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The 5 minute toxicology consult for PDA
  1. S Bush

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    R C Dart, Philadelphia: Lippincott Williams and Wilkins, 2002, ISBN 0-78173-883-0

    Why am I writing a review of an e-book?

    PDAs are small but immensely capable mobile computers with greater processing power than the desktop machines of five years ago. These handheld computers have matured from simple address books to devices that can word process, email, run presentations, manage databases, and (this is the best bit) switch on every television in my house.

    Their basic memory varies from 8–64 megabytes but this may be expanded into the gigabyte range. This immense memory together with the ultra portability of the PDAs means that they can always be in your pocket offering near infinite text storage. A PDA may be the perfect way to carry your textbooks with you.

    This toxicology program is supplied on a CD ROM together with nine other programs all from Lippincott Williams and Wilkins. The CD is compatible with Windows CE/PocketPC and PalmOS operating systems; this review used a Compaq IPAQ running PocketPC. The purchased program is the only one with unlimited access but all the others may be used up to 15 times on a trial basis. As the program is supplied on a CD it must be downloaded via the computer used to synchronise with the PDA rather than directly to the device. Once the CD is inserted however the installation is straightforward. The entire program is then transferred onto the PDA when it is next connected.

    The program must be activated for it to permit unlimited use. This process requires both internet access and some intuition. The 15 item alphanumeric code supplied with the disc must be entered into the Lippincott Williams and Wilkins’ web site together with the unique code of the PDA. This generates another code on the web site that then may be used to unlock the program.

    Once up and running, its appearance is straightforward. Two narrow icon bars, one at the top of the page and another down the side, leave plenty of space for the text. The text size is alterable from “quite hard to read” to “enormous” and may be made to fit the screen. Using the basic functions fortunately did not require access to the scanty “help files”.

    Access to the files is either via the main index (including the ICD-9-CM index) or the table of contents (TOC). Using the TOC option is simpler although this has no search option. Topics are divided into “General approach”, “Patient presentations with toxicological causes”, “Antidotes”, and “Chemical and Biological agents”.

    This is a 4 megabyte text only program. There are lots of entries. Each entry has a similar format, being divided up into “Smart tabs” of Basics, Diagnosis, Treatment, Follow up Indications, Contraindication and Adverse Effects, Dosage and Method of Administration, Pitfalls, and Miscellaneous. Sensibly not all “Smart tabs” are available for each entry. Some differences are seen between this North American e-book and UK practice. These include the recommendation for induced emesis for decontamination or the use of oral N-acetylcysteine in paracetamol poisoning. The vast majority of the text, however, reflects transatlantic agreement.

    A facility for written and even spoken notes exists and the entries are cross indexed. If any other LWW programs are on the PDA, these are also cross indexed. There is a “back” button to improve navigation but the lack of a “forwards” option meant I had to sometimes laboriously retrace my steps after using it. The “history” function at least made this process easier.

    Unlike written textbooks, free updates are available for one year via the Lippincott Williams and Wilkins’ web site after program purchase.

    Overall this e-book is easy to use and has a vast amount of comparatively current data on toxicology. Anyone who needs access to poisons information but cannot access Toxbase would benefit from this program. As most A&E departments in the UK have internet access there may be little scope for its use in A&E. However, it may well have a place in the general practitioner’s bag, prehospital care, or in remote environments.