Review of Prehospital Care of Neurologic Emergencies

Christopher M. Franklin, MD¹

Prehospital Care of Neurologic Emergencies
Todd J.  Crocco, Michael R.  Sayre, eds
200 pp, $45, ISBN 978-1-10767-832-3, Cambridge, England, Cambridge University Press, 2014.

Neurology is a highly specialized, complex field that requires years of training and experience to master. It requires a “breadth of knowledge and understanding” that can be daunting to many health care professionals. Moreover, managing a patient in a life-threatening neurologic emergency is an anxiety-provoking endeavor requiring the health care professional to process multiple differentials and treatment algorithms in a matter of minutes before possible brain death occurs. Furthermore, caring for these types of patients in an uncontrolled setting, outside of the hospital, can add to the difficulty in managing them. Having access to a resource that can provide critical information quickly can be a matter of life or death.Prehospital Care of Neurologic Emergencies was written to ensure that emergency medical service personnel have the necessary information when needed most.

Prehospital Care of Neurologic Emergencies is organized into 7 chapters, each individually focused on the most common neurologic symptoms and emergencies (lightheadedness and dizziness, headache, seizures, stroke and transient ischemic attack, spinal cord injury, traumatic brain injury, and altered mental status) that emergency medical service personnel will likely encounter in the field. The book is unique in that each chapter begins with guidelines for the management of these emergencies based on the strength of the available evidence: high quality (consistent randomized trials or overwhelming evidence), moderate quality (randomized trials with limitations or very strong evidence), and low quality (observational studies, unsystematic clinical observations, or randomized trials with serious flaws). Each chapter then continues into a description of the neurologic emergency, complete with an overview, differentials, evidence-based recommendations regarding management, a summary of the chapter, and then further areas of investigation.

Crocco and Sayre edited this book, and 14 authors contributed to its 7 chapters. The book is written in a clear, concise style that allows it to be easily read, which is important when the reader needs information in a matter of minutes. Also, it is a quick read, having only 200 pages. This book could be finished over a weekend by a motivated emergency medical service professional. Another plus is the book’s size. It can fit nicely in the back pocket of a pair of pants or in a shirt or jacket pocket while in the hospital or in the field. Finally, I am impressed with the exhaustive research that the authors performed to find the most current, up-to-date information to write this book. My only criticism of this book is its lack of diagrams or illustrations that would have allowed the reader to view the anatomy of the central nervous system or the spinal cord or to view the different types of stroke.

In conclusion, Prehospital Care of Neurologic Emergencies is just the resource needed to aid the health care professional in making an informative, evidence-based decision when time is of the essence. This is an easily readable book that achieves the editor’s intended purpose of “[p]roviding emergency personnel with the necessary advice and direction for complex neurologic emergencies.”

JAMA Neurol. 2015;72(9):1082. doi:10.1001/jamaneurol.2015.1292.