Data Interpretation in Critical Care Medicine
D. W. Green · European Journal of Anaesthesiology · 2004
Data Interpretation in Critical Care Medicine B. Venkatesh, T. J. Morgan, C. J. Joyce, S. C. Townsend Butterworth Heinemann: 2003, 139 pp; indexed, illustrated ISBN: 0-7506-5273-X; Price £21 This little book comes hard on the heels of Clinical Data Interpretation in Anaesthesia and Intensive Care edited by Bonner and Dodds and published by Churchill Livingstone. The similarity in title is striking so how do they compare? One difference is that Bonner and Dodds (from the UK) include an introductory section in each chapter on how to interpret sets of results while Venkatesh and colleagues (from Australia) take a running jump at each section with no preamble. There is no chance, therefore, to get the brain 'switched on' to each section. The main difference, though, is that Bonner and Dodds is orientated to the UK primary Fellowship Examination while Venkatesh and colleagues is primarily for candidates preparing for the Australian Fellowship Examination in Intensive Care Medicine (FJFICM). Therein lies the crucial difference as the questions for the latter are inevitably much more complex. The book is divided into 10 sections, each one orientated towards a specific clinical area, such as 'Blood Gases, Cardiovascular, Respiratory Mechanics, Haematology, Intoxications and Radiology'. The set of 'snap shot' questions is followed by the answers and then an extensive list of further reading at the end of each section. I am not sure how useful the latter would be to the reader as they include some pretty obscure and dated references. Personally, although data interpretation is clearly important, I find whole process of coming to a diagnosis or proposing a management strategy from the data presented rather artificial. Often the clinical details are very brief, in some cases non-existent. I found this rather off-putting at first. In addition, some of the diagnoses are either extremely obscure (such as rhinocerebral mucormycosis) or orientated towards more tropical climes, such as management of a Vibrio vulnificus infection! In addition, the poor quality of some of the artwork made diagnosis almost impossible, e.g. a chest radiograph showing a ventriculoperitoneal shunt and some of the ECGs, reproduced at quarter normal size. However, do not be put off by the above. There are some excellent clinical and data scenarios and the reader is rewarded many times over by attempting to answer the questions. For example, having gone through the section on 'Respiratory mechanics, ventilation and oxygenation', I really did feel much more confident in explaining pressure and flow waveforms to one of our residents who is studying for the primary Fellowship of the UK Royal College of Anaesthetists. I suspect that in the UK and Europe, this book will prove most useful to senior residents and consultants working full time in Intensive Care and, to a certain extent, Accident and Emergency and Anaesthesia. It should also encourage these departments to construct their own scenarios and build up their own libraries of questions for data interpretation. Those studying for primary Fellowship in Anaesthesia in the UK might well find some of the scenarios rather too complex. D. W. Green London, UK