Pediatric Emergencies: A Practical, Clinical Guide by Emily Rose MD. New York: Oxford University Press, 2020; 722 pp; $130.00 (paperback)

Abstract

The stated aim of Pediatric Emergencies: A Practical, Clinical Guide is to be, “more clinically focused than a traditional textbook but more comprehensive than a typical clinical guide.” By and large, the book successfully achieves this aim. Each chapter gets straight to the important points about common or cannot-miss pediatric emergency diagnoses. For example, there are useful discussions about the classic and atypical presentations of endocrine disorders, including pituitary apoplexy, thyroid storm, and Cushing’s syndrome (pp. 334–350). The chapter sections are succinct and focus on need-to-know information for emergency providers. The book is organized by organ system, with additional pertinent chapters on procedures, sedation, vascular access, and medicolegal issues in pediatric emergency medicine. Each chapter introduces the unique pathophysiology or diagnostic considerations of pediatric patients, then delves into the most common and pertinent diagnoses and their management. Key points and pitfalls are helpful features of each section, which naturally catch the reader’s attention in bullet point format. In general, the layout of the book allows for quick review of a topic and, for educators, preparation for easy clinical teaching pearls. In this era of FOAMed, including podcasts and blog posts, any book must be easy to read, have relevant visual stimuli, and must not force the reader to get bogged down in the weeds. As mentioned previously, the key points and pitfalls are helpful in this regard, as are the many treatment algorithms (p. 346, diabetic ketoacidosis treatment) and clinical guidelines (p. 31, brief resolved unexplained event, or BRUE, formerly known as ALTE). The sections focusing on how to best perform specific pediatric examinations are also essential (p. 457, pediatric eye exam tips) and, as any provider caring for children should know, must be peppered with playtime. Any textbook in a medical subspecialty warrants authorship from leaders in the field and representation from across the country, both of which Dr. Rose and her team achieved. Furthermore, the art of pediatric emergency medicine involves the tips and tricks that make practice easier, such as the simple mnemonic for remembering which laryngoscope blade should be used to intubate a mid–elementary aged child (Appendix 3). For those who are curious, this helpful mnemonic is, “use a 2 at [age] 2, and 3 in 3rd grade.” In several chapters, there are excellent pictures and tables to illustrate key points, such as the “Procedural Sedation and Pain Management” chapter. In fact, kudos to the pediatric model who bravely sat for the many facial and dental block illustrations (p. 596). A true benefit to many portions of this book are comparisons of how pediatric complaints contrast with adult presentations, for example, how pediatric versus adult physiology affects outcomes in thoracoabdominal trauma (p. 405). Often in the emergency medical care of adults, we rely upon laboratory and imaging studies to answer our clinical questions. There is a valid argument for this, as pathology is often more sinister in adults than children. The true test of emergency providers is the ability to appropriately choose when pediatric complaints warrant more than a comprehensive physical examination and shared decision making with the parent/guardian. As such, there are several topics that highlight this important consideration; it would have been helpful to see more focus on this in every chapter. Future iterations could also address minor oversights, such as a legend for the easy-to-read vaccination schedule (Appendix 5) and improvements in some of the photos. The authors intended for this book to neatly fill the niche between traditional textbook and clinical guide. Many chapters use a case-based format to achieve this aim, whereas others skew more toward a traditional, yet truncated, textbook version. Regardless, there is a useful niche for this book when other pediatric emergency texts fit more clearly in the wordy, traditional realm. The target audience is general emergency providers, including physicians, trainees, and advanced practice providers. To that end, it seems that most emergency physicians would be interested in exactly this. Overall, Pediatric Emergencies: A Practical, Clinical Guide is an excellent on-shift reference for all things pediatric emergency medicine, whether for community attendings who want to brush up on the latest in BRUE management or for educators looking for a visual reference to illustrate their teaching point on interpreting pediatric chest radiographs. It is also a great text for students or trainees who are looking to increase their knowledge by homing in on the most essential aspects of diagnosis and management. I highly recommend Pediatric Emergencies: A Practical, Clinical Guide for emergency physicians and other providers.