There once was a time when there were no emergency physicians and no pediatric emergency physicians. Gradually, this changed. First, there were practitioners, educators, and researchers who focused on the needs of children for emergency medical and trauma care. Journal articles, textbooks, and evidence-based medicine helped push the field forward. Eventually the American Board of Emergency Medicine and the American Board of Pediatrics jointly formed the subspecialty. Children greatly benefited from this progress. But the journey is not over. All of us want children to receive excellent, timely, high-quality emergency care.
One of the many efforts to improve pediatric emergency care was the McGraw-Hill Pediatric Emergency Medicine: A Comprehensive Study Guide textbook, published in 1996, now in its fifth edition. The initial impetus for the development of this work was the 1993 report of the Institute of Medicine on Emergency Medical Services for Children citing insufficient attention to the recognition and management of emergencies in children. It was approximately one year after the first subspecialty exam in Pediatric Emergency Medicine (PEM). Dr. Gary Strange invited several of us to help him edit this new textbook. He wanted a very readable and rapidly accessible clinical reference for clinicians. The first edition of this book, published in 1996, was developed as a resource for practitioners as well as a review book. The second edition, published in 2002, further refined the excellent trauma section and increased the depth of discussion regarding pediatric heart disease. Chapters were also added for procedural sedation and pain control, which were becoming more important topics in the practice of PEM. It remained as a clinical reference intended for topic review.
The subspecialty continued to mature and significant research was completed. Newer pharmaceuticals and new technologies also enhanced the practice of PEM. A decision was made that this would be a formal textbook Pediatric Emergency Medicine, with a significant update to many chapters. Chapters on cardinal presentations were added to help the clinicians with common symptoms. Fever and sepsis was divided into two chapters, one for neonates and the other for children. Transplants were more common in children and so a chapter regarding transplant emergencies was added. It also became apparent that clinicians needed to understand bioterrorism and chemical terrorism as well as mass casualty management. Many photographs, figures, diagrams, and algorithms were added, and the third edition of the book was published in color.
Evidence-based medicine became a cornerstone of practice and of textbooks. Research had progressed in many areas including trauma, respiratory illnesses, infectious diseases, and neurologic diseases in children. The fourth edition, published in 2015, updated the evidence and supporting references to include many of the recent guidelines, and most chapters were extensively revised. Other changes included adding chapters on ultrasound, since it was playing a much greater role in the care of children. Dr. Tenenbein added a section on abdominal surgical emergencies and extensively revised the toxicology section. He also added a freestanding chapter on foreign bodies, whether inhaled, ingested, or inserted. The book was now available online.
I feel honored and privileged to have been a part of the first four additions and to have served as senior editor for the fourth edition. My hope was that we would enhance the knowledge and expertise of clinicians so that children would receive excellent emergency care. I was also privileged to help in the planning and as a consultant for this fifth edition. Dr. Tenenbein took the baton from me for this edition. He is a skilled clinician and researcher and an excellent editor. I know that this edition will achieve the goal of having very readable and easily accessible evidence-based information to provide high-quality care to our young patients.
Even though the subspecialty is quite young, the pioneering clinicians and educators are reaching retirement and they look to the current and future pediatric emergency medicine specialists to continue the quest of quality emergency medical care for children.
Robert W. Schafermeyer, MD, FACEP, FAAP, FIFEM