Volume 188 - Issue 11
On-call help
Author: Robert P Dowsett
Med J Aust 2008; 188 (11): 661. || doi: 10.5694/j.1326-5377.2008.tb01826.x
Published online: 2 June 2008
Published online: 2 June 2008
Marshall and Ruedy’s On call: principles and protocols.
Mike Cadogan, Anthony F T Brown, Antonio Celenza. Sydney: Saunders Elsevier, 2007 (xvi + 576 pp). ISBN 978 0 7295 3803 9.
Being on call can be a daunting experience. You are called to a patient you don’t know who has become unwell. They might have developed a severe headache, be short of breath or have chest pain. What are you going to do? When should you call for more experienced help?
On call principles and protocols attempts to systematically answer such questions. Based on the book of the same name by Canadian authors Shane Marshall and John Ruedy, it differs in its arrangement, separating interpretation of common investigations and procedures, with a brief formulary to separate sections.
For the common problems encountered, the authors detail what questions to ask over the phone and what initial instructions to give. Conditions under which the patient should be given immediate priority are listed. Assessment and management of life-threatening problems are dealt with first, followed by a more complete discussion, including when to call for more experienced help.
Interestingly, the authors are all emergency physicians who have probably not been on call for ward patients for many years, but all have experience in medical education and the principles of assessing the emergency patient are not dissimilar.
Some hospitals have their own handbooks dealing with hospital emergencies but the approach taken in this text is more systematic and comprehensive. One omission is a discussion of common surgical problems, such as management of diabetes peri-operatively and postoperative analgesia. Guidelines given for managing patients on aniticoagulation therapy, a common on-call problem, are restricted to over-anticoagulation and do not provide detail on heparin and warfarin prescribing.
These omissions aside, the style and content of On call principles and protocols is well laid out and the book fills a niche for doctors practising hospital medicine. With a recommended retail price of $60 the book represents value for money.