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Synopsis of pediatric emergency medicine
The Journal of Emergency Medicine. Vol 15. No I. pp IX- 114. 1997 Copyright 0 I997 Elsewx Science Inc. Printed in the USA. All rights reserved 07%4679/9? 417.M) ? .(H) ELSEVIER
PI1 SO736-4679(96) 00247-8
m!?vicws: Books and Other Media on writing a curriculum vitae and “buffing your file” is worth the price of the book. The only down side to this book is that many of the statistics concerning the medical specialties do not include emergency medicine. This lack is not the fault of the author; the information is just not available for this relatively new specialty. A glossary of unfamiliar terms and an annotated bibliography are included. Another important but seldom seen inclusion is a “feedback form” designed to allow someone who may have new information about residencies or an unusual experience to relate to the author. This section is a very useful addition both for the author and the publisher, and I am surprised that it hasn’t become more prevalent in textbooks. In summary, if there is one textbook that every medical student should read from cover to cover, probably during their first year, it is this one. I also think that every residency director should be intimately familiar with this book because their residency applicants will be. Physicians who advise medical students can relax, Dr. Iserson has made our job much easier with this excellent work.
q GlZ-fWG INTO A RESIDENCY: A GUIDE FOR MEDICAL STUDENTS, 4th ED. lserson KV. Tucson, Galen Press, Ltd., 1999, $31.95.
I enjoy being an advisor to medical students: helping them select electives, discussing basic science, and recommending reading material. However, sometime during their third year, panic, in the form of “how am I ever going to get into a good residency program,” dominates their life. This is not necessarily a bad thing. Most of them have been students their entire lives and have had little time or need to think about life after medical school. Up until this time, all their effort has been aimed at getting into medical school and assimilating as much medical knowledge as possible. Now they have to go job hunting, usually a new experience for them. Fortunately for me, I have an answer for them, “READ THIS BOOK.” Dr. Iserson has been an innovator in medicine for the past 15 years or so. His has written about medical ethics and what happens to us after we die (physically, that is). He is knowledgeable, articulate, humorous, experienced, and, most important, practical. The book is divided into 22 chapters that cover every facet of applying to a residency program: What to wear to your interview, how to write a resume, what to look for in a training program, what questions to ask, scheduling electives, and what to do if the airlines loses your luggage. The section on choosing a specialty is particularly helpful because so many students have little or no idea about what specialty to practice or even how to find information on the different medical specialties. Dr. Iserson covers how many programs one should apply to, special situations such as pregnancy, sexual orientation, and age. preparing for the interview, what to do if you fail to match, and what to do when you match. The text is very well written, with many examples from actual situations and solutions to both common and some not-so-common problems. The section
Edward I. Otten, MD
Department of Emergency Medicine University of Cincinnati Hospital Cincinnati, Ohio 0 sYNoPssoFPEDlA~~Y~CINE Fbisher GR, Ludwig S, Siberman BK. Baltimore, Williams and Wilkins, 1996, $65.
EWBGENCYMEQIUNEACOMcl PED!AlRlc PRSTUOY Guide. Strange GR, Ahrens W, Lelyveld S, Schafermeyer R. New York, McGraw-Hill, 1996, $65.
The field of emergency medicine has become like Proteus (the god, not the bacteria), assuming many differ-
Reviews of Books and Other Media is coordinatedby Edward J. Otten,
College of Medicine, Cincinnati, Ohio 133
MD,
of the Universitl, of Cincinnati -.--l__ -_l_l-
134 ent forms and functions. Emergency medicine once was a specialty caring for emergencies, then became a general practice caring for everyone, then became a speciality again, and now is evolving into subspecialties. The evolution of emergency medicine seems to recapitulate the evolution of medicine. The driving force is not science or even technology but economics, politics, and law. Initially, any licensed physician was qualified to work in an emergency department, then only board certified physicians, and then only residency-trained board-certified physicians. Following this line of reasoning, pediatric patients can be best cared for by pediatric-emergency medicine residency-trained, board-certified physicians, and poisoned patients can be best cared for by toxicologyemergency medicine residency-trained, board-certified physicians. We now have subspecialty training and boards in these areas, and there are arguments as to the wisdom of this kind of training. Logically, such training could lead to the ophthalmalogic-pediatrictoxicology-emergency physician caring for the 2year-old child with gasoline splashed in the eye. This scenario may not be as ridiculous as it sounds; strange things are happening in the “house of medicine.” The publication of textbooks coincides with the trend of subspecialization and occasionally initiates it. There have been a number of pediatric emergency medicine textbooks published in the past 5 years; the most popular has been abbreviated and published in paperback and is the first work reviewed here, referred to as the “synopsis.” This edition was designed to be easier to read, carry, and less expensive than the parent book while still being a valuable reference to the physician caring for the pediatric patient. The synopsis has fewer contributors and 40 fewer chapters, but, in following the goals of the editors, contains enough information to assist in clinically managing a patient. I compared several topics in both the original text and the synopsis and found the synopsis adequate for clinical usage or for the student or resident looking for a brief overview of the subject. The original textbook contained much more “academic” information such as pathophysiology, epidemiology, research material, and references. The synopsis is organized along the same lines as the parent book, and the text is a condensed version of the original. The section “Signs and Symptoms” is a very efficient method for presenting common pediatric problems such as ataxia, limping, neck
Reviews: Books and Other Media
mass, or stridor. There are necessarily fewer illustrations, but the sametables and figures are included. The section on procedures is actually more practical in the synopsis than in the larger text. Time and money being in increasingly short supply for students and residents, the synopsis seemsan ideal pediatric emergency medicine textbook. The field of emergency medicine is one of breadth rather than of depth, which also makes this a good textbook for general pediatrics. I feel that $65 is a lot to pay for a paperback book, but it is about one-third the price of the original and thus a bargain. The secondbook reviewed, referred to as “the study guide,’ ’ is externally similar to Emergency Medicine: A Comprehensive Study Guide by Tintinalli, Ruiz and Krome, now in its fourth edition. There are a few contributors common to both works, but the similarity ends there. The Tintinalli text is primarily about adult emergency medicine, with about 10% of its pages devoted to pediatrics. The organization is quite different; Tintinalli chooses specific topics that are relatively common and covers them in depth: e.g., seizure and status epilepticus in children, hypoglycemia in children, or gastroenteritis. The “study guide” usesa more conventional format, e.g., respiratory emergencies, neurologic emergencies, or hematologic emergencies. I was surprised to see chapters on high-altitude illness, dysbarism, and radiation emergencies, problems not usually thought of as pediatric. There are a number of tables, but the text has too few illustrations and no section on procedures, something I found of particular value in the synopsis. There are no references as such, but a short bibliography is included at the end of each chapter. Both books attempt to summarize the new subspecialty of pediatric emergency medicine for the practitioner and as a review for the different board examinations. Although both works cost $65, the synopsis has 200 more pages and better illustrations, and I found the signs-and-symptoms format much more valuable than the traditional format for handling clinical problems. If you are looking for a good, relatively inexpensive pediatric emergency medicine textbook, the synopsis is the book to buy. Edward J. Otten, MD Professor of Emergency Medicine and Pediatrics Department of Emergency Medicine University of Cincinnati College of Medicine Cincinnati, Ohio
PI1 SO736-4679(96) 00247-8
m!?vicws: Books and Other Media on writing a curriculum vitae and “buffing your file” is worth the price of the book. The only down side to this book is that many of the statistics concerning the medical specialties do not include emergency medicine. This lack is not the fault of the author; the information is just not available for this relatively new specialty. A glossary of unfamiliar terms and an annotated bibliography are included. Another important but seldom seen inclusion is a “feedback form” designed to allow someone who may have new information about residencies or an unusual experience to relate to the author. This section is a very useful addition both for the author and the publisher, and I am surprised that it hasn’t become more prevalent in textbooks. In summary, if there is one textbook that every medical student should read from cover to cover, probably during their first year, it is this one. I also think that every residency director should be intimately familiar with this book because their residency applicants will be. Physicians who advise medical students can relax, Dr. Iserson has made our job much easier with this excellent work.
q GlZ-fWG INTO A RESIDENCY: A GUIDE FOR MEDICAL STUDENTS, 4th ED. lserson KV. Tucson, Galen Press, Ltd., 1999, $31.95.
I enjoy being an advisor to medical students: helping them select electives, discussing basic science, and recommending reading material. However, sometime during their third year, panic, in the form of “how am I ever going to get into a good residency program,” dominates their life. This is not necessarily a bad thing. Most of them have been students their entire lives and have had little time or need to think about life after medical school. Up until this time, all their effort has been aimed at getting into medical school and assimilating as much medical knowledge as possible. Now they have to go job hunting, usually a new experience for them. Fortunately for me, I have an answer for them, “READ THIS BOOK.” Dr. Iserson has been an innovator in medicine for the past 15 years or so. His has written about medical ethics and what happens to us after we die (physically, that is). He is knowledgeable, articulate, humorous, experienced, and, most important, practical. The book is divided into 22 chapters that cover every facet of applying to a residency program: What to wear to your interview, how to write a resume, what to look for in a training program, what questions to ask, scheduling electives, and what to do if the airlines loses your luggage. The section on choosing a specialty is particularly helpful because so many students have little or no idea about what specialty to practice or even how to find information on the different medical specialties. Dr. Iserson covers how many programs one should apply to, special situations such as pregnancy, sexual orientation, and age. preparing for the interview, what to do if you fail to match, and what to do when you match. The text is very well written, with many examples from actual situations and solutions to both common and some not-so-common problems. The section
Edward I. Otten, MD
Department of Emergency Medicine University of Cincinnati Hospital Cincinnati, Ohio 0 sYNoPssoFPEDlA~~Y~CINE Fbisher GR, Ludwig S, Siberman BK. Baltimore, Williams and Wilkins, 1996, $65.
EWBGENCYMEQIUNEACOMcl PED!AlRlc PRSTUOY Guide. Strange GR, Ahrens W, Lelyveld S, Schafermeyer R. New York, McGraw-Hill, 1996, $65.
The field of emergency medicine has become like Proteus (the god, not the bacteria), assuming many differ-
Reviews of Books and Other Media is coordinatedby Edward J. Otten,
College of Medicine, Cincinnati, Ohio 133
MD,
of the Universitl, of Cincinnati -.--l__ -_l_l-
134 ent forms and functions. Emergency medicine once was a specialty caring for emergencies, then became a general practice caring for everyone, then became a speciality again, and now is evolving into subspecialties. The evolution of emergency medicine seems to recapitulate the evolution of medicine. The driving force is not science or even technology but economics, politics, and law. Initially, any licensed physician was qualified to work in an emergency department, then only board certified physicians, and then only residency-trained board-certified physicians. Following this line of reasoning, pediatric patients can be best cared for by pediatric-emergency medicine residency-trained, board-certified physicians, and poisoned patients can be best cared for by toxicologyemergency medicine residency-trained, board-certified physicians. We now have subspecialty training and boards in these areas, and there are arguments as to the wisdom of this kind of training. Logically, such training could lead to the ophthalmalogic-pediatrictoxicology-emergency physician caring for the 2year-old child with gasoline splashed in the eye. This scenario may not be as ridiculous as it sounds; strange things are happening in the “house of medicine.” The publication of textbooks coincides with the trend of subspecialization and occasionally initiates it. There have been a number of pediatric emergency medicine textbooks published in the past 5 years; the most popular has been abbreviated and published in paperback and is the first work reviewed here, referred to as the “synopsis.” This edition was designed to be easier to read, carry, and less expensive than the parent book while still being a valuable reference to the physician caring for the pediatric patient. The synopsis has fewer contributors and 40 fewer chapters, but, in following the goals of the editors, contains enough information to assist in clinically managing a patient. I compared several topics in both the original text and the synopsis and found the synopsis adequate for clinical usage or for the student or resident looking for a brief overview of the subject. The original textbook contained much more “academic” information such as pathophysiology, epidemiology, research material, and references. The synopsis is organized along the same lines as the parent book, and the text is a condensed version of the original. The section “Signs and Symptoms” is a very efficient method for presenting common pediatric problems such as ataxia, limping, neck
Reviews: Books and Other Media
mass, or stridor. There are necessarily fewer illustrations, but the sametables and figures are included. The section on procedures is actually more practical in the synopsis than in the larger text. Time and money being in increasingly short supply for students and residents, the synopsis seemsan ideal pediatric emergency medicine textbook. The field of emergency medicine is one of breadth rather than of depth, which also makes this a good textbook for general pediatrics. I feel that $65 is a lot to pay for a paperback book, but it is about one-third the price of the original and thus a bargain. The secondbook reviewed, referred to as “the study guide,’ ’ is externally similar to Emergency Medicine: A Comprehensive Study Guide by Tintinalli, Ruiz and Krome, now in its fourth edition. There are a few contributors common to both works, but the similarity ends there. The Tintinalli text is primarily about adult emergency medicine, with about 10% of its pages devoted to pediatrics. The organization is quite different; Tintinalli chooses specific topics that are relatively common and covers them in depth: e.g., seizure and status epilepticus in children, hypoglycemia in children, or gastroenteritis. The “study guide” usesa more conventional format, e.g., respiratory emergencies, neurologic emergencies, or hematologic emergencies. I was surprised to see chapters on high-altitude illness, dysbarism, and radiation emergencies, problems not usually thought of as pediatric. There are a number of tables, but the text has too few illustrations and no section on procedures, something I found of particular value in the synopsis. There are no references as such, but a short bibliography is included at the end of each chapter. Both books attempt to summarize the new subspecialty of pediatric emergency medicine for the practitioner and as a review for the different board examinations. Although both works cost $65, the synopsis has 200 more pages and better illustrations, and I found the signs-and-symptoms format much more valuable than the traditional format for handling clinical problems. If you are looking for a good, relatively inexpensive pediatric emergency medicine textbook, the synopsis is the book to buy. Edward J. Otten, MD Professor of Emergency Medicine and Pediatrics Department of Emergency Medicine University of Cincinnati College of Medicine Cincinnati, Ohio