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Doody's Review ServiceReviewer: Stephen Kun Chung Ho, DDS (University of Illinois at Chicago College of Dentistry)
Description: This is the fifth edition of a book last published in 1993 on medical emergencies encountered in the dental office. The 529 pages include numerous black-and-white illustrations and an appendix of diagnostic and interventional algorithms.
Purpose: The aim, as stated by the author, is "to stimulate members of the dental profession — the doctor, dental hygienist, dental assistant, and other office personnel — to improve and maintain their skill in the prevention of medical emergencies and in the recognition and management of emergencies that inevitably occur." The somewhat grandiose aim may be unrealistic, considering the author often presupposes a familiarity with anatomy, cardiac life support, and pathophysiology.
Audience: According to the author, dentists, hygienists, dental assistants, and other office personnel are the audience. However, due to the level at which the material is presented, it would only be suitable for dentists, senior dental students, and dental hygienists. The author is a professor of anesthesia and medicine at the USC School of Dentistry. His books also include the Handbook of Local Anesthesia (Mosby, 1997) and Sedation: A Guide to Patient Management (Mosby, 1995).
Features: As with previous editions, the etiology, physiology, and care of patient medical emergencies that could manifest in a dental office are covered. The author has made an attempt to modernize the interventions to stay in line with current thinking in emergency medicine. The organization of topics according to the patient's acute signs and symptoms facilitate the formation of a differential diagnosis by the caregiver. In addition, there is a detailed section on the prevention of medical emergencies, including recommendations for a "basic emergency kit" and other baseline levels of preparedness that all offices should possess. The chapter on the differential diagnosis of chest pain is particularly well written and exceedingly pertinent today, as the percentage of ambulatory care patients with cardiovascular disease continues to increase. The presentation of the material is in a practical "question and comment" format with a focus on how the practitioner can elicit information from the patient critical to the prevention of the emergency. The appendix, "quick-reference section to life-threatening situations" provides the important information in a convenient ACLS-algorithm format. The one shortcoming of the book is in relation to the timing of this edition. With the American Heart Association set to publish their Emergency Cardiac Care guidelines later this year, one has to wonder how much of the information in this book will be rendered out-of-date.
Assessment: This is a comprehensive summary of the medical emergencies possible in a dental office and their interventions. It would be of use to senior dental students and also to practicing dentists. The presentation, comprehensiveness, and favorable history of the previous editions make this text a leader in the field.