Book Reviews

This small soft cover pocketbook, with 335 pages in 28 chapters, provides a good introduction to care of the critically ill trauma patient. This is topical in the UK and elsewhere as major trauma care is being concentrated into small numbers of major trauma centres. As a practicing clinician, in a newly designated UK major trauma centre, I was interested to be sent this book for review. This title follows other handbook size texts in the relatively new Pittsburgh Critical Care Medicine series, published by Oxford University Press. This series includes other subjects, which to date include: emergency department critical care, abdominal organ transplants, mechanical ventilation, and renal/metabolic medicine. Other topics are in preparation. Most of the authors are from Pittsburgh, with a few from other US centres. The authors and series editors do not state the target audience for this book title or series. I suspect this may vary between titles in the series, dependent on the degree of specialism and detail in individual titles. It is my impression that this title was aimed at US surgical trainees rotating through trauma-related critical care units, who need a succinct text to provide the background to care of the critically injured trauma patient. It achieves this aim well. Such trauma patients even if in relatively small numbers provide real challenges for intensive care staff and frequently spend many days or weeks in the intensive care unit (ICU) with multiple trips to theatre or interventional radiology to manage their diffuse pattern of injuries. As an experienced clinician reading the book, I felt that it could be categorized into two parts. First, as a good introductory text related to many general aspects of critical care, for example, with chapters on airway management, resuscitation, massive transfusion, assisted ventilation, acute kidney injury, endocrine disorders, infection, temperature regulation, nutrition, sedation and analgesia, and toxicology. These chapters have a bias towards trauma management but are similar to that available in other general critical care texts. Secondly, other chapters are more trauma-specific and these may be of more interest to the more experienced reader, particularly those on topics not so readily available in other books or journals. The book starts with a historical description of how care of major trauma has evolved in the USA, then covers injury severity scoring systems, the tertiary survey, and avoiding missed injuries, and finishes on legal issues in trauma care. There follows then the more general chapters discussed above, and sections on spinal cord injuries, traumatic brain injury, burns, and organ donation which are well-established topics in other texts. Specific trauma-specific chapters, which I have not seen so well covered elsewhere include: abdominal trauma with management of the open abdomen, soft tissue trauma, and orthopaedic trauma. A better understanding of such injury management enhances the inevitable difficult and complex multidisciplinary management of such patients. This book provides an overview of such injuries, which is essential for critical care staff, who are monitoring and caring for these patients hour by hour. It is the critical care staff not the more specialist teams who need to recognize early and manage and refer on complications like compartment syndromes. Further chapters on prevention of deep vein thromboses (DVTs), paediatric trauma, pregnancy trauma, geriatric trauma, and rehabilitation give useful perspectives not covered widely elsewhere. Inevitably in a bookof this size, there are omissions, but these are in my view minor. I think it will be seen as a useful starter text for ICU residents and experienced staff may read selected sections more specific to trauma care. It would also be of interest to surgeons, physicians, nurses, and physiotherapists looking after such patients. I would consider purchasing copies of the book for bedside reading by staff caring for the line of severely traumatized patients I have on my ICU this weekend.