The 5-Minute Emergency Medicine Consult for PDA

Media Review

CJEM 2002;4(5):375

The 5-Minute Emergency Medicine Consult for PDA. 1-9313022-2-7 January 2002. Version 4.0.24/2001.5.24. Peter Rosen, et al. A Part of the 5-Minute Series. Lippincott Williams & Wilkins Mobile Medicine. $108.50. ISBN 0-7817-3948-9

Emergency physicians increasingly use handheld computers during bedside clinical work. Common handheld applications include personal agendas, phone books, memo lists, calculators, drug indexes and reference materials. Many love the thought of having a textbook in their pocket, with up-to-date, clinically relevant information for those all too frequent moments when patients and residents expose gaps in our knowledge.

The 5-Minute Series claims to "carry a world-class library in your pocket!" The 5-Minute Series is already available for internal medicine, orthopedics, pediatrics, toxicology, sport medicine, and others. If you own these, you can quickly cross-reference subjects and seamlessly integrate the information in the newer EM version!

This software, prepared by Skyscape, is easy to install, whether you use Palm OS, Pocket PC or Windows CE operating system. It's as simple as transferring the files (about 20 Meg) from the CD-ROM to your PC (or downloading from the Internet), then synchronizing with your handheld. It requires Windows 9x and up or Macintosh 7 and up on your PC, as well as a Palm OS-3 MB or Windows CE/Pocket PC-4 MB system. You need Internet access to register and to get a licence from LWW to use this program beyond the 15-session trial period.

The interface is easy to use, and the information is classified in 3 ways: by main subject or diagnosis, by medication and by ICD-9 code index. There is a useful search tool covering over 600 clinical topics in alphabetical order. Each subject is subdivided by major headings: clinical presentation, pre- hospital, diagnosis, treatment, disposition and miscellaneous (e.g., prognosis, suggested readings).

Peter Rosen is the editor, and associate editors are Roger Barkin, Stephen Hayden, Jeffrey Schaider and Richard Wolfe.

There are over 400 authors and they cover most of emergency medicine well, although the section on poisoning is the highlight -- of surprisingly high quality for this kind of database. The text is the same as the printed version of The 5-Minute Emergency Medicine Consult published in 1999, which is 1287 pages. The 2 media are available at the same price.

The quantity of information on each topic could probably be read in 5 minutes as promised, but the quality is sometimes limited. The writing is succinct, with no room for comments or nuance. The "Clinical presentations" section is detailed, with signs and symptoms, mechanics/description and etiology for each topic. There is relatively little information on pre-hospital care and its usefulness is questionable. The "Diagnosis" section is well structured, with subheadings such as essential workup, laboratory, imaging, special tests and differential diagnosis. The Treatment section includes discussions of initial stabilization, ED treatments and medication guidelines.

It is rather like a cookbook, but the drugs tend to be listed without adequate comments regarding which drug is preferred. Admission and discharge criteria are well described in the disposition section, although the last section -- miscellaneous information -- is the least useful, consisting mainly of suggested readings.

Scanning the references, I noted that many were textbooks and review articles rather than original research; there were few recent references and no evidence-based reviews (i.e., Cochrane Collaboration).

In summary, The 5-Minute Emergency Medicine Consult seems like a resident pocket notebook (with some outdated information). Except for the poisoning section, I don't think it's worth keeping this 2000 KB database in my PDA. It may be useful as a basic reference, but there are a lot of unanswered questions in this text.

Claude Topping, MD
Université Laval
Quebec, Que.