Media Reviews
Top Tips in Critical Care is a small volume which is edited by G.R. Park from Addenbrookes Hospital, Cambridge, and R.N. Sladen from Columbia University, USA. It contains contributions from 32 practitioners from all over the world. The book is aimed at a wide readership of critical care specialists both in training and in practice - nurses, anaesthetists, operating department practitioners, and other professionals involved in the care of critically ill patients, for example physiotherapists. It aims to provide a list of useful 'tips' (how to do something_, and 'caveats' (how not to do something). These tips and caveats are grouped into 15 chapters, covering a variety of areas in the management of the critically ill patient, including airway management and artificial ventilation, through to guidance with the insertion of pulmonary artery catheters, and problems with sedation and nutrition. Many of the tips and caveats provided are small pieces of advice or information that are passed on from one colleague to another over the course of time; they are the useful tips that make patient management so much easier. Examples include drugs to avoid in asthmatic patients, or how to detect hypovolaemia from the arterial waveform. Another simple set of guidelines that could prove useful are on obtaining the optimum level of PEEP in the artificially ventilated patient/ Some of the tips can help to explain why the patient is behaving in an unexpected manner, when all is not going according to plan. Examples include and easy-to-follow method for calculating and checking drug doses in eadable style. It is well laid out with a clear list of contents at the beginning, and chapter contents fit into a pocket or rucksack making it easy to carry around and to refer to at the bedside on the intensive care unit In summary, this is an interesting, readable, cheap and useful little volume which will appeal to a fairly wider readership. Its size and style will certainly make Many critical care physicians recognize a significant portion of information used in the daily care of critically ill patients is not found in standard textbooks of critical care medicine, but rather passed by word of mouth from practitioner to practitioner. This 144-page paperback monograph provides common, but necessarily published, tips and caveats used in the care of critically ill patients. The editors have organized these tips and caveats, provided by 31 intensivists from six countries, by organ system or procedure. Many recommendations made in the book have never been subjected to rigorously controlled, randomized, prospective, double-blinded studies to prove their value, efficacy or safety. This seems to counter our long-held belief system as physicians that patient care should be data driven and evidence based. However, if we are brutally candid, most physicians, including critical care practitioners, will acknowledge the value of information and techniques learned not from journal articles, but by word of mouth from colleagues. This book is an attempt to collate these tips learned from years of experience by practitioners of critical care medicine in an organized, systemized manner. Unfortunately, by the editors' own admission, very few of the tips submitted for inclusion were rejected. Therefore most were published despite the fact the editors did not agree with them all. The tips included range from very elementary and obvious to the resident beginning training in anesthesiology, to tips that even the most experienced practitioner with expertise in critical care medicine would find helpful. However, as the editors note, the readers must intelligently evaluate each tip before using it on patients. Unfortunately, the inexperienced physician or the physician-in-training may neither have the ability to determine which tips should be applied to patient care nor the recognition of the potential hazards. Alternatively, the experienced criti.
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