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Clinical manual of emergency pediatrics, second edition
238
AMERICAN JOURNAL OF EMERGENCY MEDICINE • Volume 13, Number 2 • March 1995
give step-by-step emergency approaches to ventricular tachycardia, slow atrial rhythms, atrioventricular block, acute pulmonary embolism, drug-related emergencies, potassium abnormalities, and pacemaker malfunctions. Emergency drug treatment dosages are accurate and reasonable; however, an international approach to cardiac drugs is used and not all drugs listed are currently available or are in current standard use in the United States. The authors predict that paramedics will have an increasingly important role in prehospital administration of thrombolytic therapy and offer guidelines for paramedic administration of these drugs. Once the reader has read and studied the preceding chapters, both the appendix and pocket reference cards provided at the end of the book are helpful for rapid ECG decision making. The book's target audience includes emergency health care professionals with extensive experience in reading 12-lead ECGs. Although the basics of 12-lead ECG interpretation are discussed, this book would probably be difficult to comprehend without a good prior understanding of 12-lead ECG interpretation. Table of Contents and Index: The table of contents, index, and quality of production are clear and have an excellent, thorough format. Comparison to Other Texts: This book is a good adjunct to other basic books on 12-lead ECG interpretation, such as Dubin's Rapid interpretation of EKGs. It should be studied after the reader has a good basic understanding of ECG interpretation. Because of the book's emphasis on emergencies, it is especially valuable to the emergency specialist. Strong Points: The book's strong points include easy readability and structured format. The authors stay focused and have a strong grasp of the subject, and they convey this knowledge well. Weaknesses: At times, the exceptions to the general rules presented are lengthy and become so involved that the reader is forced to read the rule several times to keep it in focus. This may make the important exceptions difficult to remember.
General Recommendations: The ECG in Emergency Decision Making is definitely worth purchasing, both for the emergency medicine specialist and for use in the emergency department library as a reference. KATHLEEN J. CLEM, MD
Department of Emergency Medicine Loma Linda University Medical Center Loma Linda, CA Clinical Manual of Emergency Pediatrics, Second Edition. Ellen F. Crain, Jeffrey C. Gershel, E. John Gallagher (editors). McGrawHill, 1992.
Overview: This is the updated second edition of this pocket-sized handbook first published in 1989. The authors' purpose was to create a "concise, portable handbook summarizing most of the conditions that are seen in a pediatric emergency department." The book is targeted to the resident and staff physician handling emergencies in the emergency department as well as the office setting. The initial chapter covers resuscitation, and the remaining chapter are listed alphabetically by subject matter. After a brief introduction, each topic is discussed in terms of clinical presentation, diagnosis, emergency department management, and indications for admission. Most chapters include signs and symptoms of a given problem, a differential diagnosis, and recommended laboratory or radiographic studies. One drawback to this format is that once a subtopic is found under the clinical presentation and diagnosis section the reader must locate it again under management. In some chapters these subtopics, such as "urethritis" under "sexually transmitted diseases," are distinguished by number or different typeface but this is not consistent throughout the book. Cross-referencing would have eliminated some redundant text.
Candidiasis is discussed under the subheading "candida" as well as "diaper dermatitis." Oral candidiasis is covered in both the dental and dermatological emergencies chapters, In general, the diagnostic and therapeutic recommendations are current, with some exceptions. This book was published before the revised American Heart Association basic life support and pediatric advanced life support guidelines. In-line traction rather than immobilization is recommended during endotracheal intubation if there is potential cervical spine trauma. In the section on head trauma, criteria are given for obtaining skull films but not for computed tomography (CT) of the head. For patients presenting with a Glasgow coma scale score of 9 to 14, recommendations are for intravenous access, observation, and repeat of the Glasgow coma scale every 15 minutes, with no mention of obtaining a CT scan. In some ways this manual is geared more to the pediatrician than the emergency medicine specialist. Referral to a plastic or oral surgeon is advised for through-and-through lip lacerations or those crossing the vermilion border, but these are commonly repaired by emergency physicians. Four pages are allocated to the evaluation and treatment of acne and alopecia, but most emergency physicians would refer these to a clinician for long term care. Some tests are recommended that would normally be done in the clinic or inpatient setting, such as skin testing for cell-mediated immunity. Table of Contents and Index: The table of contents and index are organized and complete with appropriate cross-references. The word "acute" is overused in the index with listings such as "acute adrenal crisis," "acute ataxia," "acute hemiparesis," and "acute otitis media." Comparison to Other Texts: In comparison to the Handbook of Pediatric Emergencies, second edition (Gregory A. Baldwin, editor) the clinical Manual of Emergency Pediatrics is as complete but less readable. The print is smaller, and subtopics are not distinguished by an outline format as in Baldwin's book. Baldwin's manual uses brand as well as generic drug names and includes dosages in both the text and in a separate reference table in an appendix. Baldwin's book was published in 1994 and contains more current information, including the most recent basic and advanced pediatric life support guidelines. However, HIV-related emergencies and would repair techniques are covered in better detail in this book. Strong Points: A useful feature is the inclusion of drugs and specific dosages in the management sections of each chapter. Charts used throughout the book help to condense information, such as the various toxicologic syndromes, nontoxic ingestions, and the outpatient management of coagulation disorders. The quick reference guide located at the back of the book allows rapid access to emergency medication dosages, equipment size by age and weight, frequently-used formulas, and several mnemonics. The inclusion of indications for admission is particularly useful for problems not routinely encountered in the emergency department. The section on HIV-related emergencies covers the most frequently seen problems in a clear and concise manner. The sedation and analgesia chapter has a thorough discussion of various medications including practical guidelines for their use. Weaknesses: Although this text is complete for a handbook, there are some gaps in coverage, eg, no discussion of disseminated intravascular coagulation and only brief coverage of multiple trauma. There are no descriptions or illustrations of emergency procedures except for intraosseous needle placement and suture technique. More frequent use of tables or an outline format would have made information more accessible to the reader. General Recommendations: The authors have succeeded in creating an inexpensive ($29.50) and comprehensive yet portable handbook of emergency medicine. It would make a useful addition to either an emergency department or an office library. JEAN T. MARTIN, MD
Rocky Mountain Emergency Physicians Aurora, CO
AMERICAN JOURNAL OF EMERGENCY MEDICINE • Volume 13, Number 2 • March 1995
give step-by-step emergency approaches to ventricular tachycardia, slow atrial rhythms, atrioventricular block, acute pulmonary embolism, drug-related emergencies, potassium abnormalities, and pacemaker malfunctions. Emergency drug treatment dosages are accurate and reasonable; however, an international approach to cardiac drugs is used and not all drugs listed are currently available or are in current standard use in the United States. The authors predict that paramedics will have an increasingly important role in prehospital administration of thrombolytic therapy and offer guidelines for paramedic administration of these drugs. Once the reader has read and studied the preceding chapters, both the appendix and pocket reference cards provided at the end of the book are helpful for rapid ECG decision making. The book's target audience includes emergency health care professionals with extensive experience in reading 12-lead ECGs. Although the basics of 12-lead ECG interpretation are discussed, this book would probably be difficult to comprehend without a good prior understanding of 12-lead ECG interpretation. Table of Contents and Index: The table of contents, index, and quality of production are clear and have an excellent, thorough format. Comparison to Other Texts: This book is a good adjunct to other basic books on 12-lead ECG interpretation, such as Dubin's Rapid interpretation of EKGs. It should be studied after the reader has a good basic understanding of ECG interpretation. Because of the book's emphasis on emergencies, it is especially valuable to the emergency specialist. Strong Points: The book's strong points include easy readability and structured format. The authors stay focused and have a strong grasp of the subject, and they convey this knowledge well. Weaknesses: At times, the exceptions to the general rules presented are lengthy and become so involved that the reader is forced to read the rule several times to keep it in focus. This may make the important exceptions difficult to remember.
General Recommendations: The ECG in Emergency Decision Making is definitely worth purchasing, both for the emergency medicine specialist and for use in the emergency department library as a reference. KATHLEEN J. CLEM, MD
Department of Emergency Medicine Loma Linda University Medical Center Loma Linda, CA Clinical Manual of Emergency Pediatrics, Second Edition. Ellen F. Crain, Jeffrey C. Gershel, E. John Gallagher (editors). McGrawHill, 1992.
Overview: This is the updated second edition of this pocket-sized handbook first published in 1989. The authors' purpose was to create a "concise, portable handbook summarizing most of the conditions that are seen in a pediatric emergency department." The book is targeted to the resident and staff physician handling emergencies in the emergency department as well as the office setting. The initial chapter covers resuscitation, and the remaining chapter are listed alphabetically by subject matter. After a brief introduction, each topic is discussed in terms of clinical presentation, diagnosis, emergency department management, and indications for admission. Most chapters include signs and symptoms of a given problem, a differential diagnosis, and recommended laboratory or radiographic studies. One drawback to this format is that once a subtopic is found under the clinical presentation and diagnosis section the reader must locate it again under management. In some chapters these subtopics, such as "urethritis" under "sexually transmitted diseases," are distinguished by number or different typeface but this is not consistent throughout the book. Cross-referencing would have eliminated some redundant text.
Candidiasis is discussed under the subheading "candida" as well as "diaper dermatitis." Oral candidiasis is covered in both the dental and dermatological emergencies chapters, In general, the diagnostic and therapeutic recommendations are current, with some exceptions. This book was published before the revised American Heart Association basic life support and pediatric advanced life support guidelines. In-line traction rather than immobilization is recommended during endotracheal intubation if there is potential cervical spine trauma. In the section on head trauma, criteria are given for obtaining skull films but not for computed tomography (CT) of the head. For patients presenting with a Glasgow coma scale score of 9 to 14, recommendations are for intravenous access, observation, and repeat of the Glasgow coma scale every 15 minutes, with no mention of obtaining a CT scan. In some ways this manual is geared more to the pediatrician than the emergency medicine specialist. Referral to a plastic or oral surgeon is advised for through-and-through lip lacerations or those crossing the vermilion border, but these are commonly repaired by emergency physicians. Four pages are allocated to the evaluation and treatment of acne and alopecia, but most emergency physicians would refer these to a clinician for long term care. Some tests are recommended that would normally be done in the clinic or inpatient setting, such as skin testing for cell-mediated immunity. Table of Contents and Index: The table of contents and index are organized and complete with appropriate cross-references. The word "acute" is overused in the index with listings such as "acute adrenal crisis," "acute ataxia," "acute hemiparesis," and "acute otitis media." Comparison to Other Texts: In comparison to the Handbook of Pediatric Emergencies, second edition (Gregory A. Baldwin, editor) the clinical Manual of Emergency Pediatrics is as complete but less readable. The print is smaller, and subtopics are not distinguished by an outline format as in Baldwin's book. Baldwin's manual uses brand as well as generic drug names and includes dosages in both the text and in a separate reference table in an appendix. Baldwin's book was published in 1994 and contains more current information, including the most recent basic and advanced pediatric life support guidelines. However, HIV-related emergencies and would repair techniques are covered in better detail in this book. Strong Points: A useful feature is the inclusion of drugs and specific dosages in the management sections of each chapter. Charts used throughout the book help to condense information, such as the various toxicologic syndromes, nontoxic ingestions, and the outpatient management of coagulation disorders. The quick reference guide located at the back of the book allows rapid access to emergency medication dosages, equipment size by age and weight, frequently-used formulas, and several mnemonics. The inclusion of indications for admission is particularly useful for problems not routinely encountered in the emergency department. The section on HIV-related emergencies covers the most frequently seen problems in a clear and concise manner. The sedation and analgesia chapter has a thorough discussion of various medications including practical guidelines for their use. Weaknesses: Although this text is complete for a handbook, there are some gaps in coverage, eg, no discussion of disseminated intravascular coagulation and only brief coverage of multiple trauma. There are no descriptions or illustrations of emergency procedures except for intraosseous needle placement and suture technique. More frequent use of tables or an outline format would have made information more accessible to the reader. General Recommendations: The authors have succeeded in creating an inexpensive ($29.50) and comprehensive yet portable handbook of emergency medicine. It would make a useful addition to either an emergency department or an office library. JEAN T. MARTIN, MD
Rocky Mountain Emergency Physicians Aurora, CO