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Doody's Review ServiceReviewer: Sanford M. Melzer, MD (Children's Hospital and Regional Medical Center)
Description: This manual for residents and medical students covers the evaluation and management of common symptoms and problems encountered while on call on a pediatric inpatient service. It was first published in 1997.
Purpose: The book is intended to serve as a resource to aid physicians-in-training in the evaluation and management of common problems encountered in the care of hospitalized pediatric patients. The types of symptoms and problems are representative of the typical range of problems that are encountered in everyday inpatient practice. Because many of these issues are often not well covered in standard textbooks and manuals, the authors are successful in meeting their objectives.
Audience: The book is written for physicians-in-training caring for hospitalized children. It is appropriate for medical students and pediatric and family medicine house officers in inpatient rotations.
Features: The book begins with a brief discussion of the art and science of managing problems while on call. The main focus of the book concerns management of specific symptoms, ranging from abdominal pain to vomiting. There is also a section on laboratory related problems, appendixes, and an "on call" formulary with doses of common medications used in the inpatient setting. The book's symptom-based approach is unique and valuable, and covers a number of topics not covered in standard textbooks and manuals. The section on initial telephone management is useful. The choice of questions to ask upon arrival at the bedside and the brief physical exam are relevant and should provide the house officer with an accurate and efficient guideline to problem evaluation. Despite this useful approach, the clinical chapters are uneven in their organization and quality of advice. For certain conditions it is difficult to find specific information in the book. For example, a house officer seeking to evaluate a child with bronchiolitis, a very common condition among hospitalized children, would not find this term in the index. The book's coverage of common procedures is also uneven and the ones chosen do not necessarily reflect those that a house officer might perform. For example, in the chapter on respiratory distress there is a detailed description of how to perform an emergency pericardiocentesis, yet no description or diagram showing techniques for endotracheal intubation. The procedures appendix illustrates femoral and arterial line placement and lumbar puncture but does not cover thoracentesis or suprapubic aspiration.
Assessment: This book can be useful to a junior house officer faced with the challenges of managing common symptoms among hospitalized patients. Its limited coverage of differential diagnosis, formulary, and quality of illustrations make it unlikely to become the only manual that house officers would want in their coat pocket for a night on call. However, this manual would be valuable to have in an on call room, along with other books.