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Doody's Review ServiceReviewer: Susan C. Immelt, PhD, RN (Johns Hopkins University School of Nursing)
Description: This procedure manual for pediatric acute and critical care is thorough, clear, and based on the best evidence for practice. There are a total of 201 procedures (every procedure that I could think of) from frequently performed heel sticks for blood sampling to monitoring the child with pulmonary hypertension. Each procedure is clearly described. Clear diagrams and photos are included where helpful. Tables showing appropriate equipment for age and size are included with the procedure as needed. Each guideline is presented in bullet format and is easy to follow. It includes sections on prerequisite knowledge, child and family assessment, education, the procedure itself, expected outcomes, monitoring, and documentation, and a reference list. Levels of evidence are indicated where appropriate. Rationales for assessment and teaching are provided. A caveat concerning this manual: it is based on a high level of prerequisite knowledge. The practitioner who uses it needs to have a baseline knowledge of acute and/or critical care of children, as well as developmental characteristics of children of different ages. With that caveat, the manual clearly does not waste the time of the experienced practitioner needing to implement a new procedure.
Purpose: The authors' purpose is to provide a comprehensive manual of procedures related to acute and critical care of infants and children. This book fills a void in pediatric care, and I have used it several times since I received it.
Audience: Students of nursing and medicine could use this manual. The most experienced critical care nurse will find this book a useful resource in implementing a new procedure. Together, the two main authors have over 50 years of pediatric critical care experience. Leaders in the field, they have pulled together nearly 200 experts to describe procedures in subspecialties and they have carefully edited and reviewed the manual to maintain a high level of consistency and clarity.
Features: The manual addresses each procedure and guideline in a consistent way. For example, non-invasive positive-pressure ventilation (NPPV) (#30) is used for noninvasive support for children with respiratory insufficiency. Prerequisite knowledge includes child development, indications, contraindications, advantages and disadvantages. Assessment and teaching points for child and family are generic enough that the practitioner can apply them to the negative pressure system chosen. Areas not generally included in the procedures are the application of specific developmentally appropriate techniques to make a procedure more acceptable to the child, so as to increase compliance. The procedure description lists agitation among the relative contraindications for NPPV, but does not address some of the specific measures to decrease agitation. The lists and descriptions of the equipment and the physical implementations of the procedures are well done. One area that could be expanded would be inclusion of specific developmentally appropriate techniques that apply to specific procedures. Knowledge regarding general developmentally appropriate care should be a prerequisite for users of this manual. However, specific techniques may assist in implementing certain procedures (such as noninvasive positive airway pressure devices like masks and nasal prongs), ultimately increasing patient comfort, decreasing agitation, and enabling parents to manage the procedure at home would be helpful. This manual is unique in having a comprehensive index, very little overlap of material among procedures, and levels of evidence noted where indicated. Although there is no color art, all the images are clear, accurate, and useful.
Assessment: This manual is unique in its scope: pediatric and acute care of infants and children. It addresses a higher level of care than other pediatric procedure manuals.