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Lecture Notes: Emergency Medicine, 3rd edn CHRIS MOULTON, DAVID YATES
EXTENT P/H 446 pages, Paperback
PRICE/ISBN £24.99, 1405122730
PUBLISHER Blackwell (Oxford), 2006
REVIEWER John Lowry
STAR RATING ****
This is the third edition of a text that was born in 1985 as Lecture Notes in Accident and Emergency Medicine, under the co-authorship of Professors David Yates and Anthony Redmond. Following seven reprints, it was completely rewritten in 1999 by Chris Moulton and David Yates. Again, after several reprints, they have endeavoured to present an up-to-date approach to emergency medicine based on progressive improvements in clinical practice albeit in the light of enormous change in the delivery of healthcare in the UK. The authors point out that, although they have attempted to use the best available evidence, they have not been slaves to an evidential doctrine when there are no clear recommendations for commonly occurring problems.
It very successfully presents current core knowledge in the field of accident and emergency medicine in a logical manner with a significant amount of cross-referencing between chapters particularly where boxed sections presenting key elements to assist diagnosis and management are relevant to the specific text. For example, the chapter on burns includes a valuable summary box on fluid replacement and provides cross references to radiation injury within a later chapter on poisoning. In addition, the chapter on cardiac arrest and dysrhythmias includes the latest guidelines from the Resuscitation Council.
The introductory chapter on the principles of emergency medicine includes a helpful section on sedation and general anaesthesia with important guidance for the discharge of patients who have received sedative drugs in the emergency department. Following an outline of the management of major trauma and multiple injuries, the text proceeds in a logical anatomical manner through injuries to the head, face and neck: the trunk (including chest and abdomen) and upper and lower limbs, with a separate chapter covering the hand. Cardiac arrest, chest pain, respiratory distress, collapse and sudden illness are followed by abdominal pain, obstetric, gynaecological, genito-urinary and perineal problems before moving on to sensitively constructed chapters on children's problems, disturbed patients and medicolegal aspects of emergency medicine.
The penultimate chapter on small wounds and localised infections emphasises that ‘small does not mean trivial’ and covers a comprehensive field including transmission of blood-borne viruses very succinctly. The concluding section covering ophthalmic, ENT and dental conditions together with facial pain reminds us that over 5% of emergency department attendances involve eye-related problems. The comprehensive index extends over 20 pages and helpfully has separate italicised entries referring to figures and tables.
Although aimed at undergraduates, junior doctors on foundation programmes, trainees in accident and emergency medicine, and doctors and nurses in the primary care setting, there is little doubt that this book will have a wider interest for those in early years surgical training and for more senior colleagues wishing to update themselves in the management of patients presenting with acute conditions outside their immediate field of specialist expertise.