Preface

When the first edition of this book was published, in black and white, in 2004 we did not expect it to become so popular, with more than 16,000 copies sold internationally, and nine reprints over a decade. The second edition, published in 2014, added 20 new chapters and continued to remain popular, selling more than 11,000 copies. This is probably because we have created a niche textbook which is succinct enough to be read cover-to-cover and used in real-time clinical practice and, at the same time, it is comprehensive enough to avoid gaps in the knowledge of key points.

As Emergency Medicine is such a vast and rapidly progressing field, we faced the challenge of making the book even more comprehensive while keeping it still manageable. This was a key consideration in this edition especially as we added 9 brand-new chapters and more than 100 between full-colour clinical photos and videos, and thoroughly revised all chapters according to the latest evidence. We managed to achieve this by carefully categorizing the content into basic chapters, for medical students, and advanced chapters, which are marked by blue triangles on the chapters’ first page and blue bars on the side and by in the Contents section (page v), for doctors practising in the emergency departments and residents taking examination.

Key Features

Part I: Common Presentation in Adult Patients

This section is one of the key strengths of this book. Emergency patients present in a myriad of ways. Mastery in the approach to different presenting complaints is one of the core skills of an emergency doctor, and this book places a lot of emphasis on this, as it can be seen by the 29 chapters in this section. These include 2 new chapters:

• Chapter 12 Jaundice

• Chapter 29 Weakness.

Part 2: Specific Conditions

This section is organised into 23 different sub-parts to facilitate learning and revision for examinations. In each of these sub-parts, the advanced chapters are deliberately placed after the basic chapters, to assure readability for medical students. We have reorganised a few chapters from the second edition: Febrile Fit has been incorporated into Child, Fitting; Commonly Used Scoring Systems and Useful Formulae chapters have been removed and their content has been integrated into the relevant chapters instead; similarly, we have removed Chikungunya from the Dengue Fever and Chikungunya chapter; the chapter Overwarfarinisation has been titled Emergency Anticoagulation Reversal; we have greatly expanded Chapter 83 Dermatology in Emergency Care with an Introduction chapter and four sub-chapters, 83A-D, focusing on the different categories of presentation of rashes.

The 7 new chapters in this section include the following:

• Chapter 82 Palliative and End-of-life Emergency Care

• Chapter 93 Poisoning, Novel Psychoactive Substances

• Chapter 94 Poisoning, Serotonin Syndrome

• Chapter 123 Emergency CT Brain Interpretation

• Chapter 126 Emergency CT Abdomen and Pelvis Interpretation

• Chapter 127 Emergency CT Thorax Interpretation

• Chapter 145 Child with Altered Mental State

Intended Audience

This book is meant for:

• Medical Students doing their ED rotations, as it virtually covers all the common conditions they may encounter during their EM posting. Part 1 is practical, focused and concise, and students should be able to finish reading it within a 4-week posting. Moreover, as already mentioned, the chapters in Part 2 that they should read are clearly marked. This will reduce the number of pages they have to read to around 800 pages.

• Junior Doctors serving their EM rotations, and Emergency Nurses. This will be a quick reference for 90–95% of the most commonly encountered conditions in their daily practice. The Caveats sections are especially useful to help prevent fatal and costly errors in patient management.

• Emergency Medicine Residents preparing for their postgraduate exams. This book can be easily read cover-to-cover, as it is written in point form with keywords highlighted. The content is evidence-based and follows international guidelines. To explain the rationale of certain points in the management, pertinent information is given without the cumbersome details of the pathophysiology, unless absolutely necessary. If you master the content of this book, you can almost be certain of being able to handle any international exams!

• Junior Doctors serving their rotations outside of ED. This book will assist them in managing multidisciplinary emergencies as these can arise unexpectedly in the course of their work. It will help them managing patients in the first half-hour while waiting for additional help.

• General Practitioners. This book will guide them on how to treat multidisciplinary emergencies within the first half-hour, while arrangements are made to send their patients to the ED. The Special Tips for GPs sections will be of particular interest to them.

• Paramedics and Prehospital Care Personnel. Part 1 and Special Tips for GPs will be very useful in guiding them in the symptom-based approach to emergency conditions.

Acknowledgements

This book would not have been possible without the invaluable help of our numerous contributors, whom we wish to thank. This edition is particularly special because the project started in the first half of 2020, in the thick of the COVID-19 pandemic, while we were battling the then little-known virus. Even though 2 years have gone by, we are still not out of the pandemic. The cover designed by Dr Lim Kwee Kuang, one of our own Emergency Medicine Senior Residents, pertinently illustrates the use of personal protective equipment while intubating a mock patient. We would also like to thank our illustrators for this edition, Dr Roger Teo, Dr Ada Ngo, and medical student Nah Jie Hui, for willingly assisting us. We would also like to thank Ms Lee Li Li, National University Hospital Emergency Medicine Department Manager, and Ms Neo Yen Yen, Emergency Medicine Department Secretary, for assisting us.

We are greatly indebted to:

• Professor Aymeric Lim, NUH Chief Executive Officer, and Professor Brian Gibler, from the University of Cincinnati, for graciously writing the Forewords for us;

• The following for writing the endorsement for our book:

  • – Professor Colin A. Graham, Director of Emergency Medicine and Dean of Students, Morningside College, Chinese University of Hong Kong

  • – Dr Ali Haeder, Clinical Lecturer & Senior Consultant Emergency Physician, Universitas Brawijaya, Indonesia

  • – Dr Taj Hassan, Immediate Past President of the Royal College of Emergency Medicine, United Kingdom

  • – Dr Mohan Tiru, Immediate Past Singapore Emergency Medicine Residency Advisory Committee Chair

  • – Professor Tamarish Kole, President of the Asian Society for Emergency Medicine (ASEM)

  • – Dr Tan Tze Lee, President of the College of Family Physicians, Singapore

  • – Professor Hisamuddin NA Rahman, Senior Consultant and Lecturer in Emergency Medicine, University Sains Malaysia

We hope you will find this edition even more pleasant and useful to read and we will welcome your feedback, please email Neo Yen Yen at nuh_emd@nuhs.edu.sg.

Associate Professor Shirley Ooi

Dr Matthew Low

Associate Professor Peter George Manning