preparation for joint