I felt a sense of impending despondency when I first looked inside the front cover and discovered this book is ‘….useful to doctors and nurses based on the intensive care unit.’ Yet I read on. Ok, so this was only the preface so perhaps I should have demonstrated more literary ‘nouse’ and at least got to the contents page! Here, at least, some key themes of paramedic practice appear in the form of assessment and stabilisation and the ever-present airway, breathing and circulatory assessment.
What was surprising, given the target readership of the book, is the very broad approach taken in addressing some of the subject areas. Often lacking in depth, I struggled to identify how a paramedic would glean much additional information on the prescribed interventions during the hospital and rehabilitation phase of critical care, should additional reading be undertaken in the quest for continuing professional development.
Then there is the ubiquitous question of relevance to existing paramedic practice. Consider the proposed management of an MI. The advocated treatment included Us and Es, LFTs, serum magnesium, calcium and phosphate screening. Response bags are undoubtedly getting bulkier but paramedics would need to recruit the services of a pack mule. A similar tale exists for stroke management which cites CT scans, Carotid Doppler studies and coagulation screening as part of the clinical care package. All have their place, no doubt, but do little to aid the paramedic in the field with that all important initial diagnosis.
I suppose this is more of a scope of practice issue and as such, that is why the text is not best suited to our field —more of an introductory text for those assessing and triaging patients on arrival at hospital. There is some useful stuff in here for paramedics, but I would suggest there are more appropriate texts available. When compared to the recently reviewed Nancy Caroline, I’m afraid there can only be one winner.