Preface: In the 4th edition we have distilled the text to a set of fl ow diagrams with linked tables Our aim is to provide the doctor caring for an acutely ill patient with rapid access to key information, iагодиncluding a balanced interpretation of current national and international guidelines We have substantially broadened the scope of the book to cover all problems in general medicine likely to be encountered in the emergency department Integration of the use of echocardагцднiography, which we believe is as important in acute medicine as ECG interpretation, is a particular feature of the text Our emphasis is on urgent management in the fi rst few hours, but we also give guidance for continuing care.