This indeed is a time of change. Rapid change. Warp speed change. A time of excitement and confusion. A time of bewilderment and futuristic goals. A time for huge potential growth.
The primary care clinician stands at the threshold of this change. Measuring quality has been implemented. The Family Medical Home has been introduced and is being incorporated into routine care by many. It is now the focus of hope to manage healthcare delivery in the future.
In all this change and turmoil, we must be careful to recall that the care of the patient remains the primary goal of the medical system. The goal is not to meet some time constraint for an office visit or hospital stay, or to follow some protocol or clinical guideline, or to meet the budget. Rather, the goal of our care is the health of our patients and their families. That goal gives us our purpose and is the reason we became physicians, clinicians, and healers.
Having primary care providers perform procedures still makes sense in the new order of healthcare. It can be a part of the proposed Family Medical Home. Many of these procedures can be performed in the office, which reduces cost. They can be offered by clinicians who know their patients, which the patients appreciate. Performing procedures in the office reduces the time needed to complete referrals to other specialists and reduces delay in the diagnosis and treatment of many conditions. It also makes it easier to document that necessary procedures were actually performed and that patients were not lost in the system. If healthcare reimbursement becomes more “bundled,” it will make sense for the primary care clinician to provide even more procedural care. Performing procedures is also rewarding for practitioners and can enhance their enjoyment of the practice of medicine. That said, the quality of the procedures performed can and must meet or surpass the highest of standards. This text helps meet that goal.
We appreciate the feedback we have received on the first two editions. New features in this edition include colored photos and two complete new sections: Aesthetic Medicine and Hospitalist Procedures. Adding these sections reflects some of the changes in medicine. The patient's desire to look younger and healthier has been coupled with advancements in technology to accomplish just that. Hospitalist care has become the norm and is more focused and complicated; yet the associated procedures are not out of the range of primary care clinicians. Family physicians and other primary care clinicians, because of their breadth and depth of training, can step up to these new areas of healthcare and bring these procedures to their patients.
Times change. The experts, academics, and politicians move on. New technology and procedures are invented. But the need for that healer and caregiver who really does care will never change. The fear and trepidation that a patient often experiences can only be alleviated by the touch, the words, and the expertise of the caring clinician. In our search for the knowledge and expertise to perform the procedures presented in this text, we should never forget that, first and foremost, we are people who treat patients and their families, not just their symptoms. We learn and gain the skills to perform the procedures reviewed in this text to aid healing. Procedures are not goals unto themselves; rather, they are included in our expertise as another way to help people feel better and be healthier.
John L. Pfenninger and Grant C. Fowler
Pfenninger and Fowler's Procedures for Primary Care, 3rd Edition is a comprehensive, "how-to" resource offering step-by-step strategies for nearly every medical procedure that can be performed in an office, hospital, or emergency care facility by primary care clinicians. Designed for everyday practice, the outline format allows speedy reference while the detailed text and clear illustrations guide you through each procedure. The new edition of this best-selling book features full-color illustrations and easy access to the complete contents and illustrations, patient forms, and more online at www.expertconsult.com.
Book Features
- Understand how to proceed, step by step, thanks to detailed text and illustrations.
- Locate critical information at a glance with numerous boxes and tables.
- Use the book for years with minimal wear and tear thanks to its sturdy cover.
- Patient education handouts to educate, save time, and reduce liability
- Coding guidelines included
- This best selling text now includes full-color photos and new sections on Aesthetic and Hospitalist Procedures in addition to an update of all the previous procedures discussed in prior editions!
- Access the complete contents and illustrations online, download patient education handouts and consent forms, view lists of device manufacturers, and more at www.expertconsult.com.
- Offer your patients a variety of cosmetic procedures using lasers and pulsed-light devices (including individual chapters on procedures for hair removal, photorejuvenation, skin tightening and skin resurfacing, and tattoo removal), and botulinum toxin, as well as new coverage of cosmeceutical skin care, tissue fillers, and photodynamic therapy.
- Master new procedures such as maggot treatment for chronic ulcers, endovenous vein closure, stress echo, insertion of the contraceptive capsule (Implanon) and tubal implant (Essure), musculoskeletal ultrasound, no-needle/no-scalpel vasectomy, procedures to treat acute headaches, and more.
- Don't worry! All the more basic office procedures are still included...with improved and updated discussions!
About the Author
- John Pfenninger, MD, FAAFP, Director, The National Procedures Institute, Midland, MI; Clinical Professor, Department of Family Practice, Michigan State College of Human Medicine, East Lansing, MI; and
- Grant C Fowler, MD, Professor and Vice Chair, Department of Family Practice & Community Medicine, University of Texas Houston Health Science Center Medical School, Houston, TX.
Part One Anesthesia
- Bier Block
- Conscious Sedation
- Epidurals
- Local Anesthesia
- Local and Topical Anesthetics Complications
- Nitrous Oxide Sedation
- Pediatric Sedation
- Peripheral Nerve Blocks and Field Blocks
- Site Specific and Facial Anesthesia
- Technique of Trigger Point Injection
- Topical Anesthesia
Part Two Dermatology
- Acne Therapy
- Approach to Various Skin Lesions
- Burn Treatment
- Cryosurgery
- Dermoscopy
- Fishhook Removal
- Flaps and Plasties
- Foreign Body Removal from Skin and Soft Tissue
- Fungal Cultures
- Incision and Drainage of an Abscess
- Incisions: Planning the Direction of the Cut
- Laceration and Incision Repair
- Laceration and Incision Repair: Needle Selection
- Laceration and Incision Repair: Suture Selection
- Laceration and Incision Repair: Suture Tying
- Laser Therapy
- Mucocoele Removal
- Nail Bed Repair
- Nail Plate and Nail Bed Biopsy
- Radiofrequency Surgery
- Ring Removal from an Edematous Finger
- Skin Biopsy
- Skin Grafting
- Skin Stapling
- Subungual Hematoma Evacuation
- Tick Removal
- Tissue Glues
- Hypertrophic Scars and Keloids
- Ingrown Toenails
- Trichiasis
- Topical Hemostatic Agents
- Unna Paste Boot
- Wart (verruca) Treatment
- Wood's Light Examination
- Wound Dressing
Part Three Aesthetics
- Body Piercing
- Botox (Botulinum A Exotoxin
- Collagen Injections
- Dermasanding (Manual Dermabrasion)
- Hair Removal
- Microdermabrasion
- Skin Peels (Chemical, Laser)
- Tattoo Removal
Part Four Eyes, Ears, Nose and Throat
- Section One: Eyes
- Chalazion and Hordeolum
- Corneal Abrasions and Removal of Corneal or Conjunctival Foreign Bodies
- Slit Lamp Exam
- Tonometry
- Visual Function Evaluation
- Section Two: Ears, Nose and Throat
- Audiometry
- Auricular Hematoma Evacuation
- Bifid Earlobe Repair
- Cerumen Impaction Removal
- Ear Piercing
- Myringotomy and Tympanocentesis
- Reduction of Dislocated Temporomandibular Joint (with TMJ Syndrome Exercises)
- Tympanometry
- Removal of Foreign Bodies from the Ear and Nose
- Flexible Fiberoptic Rhinolaryngoscopy
- Management of Epistaxis
- Nasal Turbinate Reduction
- Emergency Cricothyroidotomy and Tracheostomy
- Indirect Mirror Laryngoscopy
- Peritonsillar Abscess Drainage
- Reimplantation of an Avulsed Tooth
- Tongue-Tie Snipping (Frenotomy) for Ankyloglossia
Part Five Cardiovascular and Respiratory
- Ambulatory Blood Pressure Monitoring
- Ambulatory Phlebectomy
- Arterial Puncture
- Carioversion
- Central Venous Catheter Insertion
- Chest Tube Insertion and Removal
- Endotracheal Intubation
- Holter Monitoring
- Noninvasive Venous and Arterial Studies of the Lower Extremities
- Office Electrocardiograms
- Percutaneous Arterial Line Placement
- Pericardiocentesis
- Pulmonary Function Testing
- Sclerotherapy: Injection
- Sclerotherapy: Radiofrequency
- Stress (Exercise) Testing
- Swan-Ganz Catheterization
- Temporary Pacing
- Thoracentesis
- Venous Cutdown
Part Six Gastrointestinal
- Abdominal Paracentesis
- Anal Fissure/Lateral Sphincterotomy
- Anorectal Anatomy and Examination
- Anoscopy
- Colonoscopy
- Esophagogastroduodenoscopy (EGD)
- Fecal Impaction Removal
- Flexible Sigmoidoscopy
- Gastric Lavage
- Inguinal Hernia Reduction
- Nasogastric Tube and Salem Sump Insertion
- Office Treatment of Hemorrhoids
- Perianal Abscess Incision and Drainage Fistulas
- Perianal Skin Tags (External Hemorrhoidal Skin Tags)
- Pilonidal Cyst/Abscess Incision and Drainage
- Peritoneal Lavage:Diagnostic
Part Seven Urinary
- Bladder Catheterization
- Diagnostic Cystourethroscopy
- Suprapubic Catheter Insertion/Change
- Suprapubic Taps or Aspirations
- Bedside Urodynamic Studies for Urinary Incontinence
- Urodynamics
- Adult Circumcision
- Androscopy
- Dorsal Slit for Phimosis
- Prostate Biopsy
- Prostate Massage
- Prostate and Seminal Vesicles Ultrasonography
- Self-Injection Therapy for the Treatment of Erectile Dysfunction
- Sperm Banking
- Implantable Hormone Pellets for Testosterone Deficiency
- Vacuum Devices for Erectile Dysfunction
- Vesectomy
Part Nine Gynecology and Female Reproductive System
- Abortion: Medical
- Abortion: Surgical
- Barrier Contraceptives: Cervical Cap, Vaginal Condom, and Diaphragm Fitting
- Bartholin's Cyst/Abscess: Word Catheter Insertion Marsupialization
- Breast Biopsy
- Cervical Cerclage
- Cervical Conization
- Cervical Polyps
- Cervical Stenosis/Cervical Dilation
- Cervicography
- The Colposcopic Examination
- Contraceptive Implants (Norplant) Insertion and Removal
- Cryocone of the Cervix
- Culdocentesis (Colpocentesis)
- Diagnostic Hysteroscopy
- Dilation and Curettage
- DNA Sampling: Cervix and Other
- Endometrial Biopsy
- Hysterosalpingography
- IUD Insertion
- IUD Removal
- Loop Electrosurgical Excision Procedure (LEEP) for Treating CIN
- Pap Smear and Related Techniques for Cervical CA Screening
- Permanent Female Sterilization (Tubal Ligation
- Pessaries
- Postcoital Examination Test or Sims-Huhner Test
- Speculoscopy
- Treatment of Noncervical Condyloma Acuminata
- Endometrial Ablation
- Vaginal Exam of the Female for Rape
- Vaginal Exam of the Young Female for Possible Sexual Abuse
- Vulvar Biopsy
- Wet smear and KOH Preparation
Part Ten Obstetrics
- Amniocentesis
- Caesarean Section
- Cervical Ripening/Vaginal Prostaglandins
- Contraction Stress Test, Nonstress Test, and Spontaneous Fetal Movement Counting
- Episiotomy
- External Cephalic Version
- Fetal Scalp Electrode Application
- Forceps and Vacuum Extraction (Assisted Vaginal Delivery)
- Intrathecal Analgesia
- Intrauterine Pressure Catheter (IUPC) Insertion
- Obstetric Ultrasound
- Paracervical Block
- Pudental Anesthesia
- Saddleblocks
- Transcervical Amnioinfusion
- Vaginal Delivery
- DeLee Suctioning
- Dorsal Penile Nerve Block
- Intraosseous Venous Access (IOVA)
- Neonatal Resuscitation
- Newborn Circumcision
- Pediatric Arterial Puncture and Venous Cutdown
- Suprapubic Bladder Aspiration
- Umbilical Artery Catheterization
- Ankle Splinting, Taping, and Casting
- Cast Immobilization
- Compartment Syndrome Evaluation
- Diagnostic Needle Arthroscopic Lavage and Biopsy
- Extensor Tendon Repair
- Fracture Care
- Ganglion Treatment
- Joint and Soft Tissue Aspiration and Injection
- Knee Braces
- Nursemaid's Elbow: Subluxation of the Radial Head
- Orthoses, Plantar Warts, Corns, and Calluses
- Osteoporosis Screening
- Shoulder Dislocations
- Osteopathic Manipulative Medicine
Part Fourteen Alternative Medicine
- Acupuncture
- Allergy Testing and Immunotherapy
- Anaphylaxis
- Antibiotic Prophylaxis for Bacterial Endocarditis
- Biofeedback
- Body Fat Analysis
- Bone Marrow Aspiration and Biopsy
- Drawing Blood for Bone Culture
- Emergency Department and Office Ultrasound
- Fine-Needle Aspiration Cytology and Biopsy
- Heimlich Maneuver
- Hypnosis
- Lumbar Puncture
- Muscle Biopsy
- TENS Unit, Phonophoresis, Iontophoresis
- Venous Methylene Blue Intravenous Therapy
- Appendices
- Commonly Used Instruments
- Informed Consent
- Latex Allergy Guidelines
- Pearls of Practice
- Resources for Learning Procedures
- Supplier Information
- Universal Precautions
Product Details
- Hardcover: 1776 pages
- Publisher: Saunders; 3 edition (September 23, 2010)
- Language: English
- ISBN-10: 0323052673
- ISBN-13: 978-0323052672
- Product Dimensions: 11.1 x 8.8 x 2.5 inches
List Price: $139.00