Abstract
The dermatologic office emergency is often dismissed as medical oxymoron. The medications administered or procedures performed rarely precipitate a crisis. Nevertheless, certain medical questions and emergencies are relevant to the dermatologic physician, regardless of their low frequency. Based upon the limited literature available and clinical experience, this chapter is designed to offer a practical approach to selected emergency issues that are potentially encountered in the practice of medical and surgical dermatology.
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References
Guidelines for cardiopulmonary resuscitation and emergency cardiac care. Emergency Cardiac Care Committee and Subcommittees, American Heart Association. Part I Introduction. JAMA 1992;268:2171–2183.
Heart and stroke facts: 2000 statistical update. American Heart Association; 1999.
Weaver WD, Hill D, Fahrenbruch CE, et al. Use of automated external defibrillator in the management of out-ofhospital cardiac arrest. N Engl J Med 1988;319:661–666.
Bayes de Luna A, Coumel P, Leclercq JF. Ambulatory sudden cardiac death; mechanisms of production of fatal arrhythmia on the basis of data from 157 cases. Am Heart J 1989;117:151–159.
White RD, Hankins DG, Bugliosi TF. Seven years’ experience with early defibrillation by police and paramedics in an emergency medical services system. Resuscitation 1998;39:145–151.
Kellermann AL, Hackman BB, Somes G, Kreth TK, Nail L, Dobyns P. Impact of first-responder defibrillation in an urban emergency medical services system. JAMA 1993;270:1708–1713.
Varon J, Marik P. Treatment of cardiac arrest with automatic external defibrillators: impact on outcome. Am J Cardiovasc Drugs 2003;3:265–270.
Holmberg M, Holmberg S, Herlitz J. The problem of out-of-hospital cardiac arrest prevalence of sudden death in Europe today. Am J Cardiol 1999;83:88D–90D.
Auble TE, Menegazzi JJ, Paris PM. Effect of out-of-hospital cardiac defibrillation by basic life support providers on cardiac arrest mortality; a metaanalysis. Ann Emerg Med 1995;25:642–648.
Cummins RO, Ornato JP, Thies WH, Pepe PE. Improving survival from sudden cardiac arrest: the “chain of survival” concept. A statement for health professionals from the Advanced Cardiac Life Support Subcommittee and the Emergency Cardiac Care Committee, American Heart Association. Circulation 1991;83:1832–1847.
Eisenberg MS, Bergner L, Hallstrom A. Cardiac resuscitation in the community: importance of rapid provision and implications for program planning. JAMA 1979;241:1905–1907.
Weaver WD, Copass MK, Hill D, Fahrenbruch C, Hallstrom AP, Cobb L. Cardiac arrest treated with a new automatic external defibrillator by out-of-hospital first responders. Am J Cardiol 1986;57:1017–1021.
Guidelines of care for office surgical facilities: part I. J Am Acad Dermatol 1992;26:763–765.
Guidelines of care for office surgical facilities: part II. J Am Acad Dermatol 1995;33:265–270.
Kobernick MS. Management of emergencies in the medical office. J Emerg Med 1986;4:71–74.
Fuchs S, Jaffe DM, Christoffel KK. Pediatric emergencies in office practices: prevalence and office preparedness. Pediatrics 1989;83:931–939.
Altieri M, Bellet J, Scott H. Preparedness for pediatric emergencies encountered in the practitioner’s office. Pediatrics 1990;85:710–714.
Emergency Cardiac Care Committee and subcommittees, American Heart Association. Guidelines for cardiopulmonary resuscitation and emergency cardiac care, II: adult basic life support. JAMA 1992;268:2184–2198.
Emergency Cardiac Care Committee and subcommittees, American Heart Association. Guidelines for cardiopulmonary resuscitation and emergency cardiac care, III: adult advanced cardiac life support. JAMA 1992;268:2199–2241.
BLS for healthcare providers. American Heart Association; 2001.
Emergency Cardiac Care Committee and subcommittees, American Heart Association. Guidelines for cardiopulmonary resuscitation and emergency cardiac care, IX; ensuring effectiveness of communitywide emergency cardiac care. JAMA 1992;268:2289–2295.
Thomas RM, Amonette RA. Emergencies in skin surgery. In: Roenigk RK, Roenigk HH, eds. Dermatologic surgery, principles and practice. 2nd ed. New York: Marcel Dekker; 1996:77–89.
Nagi C, Thomas RM. Recognition and management of office medical and surgical emergencies. In: Wheeland RG, ed. Cutaneous surgery. Philadelphia: Saunders; 1994:150–158.
Cummins RO. From concept to standard-of-care? Review of the clinical experience with automated external defibrillators. Ann Emerg Med 1989;18:1269–1275.
Cummins RO, Thies W. Encouraging early defibrillation: the American Heart Association and automated external defibrillators. Ann Emerg Med 1990;19:1245–1248.
Weisfeldt ML, Kerber RE, McGoldrick RP, et al., for the American Heart Association Task Force on automatic external defibrillation. Public access to defibrillation. Circulation 1995;92:2763.
Marenco JP, Wang PJ, Link MS, et al. Improving survival from sudden cardiac arrest: the role of the automated external defibrillator. JAMA 2001;285:1193–1200.
Cummins RO, Eisenberg M, Bergner L, Murray JA. Sensitivity, accuracy, and safety of an automatic external defibrillator. Lancet 1984;2:318–320.
Liner BE, Jorgenson DB, Poole JE, et al., for the LIFE Investigators. Treatment of out-of-hospital cardiac arrest with low-energy impedance-compensating biphasic waveform automatic external defibrillators. Biomed Instrum Technol 1998;32:631–644.
Stults KR, Brown DD, Cooley F, et al. Self-adhesive monitor/defibrillator pads improve pre-hospital defibrillation success. Ann Emerg Med 1987;16:872–877.
Carlson MD, Freeman CS, Garan H, Ruskin JN. Sensitivity of an automatic external defibrillator for ventricular tachyarrhythmias in patients undergoing electrophysiologic studies. Am J Cardiol 1988;61:787–790.
Poole JE, White RD, Kanz KG, et al. Low-energy impedance-compensating biphasic waveforms terminate ventricular fibrillation at high rates in victims of out-of-hospital cardiac arrest. J Cardiovasc Electrophysiol 1997;8:1373–1385.
Ramaswamy K, Page RL. The automated external defibrillator: critical link in the chain of survival. Ann Rev Med 2003;54:235–243.
Varon J, Marik PE. Treatment of cardiac arrest with automatic external defibrillators: impact on outcome. Am J Cardiovasc Drugs 2003;3:265–270.
Das MK, Zipes DP. Sudden cardiac arrest and automated external defibrillators. Circ J 2003;67:975–982.
Liddle R, Davies CS, Colquhoun M, Handley AJ. ABC of resuscitation: the automated external defibrillator. BMJ 2003;327:1216–1218.
Soto-Aguilar MC, deShazo RD, Waring NP. Anaphylaxis: why it happens and what to do about it. Postgrad Med 1987;82:154–170.
McLean-Tooke APC, Bethune CA, Fay AC, Spickett GP. Adrenaline in the treatment of anaphylaxis: what is the evidence? BMJ 2003;327:1332–1334.
Tang AW. A practical guide to anaphylaxis. Am Fam Physician 2003;68:1325–1332.
Bochner BS, Lichtenstein LM. Anaphylaxis. N Engl J Med 1991;324:1785–1790.
Malde B, Ditto AM. Anaphylaxis. Allergy Asthma Proc 2004;25:S52–S53.
Kemp SF, Lockey RF, Wolf BL, et al. Anaphylaxis — a review of 266 cases. Arch Intern Med 1995;155:1749–1754.
Lieberman P. Anaphylaxis and anaphylactoid reactions. In: Middleton E, ed. Allergy: principles and practice. 5th ed. St. Louis: Mosby; 1998:1079–1089.
Ditto AM, Grammer LG. Food allergy. In: Grammer LG, Greenberger PA, eds. Patterson’s allergic diseases. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2002:260.
Thong BY, Chan Y. Anaphylaxis during surgical and interventional procedures. Ann Allergy Asthma Immunol 2004;92:619–628.
Joint Task Force on Practice Parameters. The diagnosis and management of anaphylaxis. J Allergy Clin Immunol 1998;101:S465–S528.
Neugut A, Ghatak, AT, Miller RL. Anaphylaxis in the United States: an investigation into its epidemiology. Arch Intern Med 2001;161:15–21.
Pippen R. Anaphylactoid reaction after Chymacort ointment. BMJ 1966;1:1168–1172.
Comaish JS, Cunliffe WJ. Absorption of drugs from various ulcers: a cause of anaphylaxis. Br J Clin Pract 1967;21:97.
Roupe G, Strennegard O. Anaphylactic shock elicited by topical administration of bacitracin. Arch Dermatol 1969;100:450–452.
Daughters D, Zackheim H, Maibach H. Urticaria and anphylactoid reactions after topical application of mechlorethamine. Arch Dermatol 1973;107:429–430.
Vale MA, Connolly A, Epstein AM, et al. Bacitracin-induced anaphylaxis. Arch Dermatol 1978;114:800.
Schechter JF, Wilkison RD, Carpio JD. Anaphylaxis following the use of bacitracin ointment. Arch Dermatol 1984;120:909–911.
Phillips TJ, Rogers GS, Kanj LF. Bacitracin anaphylaxis. J Geriatr Dermatol 1995;3:83–85.
Okano M, Nomura M, Hata S, et al. Anaphylactic symptoms due to chlorhexidine gluconate. Arch Dermatol 1989;125:50–52.
Pharm NH, Weiner JM, Reisner GS, Baldo BA. Anaphylaxis to chlorhexidine: case report: implication of immunoglobulin E antibodies and identification of an allergenic determinant. Clin Exp Allergy 2000;30:1001–1007.
Garvey LH, Roed-Petersen J, Husum B. Anaphylaxis I anesthetized patients: four cases of chlorhexidine allergy. Acta Anaesthesiol Scand 2001;45:1290–1294.
Gordon BR. Prevention and management of office allergy emergencies. Otolaryngol Clin North Am 1992;25:119–134.
Martin JB, Ruskin J. Faintness, syncope, and seizures. In: Wilson JD, et al., eds. Harrison’s principles of internal medicine. 12th ed. New York: McGraw-Hill; 1991:134–140.
Mook WH. Skin reactions to apothesin and quinine in susceptible persons. Arch Dermatol 1920;1:651–655.
Mackley CL, Marks JG. Lidocaine hydrochloride. Am J Contact Dermat 2003;14:221–223.
Chiu C, Lin T, Hsia S, et al. Systemic anaphylaxis following local lidocaine administration during a dental procedure. Ped Emerg Care 2004;20:178–180.
Giovannitt J, Bennett CR. Assessment of allergy to local anesthetics. J Am Dent Assoc 1979;98:701–706.
Chin TM, Fellner MJ. Allergic hypersensitivity to lidocaine hydrochloride. Int J Dermatol 1980;19:147–148.
Verrill PJ. Adverse reactions to local anesthetics and vasoconstrictor drugs. Practitioner 1975;214:380–387.
Amsler E, Flahault A, Mathelier-Fusade P, Aractingi S. Evaluation of re-challenge in patients with suspected lidocaine allergy. Dermatology 2004;208:109–111.
Curley RK, Macfarlane AW, King CM. Contact sensitivity to the amide anesthetics lidocaine, prilocaine, and mepivacaine: case report and review of the literature. Arch Dermatol 1986;122:924–926.
Bircher AJ, Messmer SL, Surber C, Rufli T. Delayed-type hypersensitivity to subcutaneous lidocaine with tolerance to articaine: confirmation by in vivo and in vitro tests. Contact Dermatitis 1996;24:387–389.
Whalen JD. Delayed-type hypersensitivity after subcutaneous administration of amide anesthetic. Arch Dermatol 1996;132:1256–1257.
Briet S, Rueff F, Przybilla B. “Deep impact” contact allergy after subcutaneous injection of local anesthetics. Contact Dermatitis 2001;45:296–297.
Downs AM, Lear JT, Wallington TB, Sansom JE. Contact sensitivity and systemic reaction to pseudoephedrine and lignocaine. Contact Dermatitis 1998;39:33.
Kaufman JM, Hale EK, Ahinoff RA, Cohen DE. Cutaneous lidocaine allergy confirmed by patch testing. J Drugs Dermatol 2002;2:192–194.
Finucane BT. Allergies to local anesthetics — the real truth. Can J Anesth 2003;50:869–874.
Macy E. Local anesthetic adverse reaction evaluations: the role of the allergist. Ann Allergy Asthma Immunol 2003;91:319–320.
Chandler MJ, Grammer LC. Provocative challenge with local anesthetics in patients with a prior history of reaction. J Allergy Clin Immunol 1987;79:883–886.
Lu D. Managing patients with local anesthetic complications using alternative methods. Penn Dent J 2002;69(3):22–29.
Bronner LL, Kanter DS, Manson JE. Primary prevention of stroke. N Engl J Med 1995;333:1392–1400.
Pepe PE. The chain of recovery from brain attack: access, pre-hospital care, and treatment. In: Proceedings of the National Symposium on Rapid Identification and Treatment of Acute Stroke. Bethesda, MD: The National Institute of Neurological Disorders and Stroke; 1996:20–42.
Broderick JP, Brott T, Tomsick T, et al. The risk of subarachnoid and intracerebral hemorrhages in blacks as compared with whites. N Engl J Med 1992;326:733–736.
Brott T, Thalinger K, Hertzberg V. Hypertension as a risk factor for spontaneous intracerebral hemorrhage. Stroke 1986;17:1078–1083.
Broderick JP, Brott TG, Tomsick T, et al. Ultra-early evaluation of intracerebral hemorrhage. J Neurosurg 1990;72:195–199.
The NINDS rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med 1995;333:1581–1587.
Hacke W, Kaste M, Fieschi C, et al. Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke: the European Cooperative Acute Stroke Study (ECASS). JAMA 1995;274:1017–1025.
Kwiatkowski TG, Libman RB, Frankel M, et al. Effects of tissue plasminogen activator for acute ischemic stroke at one year. N Engl J Med 1999;340:1781–1787.
Albers GW, Bates VE, Clark WM, et al. Intravenous tissuetype plasminogen activator for treatment of acute stroke: the Standard Treatment with Alteplase to Reverse Stroke (STARS) Study. JAMA 2000;283:1145–1150.
Hazinki MF. Demystifying recognition and management of stroke. Curr Emerg Cardiac Care 1996;7:8.
Barsan WG, Brott TG, Broderick JP, et al. Time of hospital presentation in patents with acute stroke. Arch Intern Med 1993;153:2558–2561.
Feldmann E, Gordon N, Brooks JM, et al. Factors associated with early presentation of acute stroke. Stroke 1993;24:1805–1810.
Kothari R, Pancioli A, Liu T, et al. Cincinnati Prehospital Stroke Scale: reproducibility and validity. Ann Emerg Med 1999;33:373–378.
Selbst SM. Office management of status epilepticus. Pediatr Emerg Care 1991;7:106–109.
Delgado-Escueta AV, Wasterlain C, Treiman DM, et al. Management of status epilepticus. N Engl J Med 1982;306:1337–1340.
Handley AJ, Becker LB, Allen M, et al. Single-rescuer adult basic life support: an advisory statement from the Basic Life Support Working Group of the International Liaison Committee on Resuscitation. Resuscitation 1997;34:101–108.
Turner S, Turner I, Chapman D, et al. A comparative study of the 1992 and 1997 recovery positions for use in the UK. Resuscitation 1998;39:153–160.
Emergency Cardiac Care Committee and subcommittees, American Heart Association. Guidelines for cardiopulmonary resuscitation and emergency cardiac care, IV: special resuscitation situations. JAMA 1992;268:2242–2250.
Sebben JE. Electrosurgery and cardiac pacemakers. J Am Acad Dermatol 1983;9:457–463.
Popkin GL. Electrosurgery. In: Epstein E, ed. Skin surgery. Springfield, IL: Thomas; 1982:385–404.
Escher DJW. Types of pacemakers and their complications. Circulation 1973;47:1119–1129.
Krull EA, Pickard SD, Hall JC. Effects of electrosurgery on cardiac pacemakers. J Derm Surg 1975;1:43–45.
Wajszezak WJ, Mowry RM, Dugan WL. Deactivation of a demand pacemaker by transurethral electrocautery. N Engl J Med 1969;280:34–35.
Schwingshackl H, Maurer R, Amor H. Interfering influence of low frequency alternating currents on asynchronous and controlled pacemaker systems during the use of electrosurgical devices. Schweiz Med Wochenschr 1971;101:46–52.
Green LF, Merideth J. Transurethral operations employing high frequency electrical currents in patients with demand cardiac pacemakers. J Urol 1972;108:446–448.
Smith BR, Wise WS. Pacemaker malfunction from urethral electrocautery. JAMA 1971;218:256.
Batra YK, Bali IM. Effect of coagulation and cutting current on a demand pacemaker during transurethral resection of the prostate. A case report. Can Anaesth Soc J 1978;25:65.
O’Donoghue JK. Inhibition of a demand pacemaker by electrocautery. Chest 1973;64:664–666.
Parsonnet V, Furman S, Smyth NPD, et al. Optimal resources for implantable cardiac pacemakers. Intersociety commission for heart disease resources. Circulation 1980;68:226A.
Domino KB, Smith TC. Electrocautery-induced reprogramming of a pacemaker using a precordial magnet. Anesth Analg 1983;62:609–612.
Schultz W. Transurethral electro-resection in patients with cardiac pacemakers. Urologe 1979;18:247–249.
Levine PA, Balady GJ, Lazar HL, et al. Electrocautery and pacemakers: management of the paced patient subject to electrocautery. Ann Thorac Surg 1986;41:313–317.
Hayes DL, Vlietstra RE. Pacemaker malfunction. Ann Intern Med 1993;119:828–835.
Kellow NH. Pacemaker failure during transurethral resection of the prostate. Anaesthesia 1993;48:136–138.
Goodman NW. Diathermy and failure of cardiac pacemakers. Anaesthesia 1993;48:824.
Furman S. Electrosurgical device interference with implanted pacemakers. JAMA 1978;239:1910.
Pinski SL. Emergencies related to implantable cardioverter-defibrillators. Crit Care Med 2000;28(Suppl):N174–N180.
Niehaus M, Tebbenjohanns J. Electromagnetic interference in patients with implanted pacemakers or cardioverter-defibrillators. Heart 2001;86:246–248.
Madigan JD, Choudhri AF, Chen J, et al. Surgical management of the patient with an implanted cardiac device: implications of electromagnetic interference. Ann Surg 1999;230:639–647.
LeVasseur JG, Kennard CD, Finly EM, Muse RK. Dermatologic electrosurgery in patients with implantable cardioverter-defibrillators and pacemakers. Dermatol Surg 1998;24:233–240.
Sebben JE. The status of electrosurgery in dermatologic practice. J Am Acad Dermatol 1988;19:542–549.
El-Gamal HM, Dufresne RG, Saddler K. Electrosurgery, pacemakers and ICDs: a survey of precautions and complications experienced by cutaneous surgeons. Dermatol Surg 2001;27:385–390.
Riordan AT, Gamache C, Fosko SW. Electrosurgery and cardiac devices. J Am Acad Dermatol 1997;37:250–255.
Martinelli PT, Schultze KE, Nelson BR. Mohs micrographic surgery in a patient with a deep brain stimulator: a review of the literature on implantable electrical devices. Dermatol Surg 2004;30:1021–1030.
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Fader, D.J. (2008). Acute Emergencies in the Dermatology Office. In: Gloster, H.M. (eds) Complications in Cutaneous Surgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-73152-0_2
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