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Paediatric Toxicology Handbook of Poisoning in Childhood.
  1. Hugh Jackson
  1. Child Accident Prevention Trust, London, UK

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    Edited by N Bates, N Edwards, J Roper, and G Volans. (Pp 411; £59.) Published in the USA by Stockton Press, 1997. Published in the UK by Macmillan Reference Ltd, 1997. ISBN 0-333-60951-4.

    The main part of this excellent book is based on the experience of the National Poisons Information Service, London, and consists of 78 chapters on poisonous drugs or chemicals, or groups of substances. Plants, fungi, and snakes are also included. Each chapter is similarly structured, with key points of presentation and management, followed by a description of the substance and its use, its toxicity, clinical effects and case reports, treatment, and references etc. There are 29 very clear pictures of poisonous plants and berries and a surprisingly long list of non-venomous snakes. Not being a toxicologist, I cannot comment on the completeness or accuracy of the information given in this main section, but the expertise of the various authors would appear to guarantee that the information given is comprehensive and practical as well as correct.

    The initial chapter of this book looks at more general aspects of poisoning. There is a detailed chapter on risk assessment and management of the poisoned child, with a list of clinical effects (for example, arrhythmias) and the agents that may cause them and also a guide to the paediatric doses of common agents used in the treatment of poisoning. The pros and cons of the major methods of management are examined—emesis and gastric lavage, whole bowel irrigation, together with the use of syrup of ipecac and activated charcoal. This is an excellent chapter.

    There is also a chapter on the epidemiology of poisoning. Considering that the book is presumably for use in the USA and Canada as well as in Australia and New Zealand and presumably Europe and elsewhere, perhaps more details could have been given of the incidence of the different types of poisons in these different countries, though the relative important inquiries to the UK and USA poisons centres are mentioned.

    The third chapter relates to the prevention of poisoning. Here again, the different approaches to the legislation on child resistant packaging in the different countries could have been mentioned, and there is no discussion on the current controversy on the use of reclosable child resistant containers compared with non-reclosables (strip and blister packs). The difficulties of carrying out and evaluating community programmes and of the education of individuals is rightly stressed.

    Altogether a very useful, high quality, and well produced book.

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