Clinical Emergency Medicine Casebook


Clinical Emergency Medicine Casebook By Joel T. Levis and Gus M. Garmel . New York, NY : Cambridge University Press , 2009 ; 489 pp; $75.00 .

Clinical Emergency Medicine Casebook is a compilation of 111 clinical case studies covering a wide variety of cases, divided into topic area sections. The resulting coverage of core concepts in emergency medicine (EM) is impressive and allows this book to function both as a practice and training book and as a refresher for more seasoned emergency physicians and practitioners. The authors note that the book is specifically geared toward EM physicians in training, as well as students and nurses.

The book is divided into sections covering head, eyes, ears, nose, and throat; cardiovascular; pulmonology; gastroenterology; genitourinary and gynecology; neurology and neurosurgery; trauma; orthopedics; hand; pediatrics; infectious disease; and toxicology and environmental. A series of miscellaneous cases closes the book, and an answer index follows, making for easy cross-referencing with the symptom-based case titles. While on first look it appears impossible to gain an adequate coverage of the breadth of cases seen in EM with only 111 offerings, the authors have done a wonderful job of including key diagnoses in EM. Acute epiglottitis, aortic dissection, ST-elevation myocardial infarction, community-acquired pneumonia, traumatic subarachnoid hemorrhage, ovarian torsion, ruptured ectopic pregnancy, hemolytic uremic syndrome, angioedema, and many more diagnoses are covered. While a few more rare, but important, diagnoses such as “ventriculoatrial shunt causing septic emboli and recurrent pneumonias” and “painless type A aortic dissection” are included, the vast majority of the cases represent the true “bread-and-butter” of EM.

For each case, the authors use a first page that includes “History of Present Illness” and “Physical Examination” sections, followed by a question: “What is your diagnosis?” The answer is included on the following page(s), with a brief discussion and pertinent x-rays, computed tomography scans, ultrasounds, electrocardiograms (ECGs), clinical photographs, or other images and a nice wrap-up section entitled “Key Teaching Points.” Tables highlighting clinical information are included when appropriate, and the image quality is excellent for radiologic and ultrasound images, ECGs, and clinical photographs. The case discussions are well written yet concise and cover the salient points of each case. Each case concludes with associated literature references.

The amount of information included in this relatively short volume is astonishing. The topics for case inclusion in the book were well thought out and provide an outstanding overview of some key areas in EM. As noted above, the included images are a significant enhancement to the cases, and the overall quality of the book is outstanding. The authors deserve substantial credit for producing such a high-quality learning tool. The only apparent negatives are the size of the book (full size 8.5 × 11 inch with 489 high-quality glossy pages) and the cost. While a pocket-sized reference might be useful, it would likely be difficult to duplicate the excellent layout, image quality, and flow of the book in a different size. Similarly, the cost of the book is reflective of the quality of work included within the cases. Apart from these minor considerations, the authors appear to have hit a home run with this book. While the cases may be most appropriate for medical students or resident physicians training or rotating in EM, the wealth of clinical information and excellent discussions make this a good reference for practicing emergency physicians, as well as any other students or practitioners caring for emergency or urgent care patients. Given the relative paucity of true case-based learning references geared specifically for emergency physicians, this book truly fills an important void in the EM literature. It has all of the key ingredients for successful integration in any learning or study program and should be a sought-after reference for years to come.