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xvi Foreword
The authors of the book are aware of all these problems and try to make
allowances for varying attitudes about evidence, as well as varying quality of
the evidence. Upon reading many of the chapters concerning the difficult
pain areas, I was often struck by the absence of a superior management, but
overall, was left with a sense of comfort that, by drawing upon clinical
experience, I would not be harming the patient.
In many chapters, one finds recommendations for how to avoid problems
that the reader might otherwise not have considered, such as systemic
absorption of ocular medications – therefore NSAID drops should not be
used in pregnant patients. Most readers would probably know that the
NSAIDs can prematurely close a ductus that needs to be patent in the fetus,
but would they think of it in relationship to an ophthalmic drop?
This book is very useful for a wide group of readers with varying experience.
Many students and residents will be commencing their clinical practice
and attempting to learn appropriate dosages as well as which medications
are preferable. For them, this book will provide an indispensable reference. It
is probably best read in conjunction with caring for a given patient rather
than trying to absorb the material by reading the book from cover to cover,
which could be confusing and would certainly represent an unretainable
amount of information.
The more experienced physician will also profit from the material in the
book. There is always room to discover what your own individual style of
practice is based upon, alter it where there is new information that you did
not previously possess, or continue with your old style as you supplement the
book evidence with your own clinical experience.
While the book is oriented towards the emergency physician and acute
care provider, the material is broad enough that it would certainly also be
useful for any office practice, as well as for many inpatient physicians in a
variety of specialties.
The book has been very carefully edited to try to make the language, and
the recommendations, uniform. In this respect, the book’s broad subject
matter and international scope render drug names a challenge. One thing I
found particularly helpful is the tabulated lexicon of brand and generic
names. While I understand the reason for using generic names, that is not