Medical issues and emergencies in the dermatology office.
We review the medical issues and emergencies potentially encountered in the practice of general or surgical dermatology. Traditional guidelines have largely consisted of dated extrapolations from the nondermatologic literature concerning procedures that are primarily irrelevant to dermatology. This article outlines a rational approach to organizing an office emergency plan for anaphylaxis, stroke, status epilepticus, myocardial infarction, and hypertensive crisis. We discuss the literature that has influenced current office behavior regarding endocarditis prophylaxis, the use of electrosurgery with pacemakers, arrhythmogenic drug interactions, vasovagal syncope, lidocaine "allergy," and bleeding complications from oral anticoagulants. Recommendations for managing these issues in a dermatologic context are provided.
Fader
D J
DJ
Department of Dermatology, University of Michigan, Ann Arbor 48109-0314, USA.
Johnson
T M
TM
D000707:Anaphylaxis / Q000628:therapy; D000779:Anesthetics, Local / Q000009:adverse effects; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects; D000925:Anticoagulants / Q000009:adverse effects; D002561:Cerebrovascular Disorders / Q000628:therapy; D003880:Dermatology; D004194:Disease; D004342:Drug Hypersensitivity / Q000209:etiology / Q000628:therapy; D004347:Drug Interactions; D004598:Electrosurgery / Q000009:adverse effects; D004630:Emergencies; D004632:Emergency Medical Services; D004697:Endocarditis, Bacterial / Q000517:prevention & control; D017408:Guidelines as Topic; D006470:Hemorrhage / Q000628:therapy; D006801:Humans; D006973:Hypertension / Q000628:therapy; D008012:Lidocaine / Q000009:adverse effects; D009203:Myocardial Infarction / Q000628:therapy; D010138:Pacemaker, Artificial; D010824:Physicians' Offices; D012871:Skin Diseases / Q000601:surgery / Q000628:therapy*; D013226:Status Epilepticus / Q000628:therapy; D013575:Syncope / Q000628:therapy
D000779:Anesthetics, Local; D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants; D008012:Lidocaine