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EM Fundamentals: The Essential Handbook for Emergency Medicine Residents

2016; Elsevier BV; Volume: 68; Issue: 6 Linguagem: Inglês

10.1016/j.annemergmed.2016.08.427

1097-6760

Peter Moffett,

Health Sciences Research and Education

Do you remember when you were a fourth-year medical student, or worse yet an intern? Of course not. We've all blocked those years from our memory. But thankfully, Laura Welsh and the folks at the Emergency Medicine Residents' Association (EMRA) have not forgotten. They have now added EM Fundamentals, another hit in the EMRA library, to help those wayward souls navigate the transition from medical knowledge to true clinical knowledge. The intent of the book is very simple: help the incoming interns figure out how to organize their thoughts, ask the appropriate questions, and think of the most important emergency diagnosis. It is organized by chief complaint and each chapter includes a basic overview, called a “Quick Guide,” that helps the busy reader prioritize actions in the first few minutes. Make no mistake; this is not a textbook, but a quick reference to be used in the trenches. After locating a chief complaint, the readers find quick points on evaluation, the emergency differential diagnosis list, and some quick examination and initial evaluation points to get them started before talking to an attending physician. After each quick guide are more detailed (yet quickly read) chapters on an individual diagnosis such as epidural abscess for back pain. These include specific evaluation, management, and risk management pearls for each condition. Although I was taken with the simplicity and ease of the guide (and found it interesting to peruse), I thought the true test was giving it to a third-year medical student who had just started an emergency medicine elective and had never practiced clinical medicine before. She used it for the entire shift (and bent the spine, which annoyed me), and although she was happy, I was enthralled. It had taken her thoughts and organized them. She functioned at a level not seen before in a third-year medical student. I realized that EMRA had once again created a winner. Although the book is amazing, it does have a few issues that would be nice to remedy in a second edition. There is no index to the current edition, and occasionally finding a diagnosis is difficult. For example, although hyponatremia is found under “weak and dizzy,” hyperglycemia is found under “altered mental status.” And although opioid overdose is under “environmental complaints,” alcohol withdrawal is under “altered mental status.” When an ischemic stroke patient was coming in, we had to scramble to find what chief complaint this might be under (“weak and dizzy,” if you'd like to know). In the end, an index is a must because although the chapters on individual diagnosis make sense after you realize where they fall, you might not be able to find them without reading the entire table of contents. I'm not an ultrasonograph zealot, but I would like to see a separate section (perhaps under “procedures”) with all of the views and measurements needed for each of the common bedside emergency ultrasonographic techniques. Mostly to keep the ultrasonograph zealots off my back. EM Fundamentals is an instant hit and a fantastic addition to the EMRA library. We are ordering them now for our medical students, have them already for our interns, and hope that future editions build on this first-edition success.