Critical Images in Emergency Medicine - Annals of Emergency Medicine

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Like emergency medicine, emergency medical services (EMS) ... disaster, customer service/medicolegal, behavioral/psychiatric, .... an iPad app as well.
BOOK AND MEDIA REVIEWS Avoiding Common Prehospital Errors Review by Robert L. Mabry, MD

Critical Images in Emergency Medicine Review by Gabrielle A. Jacquet, MD, MPH 0196-0644/$-see front matter Copyright © 2013 by the American College of Emergency Physicians

Avoiding Common Prehospital Errors Lawner BJ, Slovis CM, Fowler R, et al Lippincott Williams & Wilkins 452 pages, $39.95 ISBN-13: 978-1451131598 ISBN-10: 1451131593 Like emergency medicine, emergency medical services (EMS) is a dynamic, increasingly sophisticated and growing field of medicine that has undergone tremendous evolution during the past 4 decades. It has evolved significantly from the 1960s, when seriously ill or injured patients were often transported to the hospital by the local funeral director in a hearse, with little, if any, out-of-hospital care; in modern EMS systems, cardiac arrest victims are routinely resuscitated in the field by licensed paramedics with more than 1,000 hours of initial training and using state-of-the-art emergency medicine skills and technology. In 2010, the American Board of Emergency Medicine recognized EMS as the sixth subspecialty of emergency medicine, giving physicians the opportunity to become board certified in this growing field. Avoiding Common Prehospital Errors, the latest edition in the Avoiding Common Errors series, “emphasizes high impact areas of prehospital medicine.” Organized into sections covering airway management, respiratory emergencies, cardiac care, trauma, pediatrics, aeromedical/critical care, incident command/ disaster, customer service/medicolegal, behavioral/psychiatric, obstetrics/gynecology, and neurologic emergencies, it is a surprisingly compact handbook for being 440 pages long. Each section is divided into short, easily digestible, 3- to 4-page chapters that address key out-of-hospital care concepts, “tricks of the trade,” and potential pitfalls to avoid while working the outof-hospital field setting. Avoiding Common Prehospital Errors benefits from the wealth of accumulated EMS experience of the editors and authors, who include some of the leading EMS physicians in the United States, as well as a number of seasoned field paramedics. Using the available and pertinent evidence, the authors challenge some long-standing EMS practice concepts such as the role of out-of-hospital intubation, as well as discuss newer, cutting-edge topics in out-ofhospital resuscitation such as compression-only cardiopulmonary resuscitation, postresuscitation hypothermia, field use of continuous positive airway pressure devices, and vasopressors. Although geared toward out-of-hospital providers, this text would also be of use to EMS fellows, residents, and medical students during an EMS rotation. This concise overview of key 94 Annals of Emergency Medicine

EMS literature and concepts, although not adequate as a standalone review resource, may also be useful to those preparing for the new EMS Board Certification Exam. The compact size, concise chapters, and tricks-of-the-trade approach make this book a unique and useful addition to the EMS literature. There is some overlap with a few topics between authors of different sections. Airway management, for example, is covered in multiple chapters, albeit in a slightly different context each time. These redundancies are minor and do not take away from the overall usefulness of the book. In summary, Avoiding Common Prehospital Errors is a great little book that adds to what will be a growing collection of available EMS literature. Veterans and trainees alike will find this a useful addition to their library. Robert L. Mabry, MD Military EMS and Disaster Medicine Fellowship San Antonio Military Medical Center San Antonio, TX The opinions or assertions contained herein are the private views of the author and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

Critical Images in Emergency Medicine Broder JS American College of Emergency Physicians 132 pages, $79.00 member, $119.00 non-member $69.99 iPad application ISBN-13: 978-0983428893 ISBN-10: 0983428891 Diagnostic imaging plays an increasingly vital role in modern patient care. From medical practice settings in which an emergency physician in the community does not always have 24-hour radiology interpretation available, to an academic setting in which a radiology resident may be reading emergency department (ED) studies, the ability to independently and quickly recognize critical radiologic findings is imperative. Critical Images in Emergency Medicine is an aesthetically pleasing American College of Emergency Physicians (ACEP) book containing a series of 60 clinical vignettes focused on diagnostic imaging originally published as “The Critical Image” in monthly issues of Critical Decisions in Emergency Medicine. Cases include all Volume 63, no. 1 : January 2014

Book and Media Reviews ages of patients with a variety of patterns of disease. The author has included all available emergency medicine imaging modalities: radiograph, computed tomography, magnetic resonance imaging, and the most common types of ED ultrasonography (cardiac, transabdominal, and transvaginal). On completion, readers will be able to describe the imaging tests needed to diagnose multiple lifethreatening conditions and explain, according to the images and cases presented, what the diagnosis is or what the next critical actions are in patient management. With each clinical vignette being only 2 pages long, the book is very easy to read and amenable to being read in short intervals—great features for the typical emergency physician. Each case has a first page with a brief patient description followed by a key image or images and subsequently a multiple-choice question. On the back side of the page (cleverly designed to be hidden while the reader is studying the case and image) is the answer, followed by a detailed explanation of the correct answer, as well as an annotated version of the critical image; this feature is particularly helpful for readers who may be unfamiliar with the visual findings described in the text explanation. Many of the explanations are backed up by up-to-date references, which is a nice conduit for optional supplemental reading. Because many of the vignettes within Critical Images in Emergency Medicine contain pathognomonic findings or key clues for rapid visual diagnosis, this text is an excellent self-study tool

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for in-service examinations and board certification tests, both written and oral. In addition, ACEP has approved the material for 15 ACEP Category 1 credits if a satisfactory continuing medical educational posttest score is achieved. Being lightweight, spiral-bound, and only. What’s even better is that this book was just made available as an iPad app as well. The image quality is inherently better, and this increased accessibility promotes self-study and facilitates bedside teaching. 122 pages long, this book is also a great bedside teaching tool. My only criticism is this: Just to spice things up and keep us on our toes, I would have liked to see a couple of vignettes in which the correct answer was “a normal image” and featured commonly confused or high-yield normal anatomic variants. In summary, Critical Images in Emergency Medicine is an easy-to-read collection of pertinent emergency medicine cases in which a lifesaving diagnosis or treatment depends on rapid identification of critical findings in medical imaging; it is a great resource for self-study and bedside teaching. Gabrielle A. Jacquet, MD, MPH Boston University School of Medicine Boston, MA

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