Primary care clinicians are performing more varied procedures than ever before, and physicians, residents, and students need a comprehensive, authoritative resource that provides trusted information in an easy-to-follow format. Through three outstanding editions, Pfenninger and Fowler’s Procedures for Primary Care has been the go-to reference for step-by-step strategies for nearly every medical procedure that can be performed in an office, hospital, or emergency care facility by primary care providers. This 4th Edition continues that tradition with new section editors, updated illustrations, new chapters, and much more. No other primary care procedure book compares with Pfenninger and Fowler’s breadth and depth of practical, step-by-step content!
Over 1,700 pages in breadth, this resource provides comprehensive, real-world coverage of more than 230 procedures that arise in the primary care setting, including many that were previously performed only in subspecialty settings, such as joint injections and cosmetic procedures
Includes new chapters: Esophageal Foreign Body Removal, Manual Testicular Detorsion, Symphysiotomy, Zipper Injury Management, and Blood Products
Presents the "how-to" expertise of six new section editors, for a fresh, contemporary perspective throughout the book
Additional focus on the evidence, with plentiful citations to key references, makes this the most evidence-based edition yet
Features numerous updated illustrations, including many more in full color, and incorporates updated ICD-10-CM codes throughout
Provides access to online resources including patient education handouts and consent forms, lists of device manufacturers, and more
Utilizes a concise outline format, detailed text and illustrations, and abundant boxes and tables for quick access to the information you need
Enhanced eBook version included with purchase, which allows you to access all of the text, figures, and references from the book on a variety of devices
Section 1 - Anesthesia 1. Procedural Sedation and Analgesia 2. Pediatric Sedation 3. Nitrous Oxide Sedation 4. Topical Anesthesia 5. Local Anesthesia 6. Local and Topical Anesthetic Complications 7. Peripheral Nerve Blocks and Field Blocks 8. Oral/Facial Anesthesia 9. Bier Block 10. Epidural Anesthesia and Analgesia 11. Procedures to Treat Headaches
Section 2 - Dermatology 12. Acne Therapy: Surgical Approaches 13. Approach to Various Skin Lesions 14. Cryosurgery 15. Dermoscopy (Epiluminescence Microscopy) 16. Flaps and Plasties 17. Fungal Studies and Scabies: Collection Procedures and Tests 18. Incisions: Planning the Direction of the Cut 19. Laceration and Incision Repair 20. Laceration and Incision Repair: Needle Selection 21. Laceration and Incision Repair: Suture Selection 22. Laceration and Incision Repair: Suture Tying 23. Nail Plate and Nail Bed Biopsy 24. Nail Bed Repair 25. Radiofrequency Surgery (Modern Electrosurgery) 26. Skin Biopsy 27. Skin Grafting 28. Hypertrophic Scars and Keloids 29. Unna Paste Boot: Treatment of Venous Stasis Ulcers and Other Disorders 30. Wart (Verruca) Treatment 31. Pilonidal Cyst and Abscess: Current Management 32. Wood's Light Examination 33. Wound Dressing 34. Maggot Treatment for Chronic Ulcers
Section 3 - Aesthetic Medicine 35. Introduction to Aesthetic Medicine 36. Cosmeceutical Skin Care 37. Gingival Hyperpigmentation 38. Lasers and Pulsed-Light Devices: Hair Removal 39. Lasers and Pulsed-Light Devices: Photofacial Rejuvenation 40. Lasers and Pulsed-Light Devices: Acne 41. Lasers and Pulsed-Light Devices: Skin Tightening 42. Lasers and Pulsed Light Devices: Spider Veins 43. Lasers and Pulsed-Light Devices: Tattoo Removal 44. Lasers and Pulsed-Light Devices: Skin Resurfacing 45. Nonablative Radiowave Skin Tightening with the Ellman S5 Surgitron (The Pelleve Procedure) 46. Epilation of Isolated Hairs 47. Botulinum Toxin 48. Tissue Fillers 49. Microdermabrasion and Dermalinfusion 50. Chemical Peels 51. Photodynamic Therapy 52. Cellulite Treatments 53. Thread Lift Using Barbed Suspension Sutures for Facial Rejuvenation 54. Radiofrequency-Assisted Upper Blepharoplasty for the Correction of Dermatochalasis 55. Body Piercing
Section 4 - Eyes, Ears, Nose, and Throat 56. Mucocele Removal 57. Chalazion and Hordeolum 58. Tonometry 59. Audiometry 60. Tympanometry 61. Myringotomy and Tympanocentesis 62. Cerumen Impaction Removal 63. Earlobe Repair 64. Nasolaryngoscopy 65. Indirect Mirro Laryngoscopy 66. Tonsillectomy and Adnoidectomy 67. Allergy Testing and Immunotherapy 68. Fine-Needle Aspiration Cytology and Biopsy Section 5 - Cardiovascular and Respiratory System Procedures 69. Antibiotic Prophylaxis for Prevention Bacterial Endocarditis 70. Office Electrocardiograms 71. Pre-op Evaluation 72. Ambulatory Blood Pressure Monitoring 73. Ambulatory Electrocardiography: Holter and Event Monitoring 74. Exercise (Stress) Testing 75. Echocardiography 76. Stress Echo 77. Noninvasive Venous and Arterial Studies of the Lower Extremities 78. Sclerotherapy 79. Ambulatory Phlebectomy 80. Endovenous Vein Closure 81. Pulmonary Function Testing
Section 6 - Gastrointestinal System Procedures 82. Clinical Anorectal Anatomy and Digital Examination 83. Anoscopy 84. High Resolution Anoscopy 85. Anal Fissure/Lateral Sphincterotomy 86. Perianal Abscess Incision and Drainage 87. Office Treatment of Hemorrhoids 88. Removal of Perianal Skin Tags (External Hemorrhoidal Skin Tags) 89. Flexible Sigmoidoscopy 90. Colonoscopy 91. Esophagogastroduodenoscopy 92. PEG Tube Insertion 93. Capsule Endoscopy 94. Esophageal Foreign Body Removal 95. Inguinal Hernia Reduction
Section 7 - Urinary System Procedures 96. Bladder Catheterization 97. Diagnostic Cystourethroscopy 98. Office Testing and Treatment Options for Interstitial Cystitis 99. Suprapubic Catheter Insertion and/or Change 100. Suprapubic Tap or Aspiration 101. Bedside Urodynamic Studies
Section 8 - Male Reproductive System 102. Adult Circumcision 103. Androscopy 104. Dorsal Slit for Phimosis 105. Prostate Massage 106. Prostate and Seminal Vesicle Ultrasonography 107. Self-Injection Therapy for the Treatment of Erectile Dysfunction 108. Vacuum Devices for Erectile Dysfunction 109. Implantable Hormone Pellets for Testosterone Deficiency in Adult Men 110. Sperm Banking 111. Vasectomy 112. Manual Testicular Detorsion
Section 9 - Gynecology and Female Reproductive System 113. Suction Aspiration for Elective and Spontaneous First Trimester Abortion 114. Medical Abortion 115. Emergency Contraception 116. Barrier Contraceptives: Cervical Caps, Condoms, and Diaphragms 117. Fertility Awareness-based Methods of Contraception (Natural Family Planning) 118. Bartholin's Cyst/Abscess: Word Catheter Insertion, Marsupialization 119. Breast Biopsy 120. Pap Smear and Related Techniques for Cervical Cancer Screening 121. Human Papillomavirus DNA Sampling 122. Wet Smear and KOH Preparation 123. Cervical Polyps 124. Colposcopic Examination 125. Cryotherapy of the Cervix 126. Cervical Stenosis and Cervical Dilation 127. Loop Electrosurgical Excision Procedure (LEEP) for Treating Cervical Intraepithelial Neoplasia 128. Cervical Conization 129. Endometrial Biopsy 130. Hysteroscopy 131. Permanent Female Sterilization (Tubal Ligation) 132. Insertion of ESSURE (Contraceptive Implant) 133. Endometrial Ablation (Roller Ball, Cryoablation, Thermal Balloon) 134. Hysterosalpingography and Sonohysterosalpingography 135. Intrauterine Device (IUD) Insertion and Removal 136. Insertion and Removal of Implanon 137. Pessaries 138. Treatment of Noncervical CONDYLOMATA ACUMINATA 139. Vulvar Biopsy 140. Management of the Adult Victim of Sexual Assault
Section 11 - Pediatrics 163. Neonatal Resuscitation 164. Pediatric Arterial Puncture and Venous Minicutdown 165. Umbilical Vessel Catheterization 166. Dorsal Penile and Subcutaneous Ring Block for Newborn Circumcision 167. Newborn Circumcision and Office Meatotomy 168. Pediatric Suprapubic Bladder Aspiration 169. Tonque-Tie Snipping (Frenotomy) for Ankyloglossia 170. Management of Young Female as Possible Victim of Sexual Abuse
Section 12 - Orthopedics and Sports Medicine 171. Musculoskeletal Ultrasound 172. Extensor Tendon Repair 173. Nursemaid's Elbow: Subluxation of the Radial Head 174. Shoulder Dislocations 175. Ankle and Foot Splinting, Casting, and Taping 176. Cast Immobilization 177. Knee Braces 178. Fracture Care 179. Compartment Syndrome Evaluation 180. Joint and Soft Tissue Aspiration and Injection (Arthrocentesis) 181. Trigger-Point Injection 182. Ganglion Treatment 183. Transcutaneous Electrical Nerve Stimulation (TENS), Phonophoresis, and Iontophoresis 184. Acupuncture 185. Podiatric Procedures 186. Body Fat Analysis 187. NC-Stat System for Office EMGs 188. Muscle Biospy
Section 13 - Urgent Care 189. Burn Treatment 190. Fishhook Removal 191. Foreign Body Removal from Skin and Soft Tissues 192. Incision and Drainage of an Abscess 193. Subungual Hematoma Evacuation 194. Ingrown Toenails 195. Ring Removal from an Edematous Finger 196. Skin Stapling 197. Tick Removal and Prevention of Infection 198. Tissue Glues 199. Topical Hemostatic Agents 200. Corneal Abrasions and Removal of Corneal or Conjunctival Foreign Bodies 201. Slit Lamp Examination 202. Auricular Hematoma Evacuation 203. Reduction of Dislocated Temporomandibular Joint (with TMJ Syndrome Exercises) 204. Removal of Foreign Bodies from the Ear and Nose 205. Management of Epitaxis 206. Peritonsillar Abscess Drainage 207. Management of Tooth Fracture and Reimplantation of an Avulsed Tooth 208. Management of Fecal Impaction 209. Gastrointestinal Decontamination 210. Peritoneal Lavage, Diagnostic 211. Tube Thoracostomy and Emergency Needle Decompression of Tension Pneumothorax 212. Anaphylaxis 213. Prevention and Treatment of Wound Infections 214. Emergency Department and Office Ultrasound 215. Heimlich Maneuver 216. Zipper Injury Management
Section 14 - Hospitalist 217. Nasogastric Tube, Nasoenteric Tube, and Salem Sump Insertion 218. Thoracentesis 219. Paracentesis 220. Bone Marrow Aspiration or Biopsy 221. Lumbar Puncture 222. Tracheal (Endotracheal and Nasotracheal) Intubation 223. Cricothyroidotomy, Transtracheal Catheter Insertion and Tracheostomy 224. Ventilation Management 225. Arterial Puncture and Percutaneous Arterial Line Placement 226. Intraosseous Venous Access 227. Venous Cutdown 228. Central Venous Catheter Insertion 229. Swan-Ganz (Pulmonary Artery) Catheterization 230. Pericardiocentesis 231. Electrical Cardioversion 232. Temporary Pacing 233. Drawing Blood Cultures 234. Blood Products 235. Principles of X-Ray Interpretation
Appendices A to M A: Commonly Used Instruments/Equipment B: Informed Consent C: Latex Allergy Guidelines D: Supplier Information E: Resources for Learning Procedures F: Universal Precautions G: Neoplasm, Skin: ICD-9 Codes H: Pearls of Practice I: The Society of Teachers of Family Medicine Procedural Skills Task Force J: Outline of a Comprehensive Operative Note K: Algorithms for the Evaluation of Abnormal Pap Smears and Treatment of Colposcopic Findings L: Buying Office Equipment M: Special Considerations in Geriatric Patients
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