Nicola Cooper - Essential Guide to Acute Care

Library of Congress Cataloging‐in‐Publication Data

Names: Cooper, Nicola, author. | Cramp, Paul, author. | Forrest, Kirsty, author. | Patel, Rakesh, author.

Title: Essential guide to acute care / Nicola Cooper, Paul Cramp, Kirsty Forrest, Rakesh Patel.

Description: Third edition. | Hoboken, NJ : Wiley‐Blackwell, [2020] | Includes bibliographical references and index.

Identifiers: LCCN 2020021082 (print) | LCCN 2020021083 (ebook) | ISBN 9781119584162 (hardback) | ISBN 9781119584216 (adobe pdf) | ISBN 9781119584056 (epub)

Subjects: MESH: Critical Care

Classification: LCC RC86.8 (print) | LCC RC86.8 (ebook) | NLM WX 218 | DDC 616.02/8–dc23

LC record available at https://lccn.loc.gov/2020021082LC ebook record available at https://lccn.loc.gov/2020021083

Cover Design: Wiley

Cover Image: © Westend61/Getty Images

‘At last! A book that addresses the needs of every junior doctor faced with the management of acutely sick patients. Concise and readable, its format allows the reader to absorb the principles of human physiology, and to apply them to everyday situations involving critically ill patients…unlike many texts, the authors have ignored the minutiae and concentrated on the most relevant and applicable information. Well illustrated throughout, the reader is guided towards establishing a logical approach to the ill patient. With self‐test questions relevant to each chapter, it becomes a valuable learning tool … if you have ever been faced with a sick patient, a blank mind and a room full of expectant faces, then this is the book for you.’ Acute Medicine Journal .

‘This small textbook offers a novel approach to understanding acute illness. Instead of offering the traditional how‐to‐manage‐a‐diagnosis format, it explains the underlying physiological changes in acute illness. This is vital because very few staff really understand basic concepts, such as how to give oxygen therapy effectively. The book is aimed at those who deal with the acutely ill patient … and aims to tell the reader ‘what you really need to know’ but cannot find in standard texts … The authors provide a simple and readable description of the underlying pathophysiology of acute illness – quite an achievement!’ British Journal of Anaesthesia .

‘This compact little text delivers a most refreshing and informative account of the basic science and the clinical practice of acute care. The chapters are designed to cover the common topics in acute care, and have been written to allow the reader to apply basic principles to clinical scenarios, and to address areas which are commonly troublesome or about which myths and misunderstandings are rife … case studies support each chapter and accurately reflect day to day clinical problems – the answers to these are very practical.’ Hospital Doctor .

‘This book should be made compulsory reading for all new doctors! I bought it after reading a review on the net and have never regretted it once, it certainly deserves the praised heaped on it so far. The book concentrates on explaining the altered physiology in illness and the science behind different interventions, like fluid therapy, oxygen, inotropes (for example, explaining the physics of each type of oxygen mask and hence their appropriate use in different situations) giving you the intellectual ammunition needed when asked to review that patient who ‘doesn't look right’ in the small hours of the morning. The section on blood gases is essential for those (like me) who struggle in their interpretation – this chapter, like all others, is followed by a great self‐assessment section with highly detailed explanations for all answers. Far removed from the more common protocol/algorithm‐based guidebooks on the market, this book will make you think more and understand more. Buy it’. Amazon reviewer .

‘Quite simply brilliant. I love this book and recommend it to everyone. It's the only book I've come across that really explains ABGs, fluid resus, inotropes, etc. It covers all the stuff you need to know that isn’t taught in medical school curricula. I actually lost my copy when someone borrowed it from me, but this book is so good I might just buy another one!’ Amazon reviewer .

…in the beginning of the malady it is easy to cure but difficult to detect, but in the course of time, not having been either detected or treated … it becomes easy to detect but difficult to cure.

— Niccolo Machiavelli, The Prince

It’s almost 15 years since the publication of the second edition of Essential Guide to Acute Care and a few more since one of the authors (NC) asked her boss at the time (PC) and a friend (KF) to help her write a book on ‘everything you need to know but no‐one told you’ about the care of acutely ill adults. In that time, it has been a best‐selling book used by doctors in training, critical care outreach teams, nurses and allied health professionals working in acute areas, medical students, and clinical teachers. Many things have changed since the second edition: new oxygen guidelines, updated practices in fluid balance and volume resuscitation, new definitions of sepsis, and ‘acute kidney injury’ instead of ‘renal failure’ among others. This edition has been extensively rewritten and updated, including a new author (RP), but we have done our best to retain the informal, easy‐to‐read style that made this book so popular with readers.

There are many books on the management of patients who are acutely ill, but all have a traditional ‘recipe’ format. Readers look up a diagnosis and the management is summarised. Few of us are trained how to deal with the generic altered physiology that accompanies acute illness. The result is that many doctors are unable to deal logically with patients in physiological decline and this often leads to suboptimal care.

In surveys of junior doctors of all specialties, few can explain how different oxygen masks work, the different reasons why PaCO 2rises, what a fluid challenge is, and how to effectively treat organ failure. This book contains information you really need to know but is not found in standard textbooks. Throughout the text are ‘mini‐tutorials’ that explain latest thinking or controversies. Self‐assessment case histories and references are included at the end of each chapter. We have dropped the Appendix on practical procedures in this edition and instead recommend the NEJM videos in clinical medicine. * It is our aim that this book will provide a foundation for learning how to care effectively for acutely ill adults. We hope you enjoy using it, we have certainly learned and enjoyed the process of rewriting it!

Nicola Cooper, Paul Cramp, Kirsty Forrest, and Rakesh Patel

January 2020

1 * www.nejm.org/multimedia/medicalvideos

Thanks goes to Dr Nick Harrison, Fellow in Anaesthesia at the Monash Medical Centre, Clayton, Australia, for his help in highlighting several areas in the fluid balance chapter that needed updating since the last edition.

We would also like to thank our families, and all the medical students, nursing staff, and junior doctors we have taught whose understanding and questions have shaped our writing.

The story behind this unique little book started many years ago when one of the authors (NC) took up a post in intensive care medicine in order to learn how to deal with sick patients. Everything she learned was immediately applicable to the general wards or the emergency department. Sick patients are everywhere! It is a sad fact that even though doctors in the acute specialties deal with sick patients all the time, they often do not do it very well. That is starting to change, and one of the reasons it is starting to change is because many people (the authors included) campaigned for acute care to be a core component of training for all doctors in the UK.