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Doody's Review ServiceReviewer: Krista G Handyside, MD (University of Texas Medical School at Houston)
Description: This handbook on prehospital care presents information used by all practitioners involved in the prehospital and hospital care of patients, and includes medical, pediatric, obstetric, and traumatic presentations. It also covers laws governing this area, scene and triage protocols, and a limited drug formulary.
Purpose: Prehospital care of a patient is becoming more important in healthcare. While it includes a lengthy chapter on trauma, this book also presents medical, pediatric, toxicological, and obstetric/gynecologic information for the prehospital provider. The information is of use to all providers of emergency care, whether in the field or at the hospital.
Audience: It is difficult to ascertain for whom the book is written. It assumes some medical knowledge, while still providing the basics of pathophysiology, pharmacology, and first aid. It also provides great detail on nonmedical aspects of prehospital care, such as law (albeit limited to the U.K.), triage, transport, and major incidents. At times, the information is very general, limiting the book's usefulness in the field, while at other times, it is very specific about interventions not likely to be used as part of a prehospital protocol. These include instructions for the insertion of a chest tube in thoracic trauma or the dosing of antibiotics for meningococcal meningitis. One of the editors is an emergency physician, the other a trauma surgeon, yet there are very few references to other authorities on prehospital care. There is also a lack of references and specific authorship for each chapter.
Features: The book starts with a description of what can be included in prehospital care, ambulance services and transport, and laws governing them. The majority of the book describes specific medical and traumatic conditions that would be encountered in patients in a prehospital setting and the stabilization and initial treatment of them. The section on trauma is well written and very thorough. Oddly, in the middle of the book is a small formulary of what I'm guessing the authors believe are the most frequently encountered medicines used in the prehospital setting. However, since this is based on practice in the U.K., some medicines are not recognized or available in the U.S. There are few pictures, but many charts and diagrams illustrate the concepts and organize the information. Both inside covers present quick information for easy access (cardiac arrest algorithm, pediatric dosing, and rule of nines). The book's greatest shortcoming is that some of the information is not applicable to U.S. practice. While most of the medical information is generic, all measurements are presented in the metric system. Also, triage protocols, laws, and other community-based information are specific to the U.K. and therefore not useful readers outside that audience.
Assessment: This is a useful reference for those involved in prehospital care of patients. While those at higher levels (physicians, residents), may want or need more information, this book addresses many areas of prehospital care and is thorough in what it covers. It could be used in the field for quick look-ups on certain conditions, although it assumes a basic knowledge of medical care. Prehospital care is constantly evolving and those involved in it are constantly being asked to shoulder more responsibility, thus the need for updated resources. This book will likely need to be revised as this trend continues.