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Prior to the spring of my third year of medical school, I hadn’t heard of the specialty emergency medicine. I didn’t know where in the medical center our “emergency room” (ER)1 was and I didn’t know that we had a combined emergency medicine (EM)/internal medicine (IM) residency program. Apparently, they didn’t promote the program much among the medical students. One day, shortly before I was to begin my final year of medical school, an EM/IM resident enlightened me and convinced me to squeeze an EM elective into my upcoming schedule. Fast forward a few months, I began my EM rotation and was hooked. On September 21,1979, three weeks into my EM elective, emergency medicine (EM) was recognized as the 23rd American specialty. Yes, I’m that old and so is our specialty.

I prepared for my initial EM certification board exams using the first edition of The Study Guide. It was well written, easy to read, and much shorter than the current eighth edition of Tintinalli’s Emergency Medicine Manual, which is derived from the eighth edition of Tintinalli’s Emergency Medicine: A Comprehensive Study Guide. What a great honor it has been to work with Dr. Tintinalli and to contribute to both her namesake textbook and manual.

While a single editor compiled Tintinalli’s first Study Guide, the eighth edition of Tintinalli’s Emergency Medicine Manual includes contributors from across the globe, including several African nations where emergency medicine is an emerging specialty. The eighth edition includes “Palliative Care,” which was certainly not on emergency medicine’s radar in 1979, but is now recognized as a subspecialty of our discipline. We continue to publish the Manual in multiple languages for our readers around the world and hope that the Manual and its online version at continues to serve the daily needs of medical students, residents, advanced practice providers, and practicing emergency physicians.

The co-editors Michael T. Fitch, Scott Joing, Vincent Wang, David M. Cline, O. John Ma, and I would like to thank all the authors for their excellent efforts in writing and updating chapters while also maintaining busy clinical schedules. Thanks, too, to the hardworking crew at McGraw Hill Education for their guidance in taking this project from draft to publication: Brian Belval, Christie Naglieri, Jessica Gonzalez, Juanita Thompson, and Poonam Bisht. Finally, I am grateful to have had such wonderful team of editors with whom to work. They made publishing this handbook a delight. Thanks Michael, Scott, Vincent, David, and John.

RKC dedicates this book to Marc, Matthew, Lissy, and Noah, as well as to emergency care providers around the world; MF dedicates this book to Missy, Mira, and Maya, and in memory of Dr. John Marx; SJ dedicates this book to wonderful Elizabeth, Micah, Owen, Britta, and Emmy along with the outstanding Hennepin County Medical Center EM faculty and residents; VW dedicates this book to Esther, Elijah, and Evaline; DMC dedicates this book to family: home, church, and professional; OJM dedicates this book to everyone dedicated to advancing quality of care and patient safety in emergency medicine.

1 Prior to becoming known as the Emergency Department (ED), the area was known as the emergency room.

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