The Washington Manual of Critical Care

Marin H. Kollef, M.D., Timothy J. Bedient, M.D., Warren Isakow, M.D., Chad A. Witt, M.D., editors, Department of Medicine

Lippincott Williams & Wilkins (2007)

Following in the footsteps of “The Washington Manual of Medical Therapeutics,” the best-selling medical text worldwide in its 32nd edition, a group of residents and attending physicians from the Department of Medicine have released “The Washington Manual of Critical Care.” This first edition is designed for health-care providers who care for critically ill patients.

Spearheading the effort to create the manual were two faculty and two resident physicians: Marin H. Kollef, M.D., professor of medicine and head of the medical intensive care unit at Barnes-Jewish Hospital; Warren Isakow, M.D., assistant professor of medicine; and Timothy J. Bedient, M.D., and Chad A. Witt, M.D., senior residents in the Department of Medicine. Together, the four wrote many of the chapters and edited those written by other physicians.

The manual took nearly two years to complete and represents the combined work of 75 residents, fellows and attending physicians from the departments of internal medicine, neurology, surgery, anesthesia and obstetrics and gynecology. The manual includes treatment algorithms for more than 80 commonly encountered problems in the intensive care unit (ICU), including septic shock, acute respiratory distress syndrome, ventilator-associated pneumonia and respiratory failure, as well as chapters on common ICU procedures and equations, nutrition and pharmacology.

Kollef, Bedient, Isakow and Witt dedicated the manual to the late Daniel P. Schuster, M.D., the Virginia E. and Sam J. Golman Chair in Respiratory Intensive Care Medicine and a professor of medicine and of radiology, who died Sept. 11, 2007.

Kollef and Bedient said the goal behind the manual was to provide physicians a concise algorithm-based tool for the management of critically ill patients.

“The motivation for writing the manual was the complex nature of critical care medicine and the expanding body of literature on the subject in recent years,” Bedient said. “There was also really no convenient critical-care text on the market. The critical care books that are out there tend to be bulky and have a lot on physiology but not much practical and specific treatment information that can be used at the bedside. We wanted to make a manual that would fit into the pocket of a white coat and provide specific evidence-based treatment guidelines.”

“Given my experience with house officers, hospitalists and intensivists, it has become clear that more innovative approaches for the acquisition of medical knowledge are needed,” Kollef said. “The manual represents the first real attempt at providing such a tool specific for this patient population.”

Keeping with the tradition of the Washington Manual series, the critical care manual is expected to be updated every three years. The authors said they hope it will become a staple in caring for critically ill patients.