Goldfrank's Toxicologic Emergencies, 8th Edition Doody's Expert Review Review Questionnaire ISBN: 9780071437639 ISBN-10: 0071437630 Copyright: 2006 Edition: 8th Editors: Flomenbaum, Neal F., Goldfrank, Lewis R., Hoffman, Robert S., Howland, Mary Ann, Lewin, Neal A., Nelson, Lewis S., Doody's Expert Review    Score: 93 Doody's Star Rating™ and Doody's Expert Review provide by Doody Enterprises, Inc. Reviewer: B. Zane Horowitz,  MD  (Oregon Health and Science University) Description This is the eighth edition of the well-regarded Goldfrank's Toxicologic Emergencies, which has evolved from its early years as a series of interesting toxicologic cases to the definitive reference for the field of toxicology. This update comes four years after the seventh edition and it retains much that has made this an authoritative textbook, adds 30 new chapters, and a "new to this edition" online link to color photographs. Purpose The preface states that the authors "continue to proudly offer readers an approach to medical toxicology based on case studies." These objectives stem from the inception of the original text in which each chapter is opened with an illustrated case. In some prior editions, this was followed by a didactic discourse in the form of questions and answers to questions posed, in a roundsmanship style. This approach has been abandoned in the last few editions and the more common form of subheadings based on clinical presentation, physiology, and treatment is followed so that users can quickly find the information they need. Audience The ultimate audience for this book includes medical toxicologists and emergency physicians who treat toxicologic emergencies, as the title implies. However, it is a useful book for other fields where toxicology issues arise and expertise is needed. This should be a valued addition to the libraries of pediatricians, internists, and occupational physicians. The authors, all members of the New York City poison center, use an impressive list of nationally recognized experts for chapter authors. Features The book is well organized. After three chapters on historical perspectives, the first section on the general approach to overdose management discusses principles in management, imaging, lab testing, treatment, pharmacokinetics, and enhanced elimination. The next section is one often thumbed though extensively when investigating a difficult case, as it contains a discussion on how toxins affect each body organ, chapter by chapter, along with lists of differential diagnoses of arcane presenting symptoms -- everything from retinal injury to blue urine. Excellent chapters on neurotransmitters have been updated. Chapters on special populations, covered in other sections in the last edition, are organized at the end of this section (postmortem toxicology, geriatrics, pediatric). The remainder of the book is organized by groups of substances, presented first with a case report, and followed with a comprehensive review of the substance's physiology, clinical manifestations, and treatment approach. Individual antidotes have their own chapters right after the substances for which they are used, another unique aspect of this book, and the revised index better reflects the location of these compared with the last edition. When one has written the "bible" of toxicology textbooks and revised it now for eight editions, one wonders what new revelations it can contain. Is there a DaVinci code for Goldfrank's? Well in this new edition, there is. Every book has a tear-out one page reference which includes a 20-digit alphanumeric code so that the user can log onto a protected website to get access to an array of color photos on plants, venomous animals, and more. But according to the book plate, access expires in around four years, presumably just in time for the ninth edition to be published. Nonetheless, this new online novelty is not likely to be used as much as the hefty volume itself. Assessment Once the lone "Old Testament" in medical toxicology, Goldfrank's now competes with at least four other comprehensive texts in what is becoming a crowded field. Ellenhorn's, now revised as Dart's Medical Toxicology, 3rd edition (Lippincott Williams & Wilkins, 2004), Brent's Critical Care Toxicology: Diagnosis and Management of the Critically Poisoned Patient (Elsevier, 2005), Haddad's Clinical Management of Poisoning and Drug Overdose, 3rd edition (Elsevier, 1998), and Ford's Clinical Toxicology (Elsevier, 2002) all cover some common ground. Each has its own strengths in a few unique chapters or by an approach to decision making. However, the breadth of Goldfrank's new edition makes it worth purchasing for anyone who frequently, or even occasionally, treats toxicologic cases, even for those who own earlier editions. The editors and authors are to be commended for their compulsive revision, with attention to detail, every four years of this authoritative book. Review Questionnaire Range Question Score 1-10 Are the author's objectives met? 10 1-10 Rate the worthiness of those objectives. 10 1-5 Is this written at an appropriate level? 5 1-5 Is there significant duplication? (1=significant, 5=insignificant) 4 1-5 Are there significant omissions? (1=significant, 5=insignificant) 5 1-5 Rate the authority of the authors. 5 1-5 Are there sufficient illustrations? 5 1-5 Rate the pedagogic value of the illustrations. 4 1-5 Rate the print quality of the illustrations. 4 1-5 Are there sufficient references? 5 1-5 Rate the currency of the references. 5 1-5 Rate the pertinence of the references. 5 1-5 Rate the helpfulness of the index. 5 1-5 If important in this specialty, rate the physical appearance of the book N/A 1-10 Is this a worthwhile contribution to the field? 10 1-10 If this is a 2nd or later edition, is this new edition needed? 8 ©2010 Doody Enterprises, Inc.