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/ Fleis Ludwig’s MS Textbook of Pediatric Emergency Medicine r Eighth Edition F / F r r EDITORS Kathy N Shaw Richard G Bachur ASSOCIATE EDITORS James Chamberlain b ^“ Welters Ktuwer Jane Lavelle Joshua Nagler Joan E, Shook Fleisher & Ludwig’s Textbook of Pediatric Emergency Medicine Eighth Edition Senior Editors Kathy N Shaw, MD, MSCE Professor and Associate Chair Department of Pediatrics Perelman School of Medicine at the University of Pennsylvania The Nicholas Crognale Endowed Chair in Emergency Medicine The Children’s Hospital of Philadelphia Philadelphia, Pennsylvania Richard G Bachur, MD Chief, Division of Emergency Medicine Professor of Pediatrics and Emergency Medicine Department of Pediatrics Division of Emergency Medicine Boston Children’s Hospital/Harvard Medical School Boston, Massachusetts Associate Editors James M Chamberlain, MD Division Chief Department of Emergency Medicine Children’s National Hospital Professor of Pediatrics and Emergency Medicine George Washington University School of Medicine and Health Sciences Washington, DC Jane Lavelle, MD Associate Professor of Pediatrics Department of Pediatrics Perelman School of Medicine at the University of Pennsylvania Medical Director, Associate Division Chief Emergency Medicine Medical Director, Pathway Program Office of Continuous Quality Improvement The Children’s Hospital of Philadelphia Philadelphia, Pennsylvania Joshua Nagler, MD, MHPEd Associate Division Chief and Fellowship Director/Associate Professor of Pediatrics and Emergency Medicine Division of Emergency Medicine/Department of Pediatrics Boston Children’s Hospital/Harvard Medical School Boston, Massachusetts Joan E Shook, MD Professor Department of Pediatrics Baylor College of Medicine Chief Safety Officer and Chief Clinical Information Officer Texas Children’s Hospital Houston, Texas Executive Editor: Sharon Zinner Senior Development Editor: Ashley Fischer Editorial Coordinator: Chester Anthony Gonzalez Editorial Assistant: Brian Convery Marketing Manager: Phyllis Hitner Production Project Manager: Catherine Ott Design Coordinator: Joseph Clark Manufacturing Coordinator: Margie Orzech-Zeranko Prepress Vendor: Aptara, Inc Eighth Edition Copyright © 2021 Wolters Kluwer Copyright © 2016 Wolters Kluwer Health Copyright © 2010 by LIPPINCOTT WILLIAMS & WILKINS, a WOLTERS KLUWER business All rights reserved This book is protected by copyright No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews Materials appearing in this book prepared by individuals as part of their official duties as U.S government employees are not covered by the above-mentioned copyright To request permission, please contact Wolters Kluwer at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at permissions@lww.com , or via our website at shop.lww.com (products and services) 987654321 Printed in China Library of Congress Cataloging-in-Publication Data Names: Shaw, Kathy N., editor | Bachur, Richard G., editor Title: Fleisher & Ludwig’s textbook of pediatric emergency medicine / senior editors, Kathy N Shaw, Richard G Bachur; associate editors, James M Chamberlain, Jane Lavelle, Joshua Nagler, Joan E Shook Other titles: Fleisher and Ludwig’s textbook of pediatric emergency medicine Description: 8th edition | Philadelphia, PA : Wolters Kluwer, [2021] | Includes bibliographical references and index | Summary: “Our primary goal as practitioners is to provide high-quality, safe care for each child who arrives in our emergency department The ability to stay current with knowledge and clinical skills across all possible conditions is impossible for any clinician Furthermore, the evidence may be poor, inconsistent, or changing for the management of many diseases or injuries This leads to a wide variation in practice, high rates of inappropriate care, patient harm, and wasted resources Additionally, the model of optimal care in emergency departments is challenged by high acuity and crowding that demands teamwork, resources, a well-structured quality program, and a ... Chair in Emergency Medicine The Children’s Hospital of Philadelphia Philadelphia, Pennsylvania Richard G Bachur, MD Chief, Division of Emergency Medicine Professor of Pediatrics and Emergency Medicine. .. Division Chief and Fellowship Director/Associate Professor of Pediatrics and Emergency Medicine Division of Emergency Medicine/ Department of Pediatrics Boston Children’s Hospital/Harvard Medical School... Division Chief Department of Emergency Medicine Children’s National Hospital Professor of Pediatrics and Emergency Medicine George Washington University School of Medicine and Health Sciences Washington,