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Clinical procedures in emergency medicine, fourth edition
BOOK AND MEDIA REVIEWS
Clinical Procedures in Emergency Medicine, Fourth Edition Roberts JR, Hedges J WB Saunders, 2003 1,486 pages, $159 ISBN 0-7216-9760-7
Roberts and Hedges’ Clinical Procedures in Emergency Medicine has long been the definitive text of procedural emergency medicine. This book, used by many as the 1minute reference and bedside procedure guide, has its humble beginnings in the emergency department (ED) staffed by physicians of all backgrounds and levels of training. Our eclectic field has grown into a rigorous specialty with an extensive body of knowledge, which is well encompassed in this book. In addition to presenting a comprehensive collection of procedures, it contains a rich review of the history of medicine, practice pearls, and in-depth physiology. Each chapter can stand alone, and despite many contributors, the organization and format remain consistent. Each chapter begins with history and background and then discusses underlying physiology and pathophysiology, literature behind current thought and practice, controversial aspects, indications, and contraindications. Finally, each chapter addresses how to perform the procedure, including a list of necessary supplies, alternative approaches, and interpretation of results. The procedural section is accompanied by either photographs or line drawings, regretfully, all in black and white, which vary in their ability to convey information. With its easily readable style, far-reaching subject matter, and versatility, Clinical Procedures is an essential in every ED. This is much more than just a procedure book—it covers topics from ECG interpretation to ED thoracotomy and everything in between. It includes recent studies relevant to medical decisionmaking, incorporating principles of evidence-based medicine. However, because of the comprehensive nature of this book, the actual technique section is sometimes dwarfed by the rest of the chapter. For example, a chapter with 3 pages discussing a procedure may have 50 pages of background information. At times concrete and overly detailed, this book is viewed as the procedure authority in the ED and in the legal community. The authors, in an apparent attempt to avoid liability for procedures gone awry, are at times overly explicit in their description of procedural technique. Because of the massive scope of this book, it is able to reach a broad audience. This is required reading for any medical student or intern about to perform their first any8 0 0
thing: laceration repair, incision and drainage, or central line. Even the more seasoned practitioner can find alternative techniques to reduce a stubborn shoulder or brush up on the anatomy for superficial nerve blocks. Moreover, it serves as a tool to educate patients, with diagrams that are quite clear and instructive. The fourth edition ushers in the age of emergency medicine ultrasonography with a chapter on ultrasonography-guided procedures. Highlights of this chapter include central line placement, pericardiocentesis, transvenous pacemaker insertion, thoracentesis, paracentesis, joint aspiration, foreign body localization, and bladder aspiration. It also includes new chapters on ECG interpretation, drugs and radiation exposure during pregnancy, and teaching procedures. In addition, more than 90% of the chapters have been revamped and revised, with many new contributors. Clinical Procedures has endured nearly 2 decades, and this new edition provides changes in keeping with the changing tides of emergency medicine. Although it is not a necessity for every emergency medicine practitioner, this is the perfect companion to any comprehensive emergency medicine text and belongs in every ED. This book captures the ingenuity and creativity prerequisite to working in the ED. In this fledgling field of medicine, Roberts and Hedges’ Clinical Procedures in Emergency Medicine has achieved departmental status. Sinikka Green, MD Emory University Atlanta, GA doi:10.1016/j.annemergmed.2003.12.030
ANNALS OF EMERGENCY MEDICINE
43:6
JUNE 2004
Clinical Procedures in Emergency Medicine, Fourth Edition Roberts JR, Hedges J WB Saunders, 2003 1,486 pages, $159 ISBN 0-7216-9760-7
Roberts and Hedges’ Clinical Procedures in Emergency Medicine has long been the definitive text of procedural emergency medicine. This book, used by many as the 1minute reference and bedside procedure guide, has its humble beginnings in the emergency department (ED) staffed by physicians of all backgrounds and levels of training. Our eclectic field has grown into a rigorous specialty with an extensive body of knowledge, which is well encompassed in this book. In addition to presenting a comprehensive collection of procedures, it contains a rich review of the history of medicine, practice pearls, and in-depth physiology. Each chapter can stand alone, and despite many contributors, the organization and format remain consistent. Each chapter begins with history and background and then discusses underlying physiology and pathophysiology, literature behind current thought and practice, controversial aspects, indications, and contraindications. Finally, each chapter addresses how to perform the procedure, including a list of necessary supplies, alternative approaches, and interpretation of results. The procedural section is accompanied by either photographs or line drawings, regretfully, all in black and white, which vary in their ability to convey information. With its easily readable style, far-reaching subject matter, and versatility, Clinical Procedures is an essential in every ED. This is much more than just a procedure book—it covers topics from ECG interpretation to ED thoracotomy and everything in between. It includes recent studies relevant to medical decisionmaking, incorporating principles of evidence-based medicine. However, because of the comprehensive nature of this book, the actual technique section is sometimes dwarfed by the rest of the chapter. For example, a chapter with 3 pages discussing a procedure may have 50 pages of background information. At times concrete and overly detailed, this book is viewed as the procedure authority in the ED and in the legal community. The authors, in an apparent attempt to avoid liability for procedures gone awry, are at times overly explicit in their description of procedural technique. Because of the massive scope of this book, it is able to reach a broad audience. This is required reading for any medical student or intern about to perform their first any8 0 0
thing: laceration repair, incision and drainage, or central line. Even the more seasoned practitioner can find alternative techniques to reduce a stubborn shoulder or brush up on the anatomy for superficial nerve blocks. Moreover, it serves as a tool to educate patients, with diagrams that are quite clear and instructive. The fourth edition ushers in the age of emergency medicine ultrasonography with a chapter on ultrasonography-guided procedures. Highlights of this chapter include central line placement, pericardiocentesis, transvenous pacemaker insertion, thoracentesis, paracentesis, joint aspiration, foreign body localization, and bladder aspiration. It also includes new chapters on ECG interpretation, drugs and radiation exposure during pregnancy, and teaching procedures. In addition, more than 90% of the chapters have been revamped and revised, with many new contributors. Clinical Procedures has endured nearly 2 decades, and this new edition provides changes in keeping with the changing tides of emergency medicine. Although it is not a necessity for every emergency medicine practitioner, this is the perfect companion to any comprehensive emergency medicine text and belongs in every ED. This book captures the ingenuity and creativity prerequisite to working in the ED. In this fledgling field of medicine, Roberts and Hedges’ Clinical Procedures in Emergency Medicine has achieved departmental status. Sinikka Green, MD Emory University Atlanta, GA doi:10.1016/j.annemergmed.2003.12.030
ANNALS OF EMERGENCY MEDICINE
43:6
JUNE 2004