Developmental dysplasia of the hip, 302 Dexmedetomidine, 39 Dextromethorphan, 1069 , 1072 Dextromethorphan, ataxia from, 108 , 108 t Dextrose, 66 t Diabetes insipidus, 668 –670 Diabetes insipidus (DI), 428 , 529 , 907 Diabetes mellitus (DM), 121 , 130 , 428 , 531 , 600 , 659 , 688 , 750 Diabetic ketoacidosis (DKA), 121 , 333 , 340 , 355 , 428 , 655 –658 Diagnostic odors, 337 Diamond–Blackfan syndrome, 418 Diaper dermatitis, 462 –463 , 463 f Diaphragmatic eventration, 1421 Diaphragmatic hernia, 1420 Diaphragmatic injuries, 1286 –1287 , 1286 f Diarrhea, 502 , 930 associated symptom, 153 association with dehydration, 153 causes, 152 t definition, 152 diagnostic approach to immunocompetent child with, 154 f differential diagnosis, 152 –153 duration, 152 evaluation and decision, 153 –154 life-threatening causes of, 152 t parenteral, 152 presence of abdominal pain in, 153 treatments, 155 –156 Diarrheal food poisoning, 1057 t Diazepam, 497 , 1109 Dicyclomine, 139 Dietary protein gastrointestinal disorders clinical indications for discharge/admission, 731 clinical recognition, 731 initial assessment, 731 management/diagnostic testing, 731 treatment, goals of, 730 –731 Diffuse axonal injury (DAI), 270 , 1254 Diffuse B-cell large cell lymphoma, 910 Diffuse injury, 1257 Diffuse lymphadenopathy, 1013 Diffusion-weighted imaging (DWI), 1256 Digital subtraction angiography, 1407 Digoxin, 1045 Dihydroergotamine (DHE), 887 Diphtheria, 847 Direct immunofluorescence assay (DFA), 1343 Direct laryngoscopes, 37 –38 blades, 37 selection of, 38 handles, 37 Direct medical control, 9e Direct ocular trauma, 171 Dirty bomb, 704 Discharge instructions, 1164 , 1164 t, 1175 , 1191 , 1e comprehension and retention of, obstacles to, 2e follow-up and, 3e formats of, 1e –3e combination method, 2e multimedia technology and, 2e verbal instructions, 1e written instructions, 1e –2e legal and regulatory considerations, 1e legal considerations, 1e literacy and language comprehension in, 3e meaningful use of, 1e medications and medication reconciliation and, 3e for nonnative English-speaking patients, 3e principles of, 1e Discitis (diskitis), 328 , 362 –363 , 1375 –1377 intervertebral disc space, 1376 f osteomyelitis, 1387 –1388 Disease-modifying antirheumatic drugs (DMARDs), 1014 , 1014 t Displaced teeth, 1107 –1109 Disseminated disease, 459 Disseminated gonococcal disease, 852 Disseminated intravascular coagulopathy (DIC), 420 , 500 , 997 Disseminated Neisseria gonorrhoeae, 645 Disorders of hemostasis acquired defects, 794 clinical indications for discharge/admission, 794 inherited bleeding disorders, 792 –793 management disseminated intravascular coagulopathy (DIC), 794 rare inherited coagulation factor deficiencies, 793 –794 Distal interphalangeal (DIP) joint, 1146 , 1343 Distal radius fractures, 1194 –1196 Distal upper extremity, neurologic examination of, 1186 t Distension, 87 See also Abdominal distention Distention abdominal, 87 –93 bowel, 87 , 91 f gastric, 87 , 89 Distraction fractures, 1210 –1211 Distributive shock, 73 , 75 foreign body related, 378 neuromuscular disorders and, 376 –378 pathophysiology, 376 postoperative, 378 treatment, 381 –382 , 382 f Drowning cardiovascular effects, 680 clinical manifestations, 681 definition, 680 hypoxemia and, 680 indications for discharge/admission, 682 initial assessment, 681 management, 681 –682 , 681 f pulmonary edema, 682 f triage considerations, 681 Dysphonia, 133 Dyspnea, 133 Dysrhythmias, 1079 Dystonia, 897 Dystonic reactions, 330 Dysuria, 531 causes dermatologic conditions, 384 t localized conditions, 384 t–385 t systemic conditions, 383 t evaluation and decision, 383 –386 history and physical examination, 383 laboratory studies, 384 –385 postpubertal children pathway, 387 f prepubertal children pathway, 386 f symptomatic management, 386 E Ear, external, 1329 auricular perichondritis, 1329 –1330 , 1330 f otitis externa, 1329 –1330 , 1329 f–1330 f treatment, goals of, 1329 Ear foreign body, 1112 “Early-onset” mushrooms, 1067 Ear pain acute otitis media (AOM), 390 –392 algorithm, 390 f cerumen impaction and, 389 differential diagnosis, 389 ear lobe infections and, 389 from foreign bodies, 389 frostbite and, 389 otitis externa, 389 –390 otorrhea, 392 referred, 393 traumatic TM perforation, 393 Ear trauma, 1112 clinical recognition, 1112 ... 1146 , 1343 Distal radius fractures, 1194 –1196 Distal upper extremity, neurologic examination of, 1186 t Distension, 87 See also Abdominal distention Distention abdominal, 87 –93 bowel, 87 , 91