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Doody's Review ServiceReviewer: David J. Dries, MD (University of Minnesota Medical School)
Description: This is the second edition of a monograph describing a physiologic approach to patients presenting with organ dysfunction.
Purpose: Presented is an approach based on detection of organ dysfunction followed by supportive care and rapid determination of differential diagnosis.
Audience: Senior medical students, nurses in the critical care unit, and junior postgraduate trainees requiring a quick introduction to patient assessment and organ system support are an appropriate audience for this work. The authors are teachers in anesthesiology, internal medicine, and critical care in the United Kingdom.
Features: Initially presented is an introduction to the patient using the airway, breathing, circulation, disability, and examination (ABCDE) approach. After this structured approach to the patient presenting with acute decompensation, a specific organ system approach, beginning with respiratory care and fluid resuscitation proceeds. Chapters include a blend of clinical physiology and treatment pearls. Line drawings are used to good effect and type font, tables, and lists identify essential points. Tutorials summarize application of specific therapies. References at the end of each chapter include review papers from the primary literature and chapters from secondary sources. Some date to the year of publication, but most come from the year 2004 and earlier. Chapters close with case presentations followed by discussion of principles of management.
Assessment: This is a timely, contemporary introduction to multisystem dysfunction in early acute illness. In addition to medical students and young postgraduate trainees, workers on medical emergency teams will benefit from this systematic approach based on the ABCs of the highly successful Advanced Trauma Life Support Program.