Emergency Medicine: a Comprehensive Study Guide

Media Review

CJEM 2000;2(2):132

Emergency Medicine: a Comprehensive Study Guide.
5th ed. Edited by Judith E. Tintinalli, Gabor D. Kelen, J. Stephan Stapczynski. 2000. McGraw–Hill Companies, Inc. 2127 pp. $230.95. ISBN 0-07-065351-8

This is the 5th edition of an emergency medicine classic. More than 20 years after the first publication by the Amer-ican College of Emerg-ency Physicians in 1978, Editor-in-chief Judith E. Tintinalli and her coed-itors have made major changes. To prepare for this edition the editors solicited written reviews of the 4th edition from a number of emergency medicine residents, clinical practitioners and academicians. They expanded the format of the study guide by 572 pages to incorporate evidence from the medical literature. This kind of review illustrates how little of the practice of medicine is founded on solid science.

There are several new sections, including "Shock," "Analgesia, anesthesia, and sedation" and "Special patients." One of the major additions is a group of new chapters based on a symptoms approach to cardiovascular diseases, pulmonary and gastrointes-tinal emergencies, and obstetrical/ gynecological emergencies.

Other new chapters include: "Break-ing bad news: notifying the living of death," "Patients who abuse alcohol and other drugs: emergency department identification, intervention, and referral," "The elder patient," "The homeless patient" and "The morbidly obese patient." The authors also incorporated an excellent resource on antibiotics: "The EMRA antibiotic handbook."

Minor cosmetic modifications, such as the 2-colour processing, contrasted tables, and new photos and drawings, make the reading easier and more relaxing. Figures and tables on the inner covers have changed for the better, but the table on myasthenia gravis, a rare disease, should have stayed in the book.

This new edition is worth buying, especially for residents interested in emergency medicine, their teachers, and "fans" of Tintinalli’s Study Guide. If you look carefully, you’ll see many new Canadian contributors to the textbook: Riyad B. Abu-Laban, Anil Chopra, Brian Goldman, Laurie Morrison, Michael Schull, Julie Spence and Ian G. Stiell.

Claude Topping, MD
Université Laval
Quebec, Que.

Cline: Emergency Medicine. A Com-prehensive Study Guide 4e Compan-ion Handbook. Edited by Daniel M. Cline and O. John Ma. @Hand Medical Technologies, Inc. Available at: http://www.handmedical.com/. US$99.95 (student pricing is available). Product code 01-01-003-1

This e-text follows the organization of the 4th edition of Tintinalli’s popular Emergency Medicine: a Com-prehensive Study Guide. I used it for 3 months during my emergency department shifts.

@Hand’s unique interface is simple and effective for navigating around the book. Tables appear when a hotlink is tapped, and custom bookmarks can be inserted. However, there are no graphics, and users cannot add their own notes to this version of the software.

This e-text took 716 KB of memory on my Palm 3x. Current Palm models have 4–8 megabytes of memory off the shelf, which leaves plenty of room for other software. New Palm operating system personal digital assistants (PDA) from HandSpring ("Visor") and TRG Products ("TRGPro") can accept plug-in memory modules. The software version I reviewed won’t yet work in these newer memory devices, but @Hand is updating their software for the new technology.

Whereas printed books can use extra words to explain concepts, the Palm can fit only 65 words per screen. In the ED, I want fast, point-form access to essential details; but I often had to scroll through several screens of text to find one fact. For example, when I looked up hyperkalemia, I couldn’t find it easily with the "Contents" tool. (It was under "Fluids and electrolytes" in "Resuscitation.") Using the "Search" tool I had to sequentially work through every instance of the word in the book. The "Index" tool was fairly efficient, but not precise, and because this e-text is just a companion to the full textbook, the information is basic.

Readers who already use the paperback version of this book may want this e-text on their PDA to read up on topics before rounds or exams, but it doesn’t work as a fast reference during busy shifts. Before buying, readers should first download the trial version for a test drive.

James M. Thompson, MD
Associate Professor
Division of Emergency Medicine
Dalhousie University
Charlottetown, PEI