Office Emergencies. By Marjorie A. Bowman and William G. Baxt. 416 pp, illustrated. Philadelphia, W B Saunders, 2003. $34.95 (paper). ISBN 0–7216-7779–7.

The editors of this paperback text state that it is “designed to provide quick and accurate information on a broad range of urgent problems and emergencies that present by telephone or in person at a primary care office or urgent care center.” The contributors are primarily academic emergency physicians and family physicians, providing “authoritative information based on both literature evidence and practical experience.” Most of the 27 chapters address emergencies of specific body systems, such as upper airway obstruction, seizures, precipitous delivery, and electrolyte disturbances, but there are also chapters on chemical terrorism and bioterrorism. Chapters typically include boxed sections on clinical recognition and telephone triage, as well as comments directed specifically at pediatric practice; many include algorithms for initial management. The sparse illustrations are comprised of line drawings and black and white photographs.

From my experience, the selection of topics is appropriate to an ambulatory setting. Even with 29 different authors, the chapters have about as consistent a format as the topics allow. The lists of differential diagnoses are comprehensive without likelihood statistics. Treatment recommendations have few evidence references. The sections on terrorism are timely.

The editors indicate they intend the book as a concise, quick-look reference for busy practitioners, but the style is prosaic, using minimal illustrations. I found this to be especially noticeable in the Clinical Recognition boxes, the sections that highlight critical elements in recognizing each emergency situation or condition. These sections are written in full sentence, paragraph format rather than as outlines or tables. The same is true of the Phone Triage boxes. For that reason, this text is probably more useful as reading in anticipation of emergencies instead of as a guide when these situations occur. From that perspective, I found some of the most useful information to be the lists of office supplies and the general remarks about telephone triage. From these resources, a physician and office manager could establish office protocols and training for staff preparedness, perhaps the most important aspects to managing urgent care and emergencies anyway.