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A Neonatal Vade-Mecum.
  1. M Y ANTHONY, Consultant neonatologist
  1. John Radcliffe Hospital, Oxford

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    A Neonatal Vade-Mecum.3rd Edn. B Speidel et al. [Pp 481; 17.99 paperback] Arnold, 1998. ISBN 0-340-69140-9.

    This is the third edition of a well recognised neonatal handbook. The authors declare their intention to provide a book of a practical nature as a ward guide for medical and nursing staff caring for newborn infants. Much revision has occurred since the previous edition and the depth and breadth of contributions is reflected in the lengthy list of editors and contributors, all of whom are recognised as experienced practitioners.

    Have the editors succeeded in their aim? Essentially, yes. The book is of a size and price to be readily accessible. It is very clear in its layout and provides essential neonatal information a shopfloor neonatologist needs. Each section has a useful bibliography as a source for more extensive information.

    My main criticism is questionable information. A brief introductory sentence pointing out that local practices may be at variance with those detailed, and should be respected, would be helpful to junior and nursing staff. Some of the information is set out didactically with no hint that there is a wide body of practice. Instances would be the roles of ultrasound and serum screening in antenatal practice, the use of Ribavarin for RSV bronchiolitis, and the choice of anticonvulsants for seizures. There is little evidence that outcome in perinatal asphyxia is helped by the use of therapies to reduce raised intracranial pressure, so mannitol is not used in many centres. The value of cerebral ultrasound in determining cerebral oedema is very questionable and it is now recognised that antenatally diagnosed cystic adenomatous malformations of the lung can regress, obviating the need for lobectomy. The infusion dose of tolazoline is given as 0.1 mg/kg/hour; do they mean this or is this a printing error? These are minor quibbles as most of the management decisions relating to these points will be conducted at a senior level, but for juniors who use this book it would be helpful to know that not all questions have only one answer.

    The one area in which it is important to state the opinion given is contentious, is the use of 40%, rather than 100% oxygen for resuscitation. It is important that all personnel called on to resuscitate newborns are aware of the local policy.

    The sections on caring for the family and the dying baby are extremely well written, particularly when considering the size and scope of the book. I recommend anyone working in this area to read them. The ethical and personal issues which have to be faced are clearly, succinctly and compassionately addressed.

    The editorial team should be congratulated on producing such a compact yet useful book which, I am sure, will find its way onto many neonatal units.