This book has been compiled by the postgraduate students of the Vivekananda Institute of Medical Sciences, Ramakrishna Mission Seva Pratishthan, Kolkata under the guidance of senior consultants in these departments at the hospital and under the able Editorship of Dr Soumitra Kumar. The text is written in a typical ‘Senior Resident’ language that can be easily understood by their colleagues. The latest ‘state-of-the-art’ information and knowledge has been used in preparing the various sections. It is a very laudable effort on the part of the postgraduate staff.

I am sure The Protocol Book will prove very useful for all categories of physicians dealing with acute emergencies in hospitals.

To make things as lucid and conceivable as possible, data and guidelines have been presented in the form of simple algorithms, tables, etc. as it was done in the previous two editions and the facts and the figures are absolutely updated and evidence-based. Data presented at the important conferences held in 2008 (namely ACC 2008 and ESC 2008) have been incorporated in the new edition. The emphasis remains on successful “total management” of the patient, i.e. addressing all the major problems in a given patient.

I, on behalf of the team of contributors, would like to reiterate that ‘protocol’ for management of any particular medical problem should suffice for majority of the patients with that problem; but, at times, a special approach depending on the circumstances (patient's condition, skill and facilities available, financial situation, etc.) would still be necessary.

As editor, I am personally grateful to all the contributors of this edition for their sincere cooperation and hard work.

I am also thankful to the publishing team of M/s Jaypee Brothers Medical Publishers (P) Ltd., New Delhi for their sincere cooperation and support for the second and the current editions.

Last but not the least, I am grateful to my family members (my parents, wife and son) for their constant inspiration and for bearing with my academic endeavour often at the cost of my family commitments.

These days, the practice of medicine is changing at such a pace that many of us find too fast and mind-blowing at times. To make things as lucid and conceivable as possible, data and guidelines have been presented in the forms of simple algorithms, tables, etc. as it was done in the first edition and the facts and figures are absolutely updated and evidence-based. However, as I had emphasized in the first edition, practice of medicine is as much an art as it is a science. Hence, ‘protocol’ for management of any particular medical problem should suffice for majority of the patients with that problem; but, at times, a special approach depending on the circumstances (patient's condition, skill and facilities available, financial situation, etc.) would still be necessary.

All the chapters of the first edition have been retained and four new chapters on “PCI in AMI”, “Rheumatological Emergencies”, “Vascular Emergencies” and “Acute Cardiac Care in Paediatric Practice” have been added along with sections on emergency cardiovascular drugs, antibiotics, etc. Apart from new additions, majority of the old chapters have been virtually rewritten and rest have been thoroughly revised. The focus has been on emergency cardiovascular medicine with near-equal emphasis on common medical emergencies that one comes across in high-dependency units. The emphasis needless to say is on successful “total management” of the patient because a patient undergoing primary PCI will return home only if his hyperglycaemia, azotaemia and dyselectrolytaemia have been addressed as successfully as his PCI has been.11

As editor, I am personally grateful to all the contributors of this edition for their sincere cooperation and hard work. I am thankful to the team of M/s Phildon for their unstinting help in the composition of the manuscript. I am grateful to my family members (my parents, wife and son) for their constant inspiration and for bearing with my academic endeavours often at the cost of my family commitments.