Clinical Intensive Care and Acute Medicine, 2nd Edition. By Ken Hillman and Gillian Bishop. Cambridge, U.K., Cambridge University Press, 2004. Pages: 685. Price: $80.00.

Clinical Intensive Care and Acute Medicine  is intended as a handbook or minitextbook for residents and serious medical students rotating through the intensive care unit (ICU). As such, it joins a relatively “crowded” field filled with numerous manuals, guides, and pocket references. Despite this fact, the authors succeed in making the book both relevant and unique.

As with many books about ICU care, the book begins with several chapters dedicated to general patient treatment, discussing principles common to all patients in the ICU. Issues including cardiopulmonary resuscitation, fluid management, nutrition, and sedation are discussed in detail. The remainder of the book is dedicated to discussion of specific disease processes. In addition, the book also includes several unique chapters aimed at providing young physicians with information that might otherwise be difficult to find in a single source. For example, the book includes an entire chapter dedicated to the interpretation of the portable chest film. Indeed, there are few things as beguiling to the junior house officer as incorporating data from a chest film into a plan when a patient is rapidly deteriorating (often, in the early morning). The book provides a step-by-step guide for general interpretation before discussing specific disease processes, such as the interpretation in patients with blunt chest trauma.

The relative conversational tone of the book provides for easy and interesting reading. Each chapter begins with several bulleted points that emphasize the key aspects of each subject. Every chapter ends with a short bibliography that refers the reader to more detailed information on each topic. The book includes several “troubleshooting” sections designed to provide on-call physicians with ready, bulleted advice regarding commonly encountered problems. In addition to the somewhat routine subjects common to many handbooks such as “arterial blood gas tricks” or “hypoxia: where to go when the patient is already on 100% oxygen,” the authors also include a discussion of unique topics. This is the only book that includes a discussion of the transportation of ICU patients around the hospital. In addition, I was particularly fond of the tips regarding assessment of patients by telephone. A discussion designed to help on-call residents to manage ICU transfers and referring physicians is absent from most textbooks. Many chapters include mnemonics that help to remind young physicians of important principles.

Nevertheless, some of the specific information, especially regarding infection pharmacotherapy, is somewhat out-of-date. For example, the authors suggest benzylpenicillin as first-line treatment of community-acquired pneumococcal pneumonia. This approach is inconsistent with guidelines published by the American Thoracic Society (New York, New York), the British Thoracic Society (London, United Kingdom), and the Infectious Diseases Society of America (Alexandria, Virginia). In addition, the authors should have included a chapter regarding the care of victims of bioterrorism. Although I hope for such information never to be necessary, it should probably be included in any current text.

Despite these few problems, I believe this is an excellent book. I am certain that its practical approach to ICU care will be popular among medical students and residents rotating through the ICU.

University of Virginia Health System, Charlottesville, Virginia.