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The Atlas of Emergency Medicine, 4th Edition Preface

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"The life so short, the craft so long to learn"

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Hippocrates

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We have a passion for improving patient care. Our journey with The Atlas of Emergency Medicine began with superb mentors who instilled in us a drive to become excellent clinicians and educators. We discovered imaging was a powerful tool to take the learner "to the bedside" and establish permanence, in a fashion unlike any other didactic technique. In 1994, much by chance, collegial networking brought three of us together to pursue an aggressive goal of producing the most comprehensive source of high-quality emergency care images available. While there were some initial detractors, our first three editions received widespread praise and have been translated into three foreign languages, flash cards, and electronic versions. We are deeply humbled and honored to present our fourth iteration.

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Emergency care is defined by time and the emergency department is the most diverse melting pot of acute conditions in the hospital. Diagnostic accuracy, prognostic prediction, and the treatment pathways rely heavily on visual clues. We desire to maximize this skill for the benefit of our patients. We also strongly believe the visual experience, while sometimes downplayed within the hectic and time-pressured environment of modern medicine, is critical to ideal education. Images can teach faster and with greater impact than many pages of text or hours of lecture.

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We continue our pursuit of these goals with a substantially updated, expanded, and improved fourth edition of The Atlas of Emergency Medicine. Nearly all of our changes and additions come from reader suggestions and criticisms, all received with sincere gratitude.

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First, we have changed the format to greatly reduce text and allow for more images. Hence, the text is more concise, providing essential information. Each chapter item is now organized into: Clinical Summary, including a differential diagnosis where appropriate, followed by Management and Disposition, and, finally, Pearls. We have, as in the past, endeavored to provide relevant "pearls" representing tips for diagnosis, management, or unique aspects of a condition difficult to find in a typical text.

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Second, after extensive review and critique, hundreds of new and replacement images have been added. We have been fortunate to draw upon new sources of photographs available on the Internet or through electronic channels unavailable to us previously. This has substantially strengthened the content and is a reminder of how much the world of media has changed. Gone are the days of manually sorting through thousands of slides or prints. There have been radical changes in the way we access medical knowledge over the past two decades. Regardless of the form, however, an image maintains a potent means to teach and learn.

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Third, we are making an initial move into video. Many chapters include links to short videos further elucidating findings and providing a powerful medium to expand upon static images.

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The audience for this text is all who provide emergency medical care, including clinicians, educators, residents, nurses, prehospital caregivers, and medical students. Many have also found it extremely useful as a review for written board examinations containing pictorial questions. Other healthcare workers, such as internists, family physicians, pediatricians, nurse practitioners, and physician assistants will find the Atlas a useful guide in identifying and treating many acute conditions, where visual clues significantly guide, improve, and expedite diagnosis as well as treatment.

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We thank the many contributors and readers who have helped make this edition possible. We are especially grateful for the many contributions from two great educators in emergency medicine who share our passion: David Effron, MD, and Larry Mellick, MD. Also, special thanks to Anne Sydor, PhD, our McGraw-Hill editor for her tireless commitment, organizational ability and focus. Lastly, and most importantly, we express our deepest gratitude to our patients who were willing to be a "great case" in the Atlas, thus ultimately paving the way for improved emergency care.

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Kevin J. Knoop, md, ms
Lawrence B. Stack, md
Alan B. Storrow, md
R. Jason Thurman, md

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