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Pocket companion of critical care: Immediate concerns
784
The Journal
the emergency physician who takes care of elderly patients presenting to the emergency department with nonspecific CNS, cardiac, or gastrointestinal signs and symptoms must consider the possibility of adverse drug effects and interactions. The radiographic reproductions in the text are of good quality, although a couple are incorrectly labeled, such as the radiograph of a “cecal volvulus” labeled as a “sigmoid vo1vulus.” In addition, some figures, such as the three half-page examples of valvular heart vegetations and thrombi, are a bit excessive. The index is extensive, complete, and well organized, which makes cross-referencing an easy task. Overall, Geriatric Emergency Medicine achieves its goal of serviug as a clinically oriented resource for the care of the elderly. The strength of the text is that it increases the emergency physician’s awareness of emergent geriatric medical conditions, the atypical presentations of these conditions, and the social issues surrounding these conditions. Another strength of the text is that although the overall slant of the book is toward geriatric care, most chapters have clinically important and relevant subject matter that would apply to patients of any age. It is in this way that the emergency physician is able to appreciate the subtle and atypical presentations of various geriatric disease processes, and this is what makes this text a worthwhile addition to the emergency physician’s library. Department
Richard J. Ryan, MD of Emergency Medicine University of Cincinnati Cincinnati, Ohio
0 POCKET COMPANION OF CRITICAL CARE: IMMEDIATE CONCERNS. Robert Ft. Kirby, Robert W. Taylor, Joseph M. Civetta. Philadelphia, J.B. Lippincott Company, 1990, 760 pages $44.95. Pocket Companion of Critical Care: Immediate Concerns, authored by the editors of the larger comprehensive text entitled Critical Care, is designed to focus on the first 24 to 48 hours of a patient’s stay in an Intensive Care Unit (ICU). In the preface, the authors state that this guide may be helpful for physicians, nurses, respiratory therapists, or other health care providers in an ICU setting. Most of the information in the Pocket Companion
of Emergency
Medicine
has been compiled from corresponding chapters in Critical Care. The general format of the book is narrative with an unusually large number of tables, figures, and photographs for this type of publication. The topics do not follow the same order as in Critical Care, although references to the corresponding chapter(s) are listed at the end of each discussion. The 16 sections, which include Fundamental Considerations, The Surgical Patient, The Obstetrical Patient, Disorders by Systems, and four special topics sections (ICU Infections, Environmental Hazards, Organ Transplantation, and Resuscitation) are divided into 94 chapters that range in length from 2 to 20 pages with 7 to 8 being the average. The initial section, fundamental considerations, presents the basics of acid-base balance, fluid and electrolytes (the longest chapter), and nutrition, with differential diagnoses, management, and potential complications, in an abridged format utilizing tables liberally. A previous familiarity with the subject matter is essential, and novices to the subject matter may be left either confused or with a false sense of understanding after reading the information. The sections arranged by patient type and organ systems disorders are easy to read and logically arranged, although once again cursory. A majority of the chapters are similar to articles that are generally found in some of the more common “throw away” journals. The final two chapters deal with Whom to Resuscitate and Termination of Resuscitation. These are short, frank, open discussions written in plain terms with concepts that should be emphasized to any individual, nonmedical staff included, working in an intensive care situation. The authors have made an admirable attempt at the difficult task of providing a portable version of their more comprehensive text. I am unable to recommend it, however, for several reasons: the Pocket Companion is too large and heavy to fit into any pocket or to be carried around; the price is prohibitive when compared to other pocket guides available, especially considering that it cannot be used as a sole source of information; and the narrative format makes the guide too difficult to use quickly in an emergent situation. Other familiar publications, generally smaller, spiral-bound handbooks published in an outline format, at about half the price, should be considered prior to investing in the Pocket Companion. Robert D. Greenberg, MD Department of Emergency Medicine University of Cincinnati Medical Center Cincinnati, Ohio
The Journal
the emergency physician who takes care of elderly patients presenting to the emergency department with nonspecific CNS, cardiac, or gastrointestinal signs and symptoms must consider the possibility of adverse drug effects and interactions. The radiographic reproductions in the text are of good quality, although a couple are incorrectly labeled, such as the radiograph of a “cecal volvulus” labeled as a “sigmoid vo1vulus.” In addition, some figures, such as the three half-page examples of valvular heart vegetations and thrombi, are a bit excessive. The index is extensive, complete, and well organized, which makes cross-referencing an easy task. Overall, Geriatric Emergency Medicine achieves its goal of serviug as a clinically oriented resource for the care of the elderly. The strength of the text is that it increases the emergency physician’s awareness of emergent geriatric medical conditions, the atypical presentations of these conditions, and the social issues surrounding these conditions. Another strength of the text is that although the overall slant of the book is toward geriatric care, most chapters have clinically important and relevant subject matter that would apply to patients of any age. It is in this way that the emergency physician is able to appreciate the subtle and atypical presentations of various geriatric disease processes, and this is what makes this text a worthwhile addition to the emergency physician’s library. Department
Richard J. Ryan, MD of Emergency Medicine University of Cincinnati Cincinnati, Ohio
0 POCKET COMPANION OF CRITICAL CARE: IMMEDIATE CONCERNS. Robert Ft. Kirby, Robert W. Taylor, Joseph M. Civetta. Philadelphia, J.B. Lippincott Company, 1990, 760 pages $44.95. Pocket Companion of Critical Care: Immediate Concerns, authored by the editors of the larger comprehensive text entitled Critical Care, is designed to focus on the first 24 to 48 hours of a patient’s stay in an Intensive Care Unit (ICU). In the preface, the authors state that this guide may be helpful for physicians, nurses, respiratory therapists, or other health care providers in an ICU setting. Most of the information in the Pocket Companion
of Emergency
Medicine
has been compiled from corresponding chapters in Critical Care. The general format of the book is narrative with an unusually large number of tables, figures, and photographs for this type of publication. The topics do not follow the same order as in Critical Care, although references to the corresponding chapter(s) are listed at the end of each discussion. The 16 sections, which include Fundamental Considerations, The Surgical Patient, The Obstetrical Patient, Disorders by Systems, and four special topics sections (ICU Infections, Environmental Hazards, Organ Transplantation, and Resuscitation) are divided into 94 chapters that range in length from 2 to 20 pages with 7 to 8 being the average. The initial section, fundamental considerations, presents the basics of acid-base balance, fluid and electrolytes (the longest chapter), and nutrition, with differential diagnoses, management, and potential complications, in an abridged format utilizing tables liberally. A previous familiarity with the subject matter is essential, and novices to the subject matter may be left either confused or with a false sense of understanding after reading the information. The sections arranged by patient type and organ systems disorders are easy to read and logically arranged, although once again cursory. A majority of the chapters are similar to articles that are generally found in some of the more common “throw away” journals. The final two chapters deal with Whom to Resuscitate and Termination of Resuscitation. These are short, frank, open discussions written in plain terms with concepts that should be emphasized to any individual, nonmedical staff included, working in an intensive care situation. The authors have made an admirable attempt at the difficult task of providing a portable version of their more comprehensive text. I am unable to recommend it, however, for several reasons: the Pocket Companion is too large and heavy to fit into any pocket or to be carried around; the price is prohibitive when compared to other pocket guides available, especially considering that it cannot be used as a sole source of information; and the narrative format makes the guide too difficult to use quickly in an emergent situation. Other familiar publications, generally smaller, spiral-bound handbooks published in an outline format, at about half the price, should be considered prior to investing in the Pocket Companion. Robert D. Greenberg, MD Department of Emergency Medicine University of Cincinnati Medical Center Cincinnati, Ohio