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Essential Guide to Acute Care


At last! A book that addresses the needs of every junior doctor faced with the management of acutely sick patients. Concise and readable, its format allows the reader to absorb the principles of human physiology, and to apply them to everyday situations involving critically ill patients. With each chapter being dedicated to a separate physiological ‘insult’, Cooper and Cramp open with a brief outline of what happens under ‘normal’conditions. This is followed by a summary of how physiology adapts under disease conditions. In this way the authors cover oxygen therapy, acid base disturbance,fluid balance, circulatory failure, sepsis, acute renal failure and coma. There are also chapters on identifying the patient at risk, and optimising physiology in the preoperative patient. With a distinct ‘anaesthetic slant’, the layout and emphasis are different to that with which most physicians will be familiar. This is however to its advantage, as it effectively bridges the traditional gap between medicine and critical care.

Unlike many texts, the authors have ignored the minutiae and have concentrated on the most relevant and applicable information. Well illustrated throughout, the reader is guided towards establishing a logical approach to the ill patient. With self-test questions relevant to each chapter, it becomes a valuable learning tool. ‘Mini- tutorials’ in each chapter highlight controversies, such as the relative merits of crystalloid versus colloid in f luid resuscitation, or the use of sodium bicarbonate in the treatment of metabolic acidosis.

The size of the book lends itself well to being carried in the white coat pocket. However the layout of the text makes it more suited to evening reading, rather than as a bedside reference. Some algorithms summarising the key points of each chapter might have added to the practical uses of the text.

Although this book will not help in passing the MRCP examination, it will hopefully make its readers into safer, better clinicians. If you ’ve ever been faced with a sick patient, a blank mind and a room full of expectant faces, then this is the book for you.

Dr Stuart Henderson Specialist Registrar in Medicine Southampton University Hospitals NHS Trust

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