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Decision Making in Emergency Critical Care: An Evidence-Based Handbook
BOOK AND MEDIA REVIEWS Emergency Care and the Public’s Health Review by Samuel J. Stratton, MD, MPH
Decision Making in Emergency Critical Care: An Evidence-Based Handbook Review by Zachary Levy, MD 0196-0644/$-see front matter Copyright © 2015 by the American College of Emergency Physicians.
Emergency Care and the Public’s Health Pines JM et al Wiley Blackwell 2014 232 pages, $99.95 ISBN-13: 978-1-1187-7980-4 ISBN-10: 1118779800 Emergency medicine care and systems of delivery in the United States and other developed nations are undergoing dramatic change. The struggle to match need and benefit to a medical specialty that combines rapid medical technology change with the daily immediate care needs of communities requires more of an emergency physician than just diagnostic and procedural skills. At the bedside, an emergency physician must not only make effective medical care decisions but also know how to direct the patient through the chaos of a complex health care system to attain the best patient outcome. A new published text, Emergency Care and the Public’s Health, provides an understanding of the emergency care system in the United States and how it integrates with the rest of the vast medical-industrial complex. Multiple authors have contributed chapters that the editors have coordinated to form a cohesive and organized book. Content includes an overview of the emergency care system in the United States, chapters exploring technology in emergency care, chapters addressing workforce, payment and legal issues in emergency care, and information about disaster and emergency preparedness and response. At approximately 200 pages, the book is a comfortable, quick read packed with information of interest to emergency physicians and nurses, other health care providers, administrators, and health services experts. Notable important areas covered within Emergency Care include information technology and telemedicine as they apply to emergency medicine. For these areas, the chapter authors appropriately provide basic concepts and the foundations for future application to emergency medicine as opposed to a discussion of technology that will soon be outdated. Another section provides excellent insight into the associations of emergency management and emergency public health with emergency medicine—concepts with recently demonstrated importance through emergency physician experiences with Hurricane Katrina and Superstorm Sandy. A subsection of a chapter on emergency medicine legal issues objectively reviews the Emergency Medical Treatment and Labor Act. Also well explored are medical payment reform models that are developing in the United States—a particularly valuable
470 Annals of Emergency Medicine
subsection for those in administrative roles in emergency services delivery because the authors provide concise descriptions and elements of the proposed future directions for cost containment of health care in the United States. There are minor issues for those considering this text. First, the title would imply to some that the book is an exploration of emergency medicine and public health. Although many of the covered topics relate to health services traditionally associated with public health, the book does not directly relate to the core areas of public health such as environmental health, community health sciences, and epidemiology-disease control. Second, this is an overview of complex and broad topics and not an “academic” text and is best suited as a read for clinicians and those who are in administrative and health services planning positions. Finally, by the nature of the topics covered in the book, it is applicable to the current period of emergency health delivery and concepts, and knowledge will likely continue to evolve. But considering these issues, the book is well written, well organized, and a comfortably concise and informative text that can be read cover to cover. Emergency Care is written for emergency physicians with the goal of expanding knowledge of a developing complex health system. The book fills a niche for which there are no other current texts in the emergency medicine field. It is particularly appropriate for emergency medicine administrators, health system directors, and those in the health services sector of public health. It is also a must-read for those in emergency medicine administrative fellowships. Samuel J. Stratton, MD, MPH UCLA Fielding School of Public Health The David Geffen School of Medicine Los Angeles, CA http://dx.doi.org/10.1016/j.annemergmed.2015.01.005
Decision Making in Emergency Critical Care: An Evidence-Based Handbook Arbo JE et al Wolters Kluwer, 2014 832 pages, $64.99 ISBN-13: 978-1-45118-689-5 ISBN-10: 1451186894 Decision Making in Emergency Critical Care: An EvidenceBased Handbook is one of several recent texts focused on the care of critically ill and injured patients in the emergency department
Volume 65, no. 4 : April 2015
Book and Media Reviews (ED) and is reminiscent of both Emergency Medicine Critical Care (McGraw Hill, 2011) and Emergency Department Resuscitation of the Critically Ill (American College of Emergency Physicians, 2011) in terms of the scope and content. Decision Making departs from its predecessors in its smaller size and relative brevity, perhaps allowing more use as a portable and convenient bedside reference. This book contains updated, evidence-based guidelines across a spectrum of disease processes and is well researched and thoroughly sourced. “Literature tables” summarizing the methodology and results of landmark trials for a given subject are excellent resources found at the end of each chapter. The text amiably walks the fine line between being both comprehensive and succinct, and chapters are interspersed with helpful graphs and figures. However, the reader may be left desiring a few more pertinent clinical images that are absent, such as ECG examples of arrhythmias or the radiographic appearance of a subarachnoid hemorrhage, though the chapters on pulmonary and critical care ultrasonography contain excellent illustrations of relevant sonography. Other strengths of the book include a useful and well-organized overview of antimicrobial therapy, detailed chapters on a wide range of subjects in medical toxicology, and a thoughtful approach to geriatric medicine and palliative care in the ED setting. There are severable notable deficiencies in this reference. One is the lack of a discrete chapter for acute coronary syndrome and acute myocardial infarction, which leaves the book seeming slightly incomplete. This is despite inclusion of dedicated
Volume 65, no. 4 : April 2015
chapters for cardiogenic shock, right-sided ventricular failure, hypertensive crisis, arrhythmia management, and postarrest considerations. In contrast, a chapter devoted entirely to biomarkers in sepsis (independent of the chapter on septic shock) seemed unnecessary and a bit redundant. In a similar vein, no chapter is devoted to the management of psychiatric emergencies and suicidal patients in the ED outside of a more general discussion of sedation in the agitated patient. Smaller omissions were apparent as well, such as the lack of mention of the utility of nasogastric lavage within the chapter on acute gastrointestinal bleeding. Finally, on a different note, readers may find the enthusiastic and unencumbered recommendations for intravenous tPA and endovascular treatment in acute ischemic stroke, written by a neurologist and a neuroendovascular surgery fellow, to be somewhat controversial. Shortcomings aside, Decision Making is an informative, practical overview for residents, fellows, and attending physicians alike. The scope is wide but not overreaching, and the material is both up-to-date and clinically relevant. Although not quite sufficient as a stand-alone text, the book is an accessible supplementary reference for any practicing emergency physician or intensivist. Zachary Levy, MD Hofstra North Shore–LIJ School of Medicine Hofstra University Hempstead, NY http://dx.doi.org/10.1016/j.annemergmed.2015.01.004
Annals of Emergency Medicine 471
Decision Making in Emergency Critical Care: An Evidence-Based Handbook Review by Zachary Levy, MD 0196-0644/$-see front matter Copyright © 2015 by the American College of Emergency Physicians.
Emergency Care and the Public’s Health Pines JM et al Wiley Blackwell 2014 232 pages, $99.95 ISBN-13: 978-1-1187-7980-4 ISBN-10: 1118779800 Emergency medicine care and systems of delivery in the United States and other developed nations are undergoing dramatic change. The struggle to match need and benefit to a medical specialty that combines rapid medical technology change with the daily immediate care needs of communities requires more of an emergency physician than just diagnostic and procedural skills. At the bedside, an emergency physician must not only make effective medical care decisions but also know how to direct the patient through the chaos of a complex health care system to attain the best patient outcome. A new published text, Emergency Care and the Public’s Health, provides an understanding of the emergency care system in the United States and how it integrates with the rest of the vast medical-industrial complex. Multiple authors have contributed chapters that the editors have coordinated to form a cohesive and organized book. Content includes an overview of the emergency care system in the United States, chapters exploring technology in emergency care, chapters addressing workforce, payment and legal issues in emergency care, and information about disaster and emergency preparedness and response. At approximately 200 pages, the book is a comfortable, quick read packed with information of interest to emergency physicians and nurses, other health care providers, administrators, and health services experts. Notable important areas covered within Emergency Care include information technology and telemedicine as they apply to emergency medicine. For these areas, the chapter authors appropriately provide basic concepts and the foundations for future application to emergency medicine as opposed to a discussion of technology that will soon be outdated. Another section provides excellent insight into the associations of emergency management and emergency public health with emergency medicine—concepts with recently demonstrated importance through emergency physician experiences with Hurricane Katrina and Superstorm Sandy. A subsection of a chapter on emergency medicine legal issues objectively reviews the Emergency Medical Treatment and Labor Act. Also well explored are medical payment reform models that are developing in the United States—a particularly valuable
470 Annals of Emergency Medicine
subsection for those in administrative roles in emergency services delivery because the authors provide concise descriptions and elements of the proposed future directions for cost containment of health care in the United States. There are minor issues for those considering this text. First, the title would imply to some that the book is an exploration of emergency medicine and public health. Although many of the covered topics relate to health services traditionally associated with public health, the book does not directly relate to the core areas of public health such as environmental health, community health sciences, and epidemiology-disease control. Second, this is an overview of complex and broad topics and not an “academic” text and is best suited as a read for clinicians and those who are in administrative and health services planning positions. Finally, by the nature of the topics covered in the book, it is applicable to the current period of emergency health delivery and concepts, and knowledge will likely continue to evolve. But considering these issues, the book is well written, well organized, and a comfortably concise and informative text that can be read cover to cover. Emergency Care is written for emergency physicians with the goal of expanding knowledge of a developing complex health system. The book fills a niche for which there are no other current texts in the emergency medicine field. It is particularly appropriate for emergency medicine administrators, health system directors, and those in the health services sector of public health. It is also a must-read for those in emergency medicine administrative fellowships. Samuel J. Stratton, MD, MPH UCLA Fielding School of Public Health The David Geffen School of Medicine Los Angeles, CA http://dx.doi.org/10.1016/j.annemergmed.2015.01.005
Decision Making in Emergency Critical Care: An Evidence-Based Handbook Arbo JE et al Wolters Kluwer, 2014 832 pages, $64.99 ISBN-13: 978-1-45118-689-5 ISBN-10: 1451186894 Decision Making in Emergency Critical Care: An EvidenceBased Handbook is one of several recent texts focused on the care of critically ill and injured patients in the emergency department
Volume 65, no. 4 : April 2015
Book and Media Reviews (ED) and is reminiscent of both Emergency Medicine Critical Care (McGraw Hill, 2011) and Emergency Department Resuscitation of the Critically Ill (American College of Emergency Physicians, 2011) in terms of the scope and content. Decision Making departs from its predecessors in its smaller size and relative brevity, perhaps allowing more use as a portable and convenient bedside reference. This book contains updated, evidence-based guidelines across a spectrum of disease processes and is well researched and thoroughly sourced. “Literature tables” summarizing the methodology and results of landmark trials for a given subject are excellent resources found at the end of each chapter. The text amiably walks the fine line between being both comprehensive and succinct, and chapters are interspersed with helpful graphs and figures. However, the reader may be left desiring a few more pertinent clinical images that are absent, such as ECG examples of arrhythmias or the radiographic appearance of a subarachnoid hemorrhage, though the chapters on pulmonary and critical care ultrasonography contain excellent illustrations of relevant sonography. Other strengths of the book include a useful and well-organized overview of antimicrobial therapy, detailed chapters on a wide range of subjects in medical toxicology, and a thoughtful approach to geriatric medicine and palliative care in the ED setting. There are severable notable deficiencies in this reference. One is the lack of a discrete chapter for acute coronary syndrome and acute myocardial infarction, which leaves the book seeming slightly incomplete. This is despite inclusion of dedicated
Volume 65, no. 4 : April 2015
chapters for cardiogenic shock, right-sided ventricular failure, hypertensive crisis, arrhythmia management, and postarrest considerations. In contrast, a chapter devoted entirely to biomarkers in sepsis (independent of the chapter on septic shock) seemed unnecessary and a bit redundant. In a similar vein, no chapter is devoted to the management of psychiatric emergencies and suicidal patients in the ED outside of a more general discussion of sedation in the agitated patient. Smaller omissions were apparent as well, such as the lack of mention of the utility of nasogastric lavage within the chapter on acute gastrointestinal bleeding. Finally, on a different note, readers may find the enthusiastic and unencumbered recommendations for intravenous tPA and endovascular treatment in acute ischemic stroke, written by a neurologist and a neuroendovascular surgery fellow, to be somewhat controversial. Shortcomings aside, Decision Making is an informative, practical overview for residents, fellows, and attending physicians alike. The scope is wide but not overreaching, and the material is both up-to-date and clinically relevant. Although not quite sufficient as a stand-alone text, the book is an accessible supplementary reference for any practicing emergency physician or intensivist. Zachary Levy, MD Hofstra North Shore–LIJ School of Medicine Hofstra University Hempstead, NY http://dx.doi.org/10.1016/j.annemergmed.2015.01.004
Annals of Emergency Medicine 471