Description

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