July 13, 2010

My primary Resources: Back to basics

This is a subpage from my Primary Resources page where I iterate all the most important (online) resources for emergency physicians to learn and stay updated in their field.

Textbooks and reference

In emergency medicine there are two 'bibles' you will oftenly see referals to, they are indeed the holy wisdom of the wise grandfathers of EM:
  • Tintinalli's emergency medicine
    For the enthusiastic EP, reading Tintinallis is like reading an epic fantasy novel. It's a beauty right from the beginning and you will want to read it all over a night. An online version is available through Kindle but costs a king's ransom. Kindle does though offer some options having had me consider seriously buying this version like synchronised bookmarking and highlighting. Lacking a trial version though I am not ready to throw $160 at something I might not like or use after all.
  • Rosen's emergency medicine
    In no way inferior to Tintinalli's and actually growing on me since it's available for online reading through a free account at MdConsult.
Another textbook worth mentioning, especially since it's available online and for free even:
  • Merck manual
    Although I prefer reading texts written by EPs for EPs, Merck is of such quality that I have used it as an reference when I need to dig into the complex maze of diseases and entities in internal medicine. Not the best for quick reference but detailed texts and tables makes it the best to read while you have plenty of time.
Good review articles are always worth reading when going back to the basics and you most probably are already using the major journals like BMJ and JAMA. My blogosphere and social network makes sure I don't miss the most important ones.
  • American Academy of Family Physicians (AAFP)
    Is worth mentioning though, a great journal from our colleges serving our patients before and after the ED. AAFP has many excellent review articles and updates on conditions we commonly see in the ED but need not intubate.
  • FPNotebook
    Speaking of general practice... FPNotebook may be old design but it's content is being updated regularly and has a very practible approach to the clinical entities as you can click trough iterated lists and quick info to find just that piece of diagnostic information you need, bedside. Take anemia as an example, oh those are the lab tests you need for ddx and oh these are the possibilities with microcytic anemia and things to consider for ddx. Lite but handy.
With the rise of the Internet, some new sources have come to the scene as fierce competitors to the classical textbooks.
  • Medscape's Emedicine
    Is one of my favorites. Almost every single condition you will ever see in your ED, described in a well written and concise yet detailed text with standardised chapters (intro, presentation, diagnosis, treatment...) makes it a joy to read and easy to find what you are looking for, even bedside to your patient.
    Unfortunately, the fact that most topics are written by MDs of the other specialities rather than EPs often makes me even more hungry for information than when I started reading. More often I will open my good and old Tintinalli for 'the wise words of the grandfathers' - those with years of experience from the floor, working with EM patients in the ED.
And then there are the EBM sites, growing more and more every year. I have found it impossible to hold count on them all and will save this for a later blogpost on it's own. I rarely find the EBM sites really useful besides answering a specific question about a clinical scenario or subcondition. Surely bound to be very powerful but in the end I find my self doing a quick search through the major guidelines instead.
  • UpToDate
    Is a bit different as it's topics cover whole conditions rather than specific questions. Obviously great work here it's wide span is also it's biggest drawback since even simple queries will yield an abundance of results, making it difficult to find that particular answer you were after. Really good though for detailed and updated texts on diseases and conditions. Because it requires a paid subscription and there are so many good alternatives, UpToDate has not had me, yet at least.

Last but definitely not least is a project which developed off the idea of using the power of crowdsourcing (using wiki) to collect links to all resources there are out there and store in a categorised format.

  • Wikiemerg
    is exactly this and was started in 2011 and is funded by the University of British Columbia (UBC) and thus has potential to become one of the big sites. You will find all EM topics in an easily searchable format and within each of these a list of links to all the most important resources to read like landmark articles, texts, blogposts etc.

Not EM but worth mentioning:

  • Wikipedia
    Wikipedia content is getting better every week and I totally disagree with those saying it's inferior quality. It's the layman's version of medicine, excellent for getting the outline and introduction to complex diseases. With the ever growing Medical project there are even stricter guidelines for authors to write medical pages on Wikipedia.
    Wikipedia is so much more than wiki, for example they have highly advanced templates to categorize the world's topics into tabular form (look at the bottom of the documents). Try the antithrombotic chapter as an example - never before has it been so easy to see the grouping of these bastard medicines and how they interconnect.
  • ECG pedia
    My all time favorite reference site for ECG patterns. It's a wiki and it's edited by cardiologists only so expect quality stuff.
  • Radiopedia
    A huge database for radiological cases with detailed descriptions and tips for e-learning.