This handy little book consists of protocols which can be applied to a range of problems commonly encountered in acute care medicine. For each condition, the format features explicit instructions regarding drug choices and doses and their indications and contraindications. Where relevant, it also contains advice about non-pharmacological and supportive treatments. Most conditions also include brief but sensible practice points and for many conditions there is an evidence-based rationale for the protocol. There are, in addition, appendices regarding choice of endotracheal tube size, interpretation of arterial blood gases and respiratory function tests and prescribing paediatric fluids. The information contained in the handbook is practical, concise, up-to-date and accurate. However, different sections vary in their clinical utility. Perhaps the most interesting and useful section of the handbook is the section regarding treatment of poisoning. In contrast, I wonder at the inclusion of the section on infectious diseases, and suspect that this handbook is not about to replace Antibiotic Guidelines in this area.

My major criticism of the book is that it is, at least at first, a little difficult to navigate. There are no clear divisions between sub-sections of the book and I imagine this might make it difficult to find what you want in an emergency. However, once this has been overcome, the instructions are succinct and easy to read. Overall, it is an interesting and informative read, but most of the handbook consists of information which is already the regular practice of doctors in emergency departments. I therefore suspect it will be of most use to medical practitioners who do not frequently encounter the conditions discussed. As such, I would highly recommend it for use by practitioners working in rural and remote areas.



Robyn Wilkinson

Emergency Medicine Registrar, Tamworth Base Hospital, Tamworth, NSW