Paediatric Anaesthesia and Critical Care in the District Hospital: a Practical Guide

Abstract

I do not think that the title of this book of nearly 300 closely printed pages really does it justice, as it might not attract those anaesthetists, of all grades, for whom it could be an extremely useful addition to the personal library. The book is written by nine UK consultant anaesthetists, some in full-time practice in specialist children's hospitals, others who are paediatric anaesthetists in district general hospitals. It is in effect a textbook of everyday paediatric anaesthesia and intensive care. There are eight chapters. The first two, ‘Development of Current Practice’ and ‘Criteria for Referral to Specialist Centres’, comprehensively summarize the current status of the subspecialty, with a review of the multitude of reports and recommendations written in the UK since 1959. This excellent resource is presented in a readable style, charting the development of paediatric anaesthesia and intensive care. In addition to being interesting reading, it will be invaluable to those preparing to do battle across the boardroom table with managers or interviewers. The next five chapters form the clinical ‘meat’ of the book and cover anaesthesia and intensive care for common paediatric (not neonatal) conditions. There are common-sense practical monographs on consent, pain management, and day surgery. I would highlight the 50-page chapter on paediatric intensive care that gives sensible, practical advice on the management of critically ill children presenting in the accident and emergency department. It does not cover the longer-term aspects or the specialist areas of cardiac surgical intensive care or critically ill neonates, but then that is not what the book is about. I would also highlight the section on specific conditions: burns, trauma, sepsis and head injury are all well covered. In my opinion, the best chapter in the book is that on ‘Anaesthetic Principles and Techniques’ by Drs Carr and Harvey. In essence, this chapter is an excellent textbook within a textbook covering ‘routine’ paediatric anaesthesia. All surgical specialties (except cardiothoracic surgery) are covered in detail with practical advice and a substantial, contemporary list of references (in total, 384). Clear photographs and logical tables summarizing many aspects of patient management will be helpful to all those who anaesthetize children. The final chapter entitled ‘Examples of Good Practice’ is rather unusual; it summarizes comments from paediatric anaesthetists in district general hospitals around the UK and offers suggestions for managing paediatric anaesthetic services in this environment. In summary, this book will find a place in district general hospital anaesthetic departments but it covers current practice of paediatric anaesthesia in a style that should also be useful to the mainstream paediatric anaesthetist. When supplemented by a monograph on principles of neonatal anaesthesia (and there are many in the literature), I believe this book to be all that a trainee will require in preparation for the paediatric aspects of the final FRCA examination. It is easy to read as well.