The scope of Emergency Medicine is extremely broad; it covers the care
of the neonate through the geriatric, surgical, and medical patients, and
encompasses all organ systems. Emergency Medicine is rapidly evolving to
reflect our increasing experience, knowledge, and research. Procedural
skills must supplement our cognitive skills. Achieving proficiency in
procedural skills is essential for the daily practice of Emergency Medicine.
In this textbook, we have produced a clear, complete, and easy-to-understand
guide to procedures. It will provide all practitioners, from the medical
student to the seasoned Emergentologist, with a single procedural reference
on which to base their clinical practices and technical skills.
The primary purpose of this text is to provide a detailed,
step-by-step approach to procedures performed in the Emergency Departmentand
it is expressly about procedures. While well referenced, it is not meant to
be a comprehensive reference but an easy-to-use and clinically useful text
that should be at hand in every Emergency Department. The content and
information are complete. The book is organized and written for ease of
access and use. The detail is sufficient to allow the reader to gain a
thorough understanding of each procedure. When available, alternative
techniques or hints are presented. Each chapter provides the reader with
clear and specific guidelines for performing every procedure. Although some
may use this text as a library reference, its real place is in the Emergency
Department where the procedures are performed. Despite its size, we hope
that this book will find its way to the bedside to be used by medical
students, residents, and practicing clinicians.
This book will satisfy the needs of physicians with a variety of backgrounds
and training. While it is primarily written for Emergentologists, many other
practitioners will find this a valuable reference. This book is written for
those who care for people with acute illnesses or injuries. Medical students
and residents will find this an authoritative work on procedural skills.
Medical students, residents, and practitioners with limited experience will
find all the information in each chapter to learn a complete procedure.
Family Physicians, Internists, and Pediatricians will find this text useful
to review procedures infrequently performed in the clinic, office, or urgent
care center. Intensivists and Surgeons involved in the care of acutely ill
patients will also find this book a wonderful resource. Experienced
clinicians can get a quick refresher on the procedure while enhancing their
knowledge and skills. Physicians actively involved in the education of
medical students and residents will find this text an easy-to-understand and
well illustrated source of didactic material.
text has 15 sections containing 173 chapters. The contents are organized
into sections, each representing an organ system, an area of the body, or a
surgical specialty. Each chapter is devoted to a single procedure. This
should allow quick access to complete information. Most of the chapters
follow a similar format, thus allowing information to be retrieved as
quickly and as efficiently as possible. There are often several acceptable
methods to perform a procedure. While alternative techniques are described
in many chapters, we have not exhaustively included all alternative
techniques. Key information, cautions, and important facts are highlighted
throughout the text in bold type.
chapter, with a few exceptions, follows a standard format. The relevant
anatomy and pathophysiology are discussed, followed by the indications and
contraindications for the procedure. A list of the necessary equipment is
provided. Preparation of the patientincluding consent, anesthesia, and
analgesiais addressed. The procedure is then described step by step.
Cautions are placed where problems commonly occur. Alternative techniques
and helpful hints for each procedure are presented. Aftercare and follow-up
are discussed. Any potential complications are described, including the
methods to reduce and care for the complications. Finally, a summary
contains a review of any critical or important information.
This book covers a wide variety of procedures. We have
made an effort to think of most procedures that may be performed in a rural
or urban Emergency Department and have incorporated them into this text.
This includes procedures performed routinely or rarely. It also includes
procedures that are often performed in the acute care, clinic, and office
setting. Some of the procedures in this book may be performed frequently in
the daily practice of Emergency Medicine, such as laceration repair or
endotracheal intubation. Other procedures, such as cricothyroidotomy, are
seldom to rarely performed but critical to the practice of Emergency
Medicine. While many of the procedures are well known to the
Emergentologist, some are uncommon and may not be so widely known. This
gives the reader an opportunity to acquire new information that may be
converted, with proper practice and training, into a useful skill. A few of
the procedures are performed only by Surgeons. They are included to promote
understanding by those who may later see the patients in the Emergency
Department and have to provide emergent care for a complication.
We have drawn on a wide variety of authors. The majority
of authors are residency-trained, board-certified, practicing
Emergentologists. We have the honor of having many contributors from outside
the field of Emergency Medicine who are experts in their own specialties.
Many of them are from Cook County Hospital, including the trauma surgeons.
The authors do have biases because of differences in education, experience,
and training. We have tried to base all recommendations on sound clinical
and scientific data. However, we have not excluded personal experience or
preferences when appropriate. In these cases, the authors also present
Hopefully, this book will
grow and change with time. Suggestions from you, the reader, would be most
appreciated. Let us know what additional procedures should be included or
excluded in future editions.
Eric F. Reichman,
Robert R. Simon, MD