Toxicology Handbook, 2nd Edition

The LITFL team is, we think, justifiably proud of Mike’s valuable contribution to rendering the esoterica of clinical toxicology accessible with his work on the original Toxicology Handbook. Now, after much anticipation, the second edition has been released.

For a forthright review of the Second edition of the Toxicology Handbook, the LITFL team turned to an esteemed emergency medicine educator, Dr Trevor Jackson. This is what he had to say:

Firstly, to set the scene, I’m an emergency physician working in a tertiary setting with a Tox service that calls the shots for most daily poisoning decisions. Despite this (or because of this?) I’ve been a regular user of the first edition of this handbook in an attempt to maintain some knowledge in this field nonetheless. So I’m no expert and I eagerly unwrapped the modest cardboard parcel containing the new second edition as soon as it arrived.

For an individual without a hint of green in his wardrobe, the green glow emanating from its contents was startling. It’s a very very green book from cover to cover. But as this review is not destined for Vogue I’ll move on…

Things I like?

As before, there is a great balance struck between size/portability and level of detail. The clear, functional and thorough discussion of individual poisons from a risk-based framework is still spot on, with a few extra agents thrown in this time including local anaesthetics, tramadol and button batteries for example. Toxinology with its many emerging controversies is dealt with expertly, an essential for antipodean clinicians. I suspect however many future owners of this text reside in lands less blessed with daily encounters with life threatening animals so these chapters may remain unthumbed for them. New additions are sections on the general approach to issues arising from tangles with mushrooms, plants and snakes and emerging antidotal therapies, most noteworthy is the use of liquid lipid emulsion.

Things I didn’t like?

Green. Oh, and Chapter two entitled ‘Specific considerations’ is a messy miscellany. I think an opportunity to correct this from the first edition has been missed. The contents here are excellent especially those pertaining to dependence and withdrawal, toxidromes and key clinical issues, but they’d make much more sense if separated into new themed chapters. My last albeit minor gripe relates to the books handling of the 12 lead ECG, a vital test in poisoned patients. Although the appendiceal ECGs are of better quality this time, I’d like to see them with more annotations actually within the earlier chapter that explains the value of this tool.

So, should you buy the new model or stay with your old faithful first edition?

Many new books are already dated by the time they get to the bookstore shelf, but I rate this two thumbs up. Concise, evidence based and well referenced, I’ll be using the new version regularly (despite the assault on my retina).

Dr Trevor Jackson MBBS FACEM F.UCEM
Emergency Physician
Perth WA

Trevor declared the following potential conflicts of interest:

1. Free review copy of this text provided by the publisher Elsevier, many thanks.
2. Opinions above are the author’s only, no other UCEM Fellows contributed to the review.