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P O Brennan, K Berry, C Powell, M V Pusic, editors. Oxford: BIOS Scientific Publishers, 2003, pp 458. ISBN 1-85995-242-4,
Knowledge is a process of piling up facts; wisdom lies in their simplification. Martin Luther King, Jr (1929–1968)
Upwards of two million children will attend accident and emergency departments in the United Kingdom every year. Many thousands more will attend general practice for advice or treatment after acute illness or injury. Large numbers of practitioners in many different settings therefore need to be prepared to deal with children with a variety of urgent and emergency conditions. As an old Chinese proverb states “Small children do not pretend to be sick”. The problem is that the vast majority of children have minor to moderate illness, much of which is self limiting. Indeed many of the injured children require little more than symptomatic relief and general supportive care.
The problem therefore is identifying the wheat from the chaff. In other words, how does one identify the critically ill child, or the child who is brewing something serious? Age and experience help. Certainly knowledge is useful. More often the wisdom of Solomon is required. There is no doubt that experience brings greater wisdom, and with it ability to deal with children effectively. I suppose that is really what I like about this book. The authors have brought their collective experience and wisdom, gathered over the years (I am not brave enough to state how many, but I know it is considerable!) to produce an extremely readable text that is well laid out and well presented. The salient features are highlighted in boxes and the use of diagrams is good. I personally would have liked to have seen more radiographs and clinical pictures, but then again this may not be the purpose of a handbook. This may best be left to a colour atlas, or better still actual clinical practice. Computed tomograms of the head are poorly produced and this is again disappointing.
This book covers virtually all the salient features of paediatric emergency medicine. There are no glaring omissions, although one always has pet subjects one would wish to see incorporated. It would be churlish to let these personal idiosyncrasies detract from the overall good feel I have for this text.
There is no doubt that this book will provide useful reading at all levels of experience. Reading it and being familiar with the contents will bring greater knowledge. Wisdom, I’m afraid will have to come with time. The only major problem with this book is that it is a bulky, heavy hardback. As such it won’t fit into a pocket conveniently and may well end up on the shelf. By being left on the shelf it runs the risk of being ignored and this, I think, would be a tragedy.
Martin Luther King would be proud of this effort.
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