Pfenninger and Fowler's Procedures for Primary Care,
Edition 4Editors: By Grant C. Fowler, MD
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Description
**Selected for 2026 Doody's Core Titles as an Essential Purchase in Family Medicine**
Primary care clinicians are performing more varied procedures than ever before, and physicians, residents, and students need a comprehensive, authoritative resource that provides trusted information in an easy-to-follow format. Through three outstanding editions, Pfenninger and Fowler’s Procedures for Primary Care has been the go-to reference for step-by-step strategies for nearly every medical procedure that can be performed in an office, hospital, or emergency care facility by primary care providers. This 4th Edition continues that tradition with new section editors, updated illustrations, new chapters, and much more. No other primary care procedure book compares with Pfenninger and Fowler’s breadth and depth of practical, step-by-step content!
Key Features
- Over 1,700 pages in breadth, this resource provides comprehensive, real-world coverage of more than 230 procedures that arise in the primary care setting, including many that were previously performed only in subspecialty settings, such as joint injections and cosmetic procedures
- Includes new chapters: Esophageal Foreign Body Removal, Manual Testicular Detorsion, Symphysiotomy, Zipper Injury Management, and Blood Products
- Presents the "how-to" expertise of six new section editors, for a fresh, contemporary perspective throughout the book
- Additional focus on the evidence, with plentiful citations to key references, makes this the most evidence-based edition yet
- Features numerous updated illustrations, including many more in full color, and incorporates updated ICD-10-CM codes throughout
- Provides access to online resources including patient education handouts and consent forms, lists of device manufacturers, and more
- Utilizes a concise outline format, detailed text and illustrations, and abundant boxes and tables for quick access to the information you need
- Enhanced eBook version included with purchase, which allows you to access all of the text, figures, and references from the book on a variety of devices
About the author
By Grant C. Fowler, MD, Chair, Family and Community Medicine, JPS Health Network
Section 1 - Anesthesia
1. Procedural Sedation and Analgesia
2. Pediatric Sedation
3. Nitrous Oxide Sedation
4. Topical Anesthesia
5. Local Anesthesia
6. Local and Topical Anesthetic Complications
7. Peripheral Nerve Blocks and Field Blocks
8. Oral/Facial Anesthesia
9. Bier Block
10. Epidural Anesthesia and Analgesia
11. Procedures to Treat Headaches
Section 2 - Dermatology
12. Acne Therapy: Surgical Approaches
13. Approach to Various Skin Lesions
14. Cryosurgery
15. Dermoscopy (Epiluminescence Microscopy)
16. Flaps and Plasties
17. Fungal Studies and Scabies: Collection Procedures and Tests
18. Incisions: Planning the Direction of the Cut
19. Laceration and Incision Repair
20. Laceration and Incision Repair: Needle Selection
21. Laceration and Incision Repair: Suture Selection
22. Laceration and Incision Repair: Suture Tying
23. Nail Plate and Nail Bed Biopsy
24. Nail Bed Repair
25. Radiofrequency Surgery (Modern Electrosurgery)
26. Skin Biopsy
27. Skin Grafting
28. Hypertrophic Scars and Keloids
29. Unna Paste Boot: Treatment of Venous Stasis Ulcers and Other Disorders
30. Wart (Verruca) Treatment
31. Pilonidal Cyst and Abscess: Current Management
32. Wood's Light Examination
33. Wound Dressing
34. Maggot Treatment for Chronic Ulcers
Section 3 - Aesthetic Medicine
35. Introduction to Aesthetic Medicine
36. Cosmeceutical Skin Care
37. Gingival Hyperpigmentation
38. Lasers and Pulsed-Light Devices: Hair Removal
39. Lasers and Pulsed-Light Devices: Photofacial Rejuvenation
40. Lasers and Pulsed-Light Devices: Acne
41. Lasers and Pulsed-Light Devices: Skin Tightening
42. Lasers and Pulsed Light Devices: Spider Veins
43. Lasers and Pulsed-Light Devices: Tattoo Removal
44. Lasers and Pulsed-Light Devices: Skin Resurfacing
45. Nonablative Radiowave Skin Tightening with the Ellman S5 Surgitron (The Pelleve Procedure)
46. Epilation of Isolated Hairs
47. Botulinum Toxin
48. Tissue Fillers
49. Microdermabrasion and Dermalinfusion
50. Chemical Peels
51. Photodynamic Therapy
52. Cellulite Treatments
53. Thread Lift Using Barbed Suspension Sutures for Facial Rejuvenation
54. Radiofrequency-Assisted Upper Blepharoplasty for the Correction of Dermatochalasis
55. Body Piercing
Section 4 - Eyes, Ears, Nose, and Throat
56. Mucocele Removal
57. Chalazion and Hordeolum
58. Tonometry
59. Audiometry
60. Tympanometry
61. Myringotomy and Tympanocentesis
62. Cerumen Impaction Removal
63. Earlobe Repair
64. Nasolaryngoscopy
65. Indirect Mirro Laryngoscopy
66. Tonsillectomy and Adnoidectomy
67. Allergy Testing and Immunotherapy
68. Fine-Needle Aspiration Cytology and Biopsy
Section 5 - Cardiovascular and Respiratory System Procedures
69. Antibiotic Prophylaxis for Prevention Bacterial Endocarditis
70. Office Electrocardiograms
71. Pre-op Evaluation
72. Ambulatory Blood Pressure Monitoring
73. Ambulatory Electrocardiography: Holter and Event Monitoring
74. Exercise (Stress) Testing
75. Echocardiography
76. Stress Echo
77. Noninvasive Venous and Arterial Studies of the Lower Extremities
78. Sclerotherapy
79. Ambulatory Phlebectomy
80. Endovenous Vein Closure
81. Pulmonary Function Testing
Section 6 - Gastrointestinal System Procedures
82. Clinical Anorectal Anatomy and Digital Examination
83. Anoscopy
84. High Resolution Anoscopy
85. Anal Fissure/Lateral Sphincterotomy
86. Perianal Abscess Incision and Drainage
87. Office Treatment of Hemorrhoids
88. Removal of Perianal Skin Tags (External Hemorrhoidal Skin Tags)
89. Flexible Sigmoidoscopy
90. Colonoscopy
91. Esophagogastroduodenoscopy
92. PEG Tube Insertion
93. Capsule Endoscopy
94. Esophageal Foreign Body Removal
95. Inguinal Hernia Reduction
Section 7 - Urinary System Procedures
96. Bladder Catheterization
97. Diagnostic Cystourethroscopy
98. Office Testing and Treatment Options for Interstitial Cystitis
99. Suprapubic Catheter Insertion and/or Change
100. Suprapubic Tap or Aspiration
101. Bedside Urodynamic Studies
Section 8 - Male Reproductive System
102. Adult Circumcision
103. Androscopy
104. Dorsal Slit for Phimosis
105. Prostate Massage
106. Prostate and Seminal Vesicle Ultrasonography
107. Self-Injection Therapy for the Treatment of Erectile Dysfunction
108. Vacuum Devices for Erectile Dysfunction
109. Implantable Hormone Pellets for Testosterone Deficiency in Adult Men
110. Sperm Banking
111. Vasectomy
112. Manual Testicular Detorsion
Section 9 - Gynecology and Female Reproductive System
113. Suction Aspiration for Elective and Spontaneous First Trimester Abortion
114. Medical Abortion
115. Emergency Contraception
116. Barrier Contraceptives: Cervical Caps, Condoms, and Diaphragms
117. Fertility Awareness-based Methods of Contraception (Natural Family Planning)
118. Bartholin's Cyst/Abscess: Word Catheter Insertion, Marsupialization
119. Breast Biopsy
120. Pap Smear and Related Techniques for Cervical Cancer Screening
121. Human Papillomavirus DNA Sampling
122. Wet Smear and KOH Preparation
123. Cervical Polyps
124. Colposcopic Examination
125. Cryotherapy of the Cervix
126. Cervical Stenosis and Cervical Dilation
127. Loop Electrosurgical Excision Procedure (LEEP) for Treating Cervical Intraepithelial Neoplasia
128. Cervical Conization
129. Endometrial Biopsy
130. Hysteroscopy
131. Permanent Female Sterilization (Tubal Ligation)
132. Insertion of ESSURE (Contraceptive Implant)
133. Endometrial Ablation (Roller Ball, Cryoablation, Thermal Balloon)
134. Hysterosalpingography and Sonohysterosalpingography
135. Intrauterine Device (IUD) Insertion and Removal
136. Insertion and Removal of Implanon
137. Pessaries
138. Treatment of Noncervical CONDYLOMATA ACUMINATA
139. Vulvar Biopsy
140. Management of the Adult Victim of Sexual Assault
Section 10 - Obstetrics
141. Postcoital Examination Test
142. Obstetric Ultrasound
143. Cervical Cerclage
144. Amniocentesis
145. External Cephalic Version
146. Antepartum Fetal Monitoring
147. Induction of Labor
148. Amniotomy
149. Fetal Scalp Electrode Applicaton
150. Intrauterine Pressure Catheter Insertion
151. Transcervical Amnioinfusion
152. Intrathecal Analgesia
153. Paracervical Block
154. Pudendal Anesthesia
155. Saddle Block Anesthesia
156. Vaginal Delivery
157. Forceps- and Vacuum-Assisted Deliveries
158. Episiotomy and Repair of the Perineum
159. Symphysiotomy
160. Cesarean Section
161. Culdocentesis (Colpocentesis)
162. Dilation and Curettage
Section 11 - Pediatrics
163. Neonatal Resuscitation
164. Pediatric Arterial Puncture and Venous Minicutdown
165. Umbilical Vessel Catheterization
166. Dorsal Penile and Subcutaneous Ring Block for Newborn Circumcision
167. Newborn Circumcision and Office Meatotomy
168. Pediatric Suprapubic Bladder Aspiration
169. Tonque-Tie Snipping (Frenotomy) for Ankyloglossia
170. Management of Young Female as Possible Victim of Sexual Abuse
Section 12 - Orthopedics and Sports Medicine
171. Musculoskeletal Ultrasound
172. Extensor Tendon Repair
173. Nursemaid's Elbow: Subluxation of the Radial Head
174. Shoulder Dislocations
175. Ankle and Foot Splinting, Casting, and Taping
176. Cast Immobilization
177. Knee Braces
178. Fracture Care
179. Compartment Syndrome Evaluation
180. Joint and Soft Tissue Aspiration and Injection (Arthrocentesis)
181. Trigger-Point Injection
182. Ganglion Treatment
183. Transcutaneous Electrical Nerve Stimulation (TENS), Phonophoresis, and Iontophoresis
184. Acupuncture
185. Podiatric Procedures
186. Body Fat Analysis
187. NC-Stat System for Office EMGs
188. Muscle Biospy
Section 13 - Urgent Care
189. Burn Treatment
190. Fishhook Removal
191. Foreign Body Removal from Skin and Soft Tissues
192. Incision and Drainage of an Abscess
193. Subungual Hematoma Evacuation
194. Ingrown Toenails
195. Ring Removal from an Edematous Finger
196. Skin Stapling
197. Tick Removal and Prevention of Infection
198. Tissue Glues
199. Topical Hemostatic Agents
200. Corneal Abrasions and Removal of Corneal or Conjunctival Foreign Bodies
201. Slit Lamp Examination
202. Auricular Hematoma Evacuation
203. Reduction of Dislocated Temporomandibular Joint (with TMJ Syndrome Exercises)
204. Removal of Foreign Bodies from the Ear and Nose
205. Management of Epitaxis
206. Peritonsillar Abscess Drainage
207. Management of Tooth Fracture and Reimplantation of an Avulsed Tooth
208. Management of Fecal Impaction
209. Gastrointestinal Decontamination
210. Peritoneal Lavage, Diagnostic
211. Tube Thoracostomy and Emergency Needle Decompression of Tension Pneumothorax
212. Anaphylaxis
213. Prevention and Treatment of Wound Infections
214. Emergency Department and Office Ultrasound
215. Heimlich Maneuver
216. Zipper Injury Management
Section 14 - Hospitalist
217. Nasogastric Tube, Nasoenteric Tube, and Salem Sump Insertion
218. Thoracentesis
219. Paracentesis
220. Bone Marrow Aspiration or Biopsy
221. Lumbar Puncture
222. Tracheal (Endotracheal and Nasotracheal) Intubation
223. Cricothyroidotomy, Transtracheal Catheter Insertion and Tracheostomy
224. Ventilation Management
225. Arterial Puncture and Percutaneous Arterial Line Placement
226. Intraosseous Venous Access
227. Venous Cutdown
228. Central Venous Catheter Insertion
229. Swan-Ganz (Pulmonary Artery) Catheterization
230. Pericardiocentesis
231. Electrical Cardioversion
232. Temporary Pacing
233. Drawing Blood Cultures
234. Blood Products
235. Principles of X-Ray Interpretation
Appendices A to M
A: Commonly Used Instruments/Equipment
B: Informed Consent
C: Latex Allergy Guidelines
D: Supplier Information
E: Resources for Learning Procedures
F: Universal Precautions
G: Neoplasm, Skin: ICD-9 Codes
H: Pearls of Practice
I: The Society of Teachers of Family Medicine Procedural Skills Task Force
J: Outline of a Comprehensive Operative Note
K: Algorithms for the Evaluation of Abnormal Pap Smears and Treatment of Colposcopic Findings
L: Buying Office Equipment
M: Special Considerations in Geriatric Patients
