Essentials of Paediatric Intensive Care

Abstract

This pocket-sized handbook of paediatric intensive care covers much of the fundamental knowledge required by those who work with critically ill children. It is aimed at nurses and doctors who work for a short time in paediatric intensive care units (PICU), or those involved in the resuscitation and stabilization of children before their transfer to PICU. It is divided into three sections; the first ten chapters cover the general principles of PICU including resuscitation, airway and ventilation, circulation and cardiac rhythm disturbances. These chapters contain a fair amount of basic physiology and the ‘bullet point’ style allows for easy reading and assimilation. It was good to see a chapter dealing with the death of children in PICU, but I was disappointed not to find a section dealing with the psychological effects of critical illness on children and their families. Section two contains 13 chapters on specific PICU problems; these pages go into greater detail on many of the problems encountered during the care of critically ill children. It includes an excellent paper ‘cardiac disease on the PICU’ written by Monica Stokes, which provides a concise overview of this subject that relates well to the clinical problems seen in the PICU setting. This chapter also stands out for its clear illustrations detailing the anatomy of common congenital heart lesions. The chapter on respiratory diseases in particular has a great deal of information regarding the aetiology, pathophysiology and management of asthma, bronchiolitis and upper airway obstruction. Once again the frequent use of lists and tables makes for an engaging layout. The final section is a PICU formulary providing indications, doses, contraindications and unwanted effects of a wide range of therapeutic agents. This is a good little book of PICU that would provide a newcomer with much of the information they will require to gain a confident footing in what is a challenging environment. If I were to have any criticisms of the book I would say that from the perspective of a paediatrician or anaesthetist involved in the resuscitation and stabilization of critically ill children, the book lacks a clear opening chapter on the recognition of the seriously ill child. From the perspective of the short-term PICU worker I might suggest that there should be proportionately more coverage of the most common problems faced in PICU; for example sections on liquid ventilation and high frequency jet ventilation might have been more usefully replaced with a diagram of a continuous veno-venous haemofiltration circuit. Similarly, a few key references may have added a further dimension and I have a feeling that there is rather too much general paediatric information here. Whilst recognizing that this book is not intended to be a complete manual of PICU a section on common practical procedures would have enriched it still further. Overall, Essentials of Paediatric Intensive Care is to be recommended as an introduction to PICU. It is a handy, relatively inexpensive book giving a lot of useful information in a very readable format.