Emergency Medicine

(2002)

14

, 113–115

Blackwell Science, Ltd

Book Review

BEES SGML

Handbook of Pediatric Emergencies

Gregory A Baldwin, Lippincott Williams and Wilkins, Philadelphia, 2001, 715 pages soft cover, RRP $101.20 ISBN 0-7817-2236-5

This large pocket-sized handbook of paediatricemergency medicine has 40 chapters encompassingresuscitation, cardiopulmonary emergencies and thefull spectrum of paediatric diagnostic categories thatpresent to emergency departments. The contributingauthors include paediatricians practising in predomin-antly paediatric emergency departments and pae-diatric medical and surgical subspecialists throughoutCanada. Some of the nomenclature, managementprinciples and therapies are more in keeping withthe local practice and are not reflective of currentAustralasian practice, as is the case with manyoffshore-derived texts.

The chapter on respiratory failure, whichencompasses APLS principles, is written more fromthe perspective of the anaesthetist, rather thanrecognizing that procedures such as RSI are animportant skill of an emergency physician. The notionof a failed intubation algorithm is not discussed, nor areindications for open versus needle cricothyroidotomyin paediatric patients. Some of the therapeutic strategiesadvocated for common problems are clearly differentto Australasian emergency department practice, suchas mist therapy in croup and bronchodilators inbronchiolitis. Some chapters (e.g. jaundice and cyanosis)clearly reflect paediatric physician authorship and,therefore, the considerable detail may have been user-friendlier in the emergency department setting ifaccompanied by a strategy algorithm.

Areas of importance that were disappointingincluded a very brief discussion of the controversyof occult bacteraemia (some argue maybe this isappropriate) and procedural techniques, such as suprapubic aspiration, are not described for theinexperienced reader who is looking for instructionbefore plunging into an infant’s belly. The sectionon paediatric conscious sedation, which may havewarranted a more detailed discussion, suggestsketamine given only in oral or intramuscular formand there is no mention of inhaled forms of analgesia/

sedation (e.g. nitrous oxide). There are few figuresor diagrams to complement procedural descriptions.

Overall, this is a useful handbook to guideinitial management, but its size precludes a com-prehensive covering of paediatric emergencymedicine. The above limitations further supportthe need for paediatric emergency texts, whichreflect Australasian practice, written by emergencyphysicians.

Ian J Everitt FACEM FRACPJoondalup Health Campus

Joondalup, WA, Australia

141March 2002297Book ReviewsBook Reviews10.1046/j.1035-6851.2001.00297.xBook Review1000BEES SGML

Pediatric Emergency Medicine Secrets

SM Selbst and K Cronan, Hanley and Belfus, Philadelphia, 2001, 425 pages soft cover, RRP $99.00 ISBN 1-56063-411-7

The title

Pediatric Emergency Medicine Secrets

maysuggest that beneath the covers lie pearls of wisdomthat will transform one’s approach to children withacute illness. The book is, in fact, 2000 questionswith short answers on paediatric emergency topics:resuscitation, common presentations, acute medicaland surgical conditions, injuries and administration.

There are over 60 contributing authors, paediatricemergency physicians, emergency physicians andpaediatricians from the US. Despite the range ofcontributors, the format is uniformly concise.

Information is relevant and up to date, with abibliography at the end of each short section. Thereare no real secrets.

The format of the book is its most appealingbut limiting feature. For trainees revising alone orin a study group, the question and answer style isideal for a quick revision or testing of key issueson a particular topic.

Pediatric Emergency Secrets

would be perfect preparation for a viva testing factualknowledge, such as the US Board examination, butnot the current ACEM examination.

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Book Reviews

114

The staccato style makes reading for an extendedperiod somewhat exhausting. Each item is a separatepiece of knowledge, usually without links to the nextquestion. In comparison, a paediatric emergency medicinetextbook gives not only greater depth, but also a farmore rounded understanding than

Pediatric EmergencySecrets

can offer. Clinical handbooks with problem-based approaches to management are far more usefulat the bedside.

In summary,

Pediatric Emergency Secrets

has limitedappeal for emergency clinicians. If a trainee prepar-ing for their fellowship examination was familiarwith the content but had become tired of the formatof the paediatric emergency textbooks, or wantedprompts for revision,

Pediatric Emergency Secrets

offers a change in style.

Matthew O’Meara FRACPPaediatric Emergency Department

Sydney Children’s Hospital

Randwick, NSW, Australia

141March 2002299Book ReviewsBook Reviews10.1046/j.1035-6851.2001.00299.xBook Review1000BEES SGML

Pediatric Education for Prehospital Professionals

American Academy of Pediatrics, Jones and Bartlett (distributed by Blackwell Publishing Asia, Melbourne), 2000, 344 pages soft cover, RRP $95.50

ISBN 0-7637-1219-1

Pediatric Education for Prehospital Professionals

(PEPP),edited by Ron Dieckmann, Director of PediatricEmergency Medicine San Francisco General Hospital,is a companion manual for the PEPP course aimedat ‘Pre-Hospital Professionals’ involved in caringfor ill and injured children. The manual is comple-mented by CD-ROM Powerpoint presentations thatare linked to the lecture content in the resourcemanual, slide sets similarly linked to the material inthe manual and a video containing real-life footagefrom the prehospital environment, the emergencydepartment and operating theatres.

The authors come from a range of healthprofessionals involved in the care of the paediatricpatient, including emergency physicians, paediatricians,intensivists, surgeons, educators and pre-hospital healthproviders.

An extensive range of acute conditions affectingchildren is covered, with each section structured in aconsistent way.

There is extensive use of graphics, includingcoloured photographs and flowcharts. In addition,important aspects are highlighted under a range ofheadings to emphasize important points. Each sectionincludes a case study, case study answers and references.

The textbook is attractive and easy to use and willprove to be a valuable educational resource not onlyfor prehospital personnel, but also for trainees inpaediatrics, emergency medicine and general practice.Nursing and allied health care staff will also find thetextbook to be particularly useful. While the textbookstands alone, it would prove particularly valuable touse the additional teaching resources contained inthe CD-ROM/slides set and video given the excellentmaterial they contain.

In summary, this is an outstanding reference andeducational text that I highly recommend to all healthprofessionals involved in the care of ill and injuredchildren.

John Vinen FACEMDirector of Emergency Support Services

Royal North Shore Hospital

Sydney, NSW, Australia

141March 2002300Book ReviewsBook Reviews10.1046/j.1035-6851.2001.00300.xBook ReviewBEES SGML

Handbook of Orthopaedic Emergencies

Hart RG, Rittenbury TJ, Uehara DT (eds), Lippincott Raven, Philadelphia, 1999, 510 pages soft cover, RRP $101.20 ISBN 0-7817-1610-1

Orthopaedic emergencies constitute a significantcaseload in most Australasian emergency depart-ments and are important sources of medicolegaldisputes when suboptimal care or outcomes occur.Previous contributions in this area of orthopaedicsthat I have consulted have been from orthopaedicsurgeons or as sections of general emergency texts.Thus, it was a pleasant surprise to see that that theauthors of this slim volume are primarily trained,work and teach in emergency medicine. They havesuccessfully combined a broad emergency focusedcoverage with a convenient and reader-friendly style.Although written from a North American viewpoint,divergence from Australasian practice wasinfrequently of note.

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Divided into six sections, the book progresseslogically from general to specific discussion of allcommonly encountered clinical areas. The conciseexplanations of general orthopaedic matters areexcellent and highlight many pearls for junior staff,such as the importance of fully elucidating mechanismof injury and appropriate utilization of diagnosticimaging modalities. Anaesthesia and analgesiaoptions are well described, with one point of exceptionbeing the advocacy of lignocaine rather than prilocainefor intravenous regional anaesthesia procedures.

Subsequent sections discuss upper and lower limb,spinal and paediatric problems. Each chapter coversrelevant anatomy, injury patterns, assessment andimaging issues prior to discussion of treatment anddisposition. I found these to be uniformly thoroughand set out in a way that enabled one to quickly findanswers to common clinical questions. Diagrams andfigures are used sparingly, as expected, but areadequate for their purpose.

This book provides just the right amount ofinformation for the intended readership of practisingemergency department staff and highlights importantpearls and pitfalls. The challenge faced by the authorsto provide a comprehensive but readily usable referencein handbook format has been well met by this text.

Trevor Jackson FACEMJoondalup Health Campus

Joondalup, WA, Australia

141March 2002301Book ReviewsBook Reviews10.1046/j.1035-6851.2001.00301.xBook ReviewBEES SGML

Anaesthesia and Emergency Situations: A Management Guide

Gajinder Oberoi and Garry Phillips, McGraw Hill, Sydney, 2000, 366 pages soft cover, RRP $55.00 ISBN 0-074-70767-1

This guide is written primarily for non-specialistdoctors who are exposed to situations where they arerequired to manage, anaesthetize or transfer patientswho may be critically ill. It is particularly targetedat doctors working in areas where resources areconstrained and equipment limited, as in developingcountries and remote areas. The book aims to bridgethe gap between specialty texts in anaesthesia,emergency medicine and critical care and bookswritten specifically on the topic of third worldmedicine. The authors have been involved in training

anaesthetists in Papua New Guinea and, as such,have gained first-hand knowledge of the problemslikely to be faced.

The format of the book is similar to manyanaesthetic texts, with chapters on pre-operativeassessment, anaesthetic equipment and resuscitation,leading on to discussions of anaesthesia for specificclinical situations. The section on regional anaesthesiaprovides excellent, succinct instructions on perfor-ming a range of local blocks, as well as a clear reviewof local anaesthetic doses and complications. Lessimpressive were the chapters on resuscitation and themanagement of common medical emergencies, wherethe discussion often lacked sufficient depth to providea definitive treatment regimen. There were also someirritating inconsistencies, such as recommending300 J as the second delivered shock in VF. In fact, theArrest–Ventricular Fibrillation algorithm in generaldoes not reflect any of the recently publishedguidelines now available. Also, in the management ofacute severe asthma, intramuscular or subcutaneousadrenaline given up to hourly is suggested, ratherthan intravenous salbutamol, which would have beenmore in line with, for instance, the AsthmaManagement Handbook.

Working in the highly technological world ofspecialty led medical practice in Australasia, it isdifficult to comprehend the anxieties of providingemergency obstetric and paediatric anaesthesia orintensive care management in isolated places, withsometimes low-key training and limited equipment.I am not convinced that this guide will go far enoughin relieving those anxieties. The large number ofweighty tomes written on anaesthesia and critical caremedicine indicate the complexities of the topicsinvolved. This book, although well structured andpresented, only hints at the multitude of problems thatare likely to be encountered. As such, it may merely‘wet the appetite’ rather than ‘slake the thirst’ forpractical knowledge. Unfortunately, it is also notreally suitable for medical students or the non-expertpractitioner working in more sophisticated medicalsystems and would be inadequate for the requirementsof advanced practice in emergency medicinedepartments in Australasia.

Catherine M Hurn MB BS DAEmergency Medicine Department

Royal Brisbane Hospital

Herston, Qld, Australia

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