Pediatric Emergency Medicine


Gary R.Strange, William R.Ahrens, Robert W.Schafermeyer, RobertWiebe , Editors .
New York, NY : McGraw Hill Medical , 2009 ; 1, 216 pp; $129.00 (hardcover ).

Pediatric emergency medicine grows and develops as a subspecialty within emergency medicine, and new pediatric-centric departments are built each year. Despite this maturation, the majority of emergent pediatric patients continue to be seen in general emergency departments. General emergency physicians retain the responsibility not only for adults, but also those patients under the age of 18 years. It is widely known that “children are not little adults,” justifying additional information and resources for those caring for them. Multiple pediatric emergency medicine texts are available, including Pediatric Emergency Medicine by Strange et al., which is now in its third edition.

A large textbook made for a library, emergency department reference area, or physician’s office, Pediatric Emergency Medicine consists of nearly 1,200 pages. The text is broken down into 23 sections, representing cardinal presentations, emergency management, and systems-based themes. The chapters’ subject matter, within the sections, represents both common emergency presentations, such as headache or abdominal pain, as well as specific diagnoses, like cerebral palsy or rickets. Each chapter begins with a “high-yield facts” section, designed for quick reference of pertinent topics. Unfortunately, the focal points of the pearls are not highlighted or in bold, which may force the reader to peruse all of the facts to glean the critical information. The remaining bulk of the chapter tends to be divided into standard parts, such as pathophysiology, broad management principles, and distinct diagnoses. Interestingly, around 200 pages of the book are dedicated to toxicology and environmental emergencies.

The strengths and weaknesses define the book, creating a balanced product. The regular text is not adequately proportioned and would benefit from an increase in font size. On the other hand, the print utilized in the tables and figures is perfectly sized and therefore quite readable. The majority of the images are informative and viewable and have explanations attached. Yet several photographs are of such poor quality, including grainy (Rocky Mountain spotted fever) or overmagnification distortion (clitoromegaly), and one must pose the question, “Why did they put that photograph in?” Schematics are also very well done and are placed in the text when photographs are not an appropriate choice. As an example, the congenital heart disease chapter is excellent, providing the individualized schematics for each cardiac anomaly, allowing further understanding and subsequently improved care.

The greatest contribution of Pediatric Emergency Medicine is the collection of algorithms. Over 100 decision trees are scattered through the book, allowing a step-by-step approach to many common and some not-so-common clinical presentations. These well-conceived figures, in contrast to the scientific prose, permit decidedly rapid reference in clinical scenarios. They also represent an administrator’s dream, empowering the leadership to create protocols and guidelines that will streamline care with an evidence-based style.

Although more amenable to beginning-to-end chapter reading rather than a quick reference, a reasonable price tag, sturdy construction, and pertinent information all make Pediatric Emergency Medicine a solid purchase. On par with other like texts, the tipping factor is the well-presented algorithms throughout. Ultimately, Pediatric Emergency Medicine would be a welcomed addition to the reference library.