Volume 197 - Issue 2
Survival guide on child health
Author: Julian J Kelly
Med J Aust 2012; 197 (2): 120. || doi: 10.5694/mja12.10547
Published online: 16 July 2012
Published online: 16 July 2012
IT WAS always going to be a difficult task to summarise all possible paediatric presentations into a single book to help junior medical staff “on call”, so the authors of this effort are to be commended.This is an Australian adaptation of the popular American handbook, and all three Australian authors - Browne, McCaskill and Cheng - are senior staff in the emergency department at the ...
Nocton & Gedeit’s on call paediatrics.
Gary Browne, Mary McCaskill, Nicholas Cheng, James J Nocton, Rainer G Gedeit. Sydney: Saunders, 2011 (xiii + 505 pp, $74.95). ISBN 9780729539128.
IT WAS always going to be a difficult task to summarise all possible paediatric presentations into a single book to help junior medical staff “on call”, so the authors of this effort are to be commended.
This is an Australian adaptation of the popular American handbook, and all three Australian authors — Browne, McCaskill and Cheng — are senior staff in the emergency department at the Children’s Hospital at Westmead, University of Sydney.
The book tries to simplify the task of making a sensible assessment of the symptom or condition presented, and then moving on to managing the problem or asking for help. Chapter 4 is titled “a survival guide” but, surely, the book itself is a survival guide.
The major problems with the book are in the detail. It is difficult to create guidelines for all paediatric centres but the ones presented often revert to emergency care rather than general hospitalist-based practice. Also, some of the guidelines seem outdated and parochial, and not really evidence-based.
In other sections, there is a wealth of detail, much more than required for a handbook — for example, the coagulation cascade tables and vasopressor effect tables for different inotropes.
Another problem is that the terminology used is inconsistent. For example, the very ill patient is described as “critical (about to die)” in one chapter, and “lethargic (critical)” in another. Management of the deteriorating patient is crucial and should be made as simple and iterative as possible.
There are a number of issues with perspective as well — rare conditions that seem to stick in paediatricians’ minds, such as C1 esterase deficiency, are given prominence. Yet there are obvious omissions of more common conditions such as juvenile idiopathic arthritis.
On a positive note, the appendices and index are excellent and would be very useful to anyone on call. On the whole, however, this book requires major restructuring to be a useful guide for junior doctors with the task of looking after sick children and adolescents in the hospital setting.