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Critical Care Nursing Body, Mind, Spirit
206
BR. J. DIS.
CHEST:
tory data and radiographs, thereby enabling safe and efficient patient management. It is not meant to replace textbooks that deal in detail with the various aspects of respiratory physiology etc. The list of contents is clearly arranged, the book being divided into three parts. Part one deals with the basicsof respiratory assessment, starting with a fairly lengthy chapter on the importance of interviewing the patient and obtaining a full and accurate history; suggestions are made on how questions should be phrased and the necessity to observe the patient’s reactions and attitudes. It states the benefit of giving plenty of time for this in surroundings which the patient feels are secure and private. The terminology and descriptions used for common symptoms such as coughing and sputum production are also given, The following chapter in this section methodically goes through the techniques of physical examination, inspection, palpation, percussion and auscultation-not purely of the thorax, but also briefly of the head, neck and abdomen and the examination of the extremities. The part bf auscultation talks about the ideal specifications of a stethoscope and how to use it correctly, aswell as a description of breath sounds and their significance. Chapters 3,4 and 5 deal clearly with clinical laboratory studies, and the interpretation of blood gases and lung function tests. Techniques such as the actual taking of arterial blood samples are mentioned. The chapter on the clinical application of chest radiographs has a short description of the physics of radiography and how standard and special views are used for assessment. There is a good attempt to demonstrate various abnormalities by reproducing chest radiographs, but they are small and therefore not very clear. However, the supporting text is good and would give a student a good idea of what to look for on an actual radiograph. Part one finishes with a chapter on the particular considerations in the respiratory assessment of the newborn and the child. Part two, on advanced assessmenttechniques for the critically ill patients in intensive care units, presents well the clinical assessment of
VOL.
80 NO.
2
cardiopulmonary function and the parameters used to evaluate ventilation, haemodynamics and tissue oxygenation. It also discusses the nutritional assessment and requirements of a patient with respiratory disease. The final part of the book is a nine-page synopsisof frequent clinical findings in common respiratory disorders. Throughout the book most of the diagrams are clear and there are well organized tables giving normals, variables, interpretations and their significance; the text is comprehensive and well presented. This would be a valuable reference book for therapists, nurses and medical students and junior doctors concerned in the care of respiratory patients. M. Lunt
Critical Care Nursing Body, Mind, Spirit Cornelia Vanderstaay Kenner, Cathie E. Guzzetta & Barbara Montgomery Dossey Toronto: Little, Brown & Co. 1985. 2nd edition. Pp. 1250. Price $35.95 This is the second edition of an American book written primarily for nurses involved in Intensive Care. Its contents are divided into nine basic parts dealing with all types of patients seen in Intensive Care Units, and all aspects of their diagnosis, management, treatment and care are covered. Particular emphasis is placed throughout the book on seeing the patient as a person and the treatment, not only of the disease, but of that person’s hopes, anxieties, apprehensions, and those of his family. There are six parts relating to specific types of patients, comprising: The Critically 111Adult with Respiratory Problems; Cardiovascular Problems; Neurological/ Neurosurgical Problems; Renal Problems; and The Critically Ill Adult Following Trauma. Each part is well written, easy and enjoyable to read and contains clear and informative diagrams. Aetiology, anatomy and physiology, investigation, treatment and management are all well covered and each chapter contains an interesting case study which consolidates the text. The chapters begin with a section on
BOOK
learner objectives which can be used to gauge one’s knowledge and progress, and end with a section on directions for further research. Overall I found this an immensely readable book: the clinical chapters are well laid out and make quick reference easy. It is perhaps a little expensive for most nurses to purchase individually but it would certainly, if kept in the I.T.U., be well used as a teaching and reference guide for nurses and may be of use to junior medical staff being involved in intensive care work for the first time. H. Summers
Lung Cancer
Joseph Aisner Edinburgh: Churchill Livingstone. 1985. 1st edition. Pp. 336. Price f40.00 Nowadays every season produces a fresh crop of books on lung cancer. Unfortunately, there are far more new books on the subject than there are new things to say about it. Nevertheless, this book, although very conventional in structure, is unusually successful and may well be the best to come out recently. It is well produced, reasonably concise and uniformly easy to read. This is an unusual feat considering that there are 29 different authors in all. The contents of the book are aimed at the clinician rather than the laboratory research worker and the chapters follow a fairly conventional pattern with half the book devoted to pathology and natural history, while the other half deals with each method of treatment including surgery. Small cell carcinoma of the lung is dealt with separately in four chapters. Each section is a balanced and concise review and in almost every instance can be strongly recommended. There are a number of most
REVIEWS
enlightening criticisms of trial design and methodology which emphasizes how much of the lung cancer literature is uninterpretabie. The most important studies are analysed in some detail and this makes the book an excellent source of reference. The two weakest chapters are those on surgery and mediastinal staging. These both produce maps of thoracic lymph nodes which disagree with each other. One of these chapters gives excessiveemphasis to transbronchial needle aspiration of mediastinal nodes, while the other dismisses preoperative staging in a few sentences and implies that preoperative scansare not really necessary. However, these chapters are balanced by excellent and thoughtful reviews of the chemotherapy of non-small cell lung cancer and the role and potential of immunotherapy. A thoracic physician’s heart may sink at the thought of reading yet another book detailing the problems and lack of progress in the treatment of lung cancer. This book does it better than most and is probably the best available at present and likely to remain so for some time. It can therefore be strongly recommended to the clinician, particularly those involved in clinical research. D. M. Geddes
Correction
The bibliographic details heading Dr P. Sherwood Burge’s review of Occupational Lung Disease in Vol. 79, p. 312, are incorrect. The correct details are: Ed. J. Bernard L. Gee Edinburgh: Churchill Livingstone. 1984. 1st edition. Pp. 254. Price $30.00
BR. J. DIS.
CHEST:
tory data and radiographs, thereby enabling safe and efficient patient management. It is not meant to replace textbooks that deal in detail with the various aspects of respiratory physiology etc. The list of contents is clearly arranged, the book being divided into three parts. Part one deals with the basicsof respiratory assessment, starting with a fairly lengthy chapter on the importance of interviewing the patient and obtaining a full and accurate history; suggestions are made on how questions should be phrased and the necessity to observe the patient’s reactions and attitudes. It states the benefit of giving plenty of time for this in surroundings which the patient feels are secure and private. The terminology and descriptions used for common symptoms such as coughing and sputum production are also given, The following chapter in this section methodically goes through the techniques of physical examination, inspection, palpation, percussion and auscultation-not purely of the thorax, but also briefly of the head, neck and abdomen and the examination of the extremities. The part bf auscultation talks about the ideal specifications of a stethoscope and how to use it correctly, aswell as a description of breath sounds and their significance. Chapters 3,4 and 5 deal clearly with clinical laboratory studies, and the interpretation of blood gases and lung function tests. Techniques such as the actual taking of arterial blood samples are mentioned. The chapter on the clinical application of chest radiographs has a short description of the physics of radiography and how standard and special views are used for assessment. There is a good attempt to demonstrate various abnormalities by reproducing chest radiographs, but they are small and therefore not very clear. However, the supporting text is good and would give a student a good idea of what to look for on an actual radiograph. Part one finishes with a chapter on the particular considerations in the respiratory assessment of the newborn and the child. Part two, on advanced assessmenttechniques for the critically ill patients in intensive care units, presents well the clinical assessment of
VOL.
80 NO.
2
cardiopulmonary function and the parameters used to evaluate ventilation, haemodynamics and tissue oxygenation. It also discusses the nutritional assessment and requirements of a patient with respiratory disease. The final part of the book is a nine-page synopsisof frequent clinical findings in common respiratory disorders. Throughout the book most of the diagrams are clear and there are well organized tables giving normals, variables, interpretations and their significance; the text is comprehensive and well presented. This would be a valuable reference book for therapists, nurses and medical students and junior doctors concerned in the care of respiratory patients. M. Lunt
Critical Care Nursing Body, Mind, Spirit Cornelia Vanderstaay Kenner, Cathie E. Guzzetta & Barbara Montgomery Dossey Toronto: Little, Brown & Co. 1985. 2nd edition. Pp. 1250. Price $35.95 This is the second edition of an American book written primarily for nurses involved in Intensive Care. Its contents are divided into nine basic parts dealing with all types of patients seen in Intensive Care Units, and all aspects of their diagnosis, management, treatment and care are covered. Particular emphasis is placed throughout the book on seeing the patient as a person and the treatment, not only of the disease, but of that person’s hopes, anxieties, apprehensions, and those of his family. There are six parts relating to specific types of patients, comprising: The Critically 111Adult with Respiratory Problems; Cardiovascular Problems; Neurological/ Neurosurgical Problems; Renal Problems; and The Critically Ill Adult Following Trauma. Each part is well written, easy and enjoyable to read and contains clear and informative diagrams. Aetiology, anatomy and physiology, investigation, treatment and management are all well covered and each chapter contains an interesting case study which consolidates the text. The chapters begin with a section on
BOOK
learner objectives which can be used to gauge one’s knowledge and progress, and end with a section on directions for further research. Overall I found this an immensely readable book: the clinical chapters are well laid out and make quick reference easy. It is perhaps a little expensive for most nurses to purchase individually but it would certainly, if kept in the I.T.U., be well used as a teaching and reference guide for nurses and may be of use to junior medical staff being involved in intensive care work for the first time. H. Summers
Lung Cancer
Joseph Aisner Edinburgh: Churchill Livingstone. 1985. 1st edition. Pp. 336. Price f40.00 Nowadays every season produces a fresh crop of books on lung cancer. Unfortunately, there are far more new books on the subject than there are new things to say about it. Nevertheless, this book, although very conventional in structure, is unusually successful and may well be the best to come out recently. It is well produced, reasonably concise and uniformly easy to read. This is an unusual feat considering that there are 29 different authors in all. The contents of the book are aimed at the clinician rather than the laboratory research worker and the chapters follow a fairly conventional pattern with half the book devoted to pathology and natural history, while the other half deals with each method of treatment including surgery. Small cell carcinoma of the lung is dealt with separately in four chapters. Each section is a balanced and concise review and in almost every instance can be strongly recommended. There are a number of most
REVIEWS
enlightening criticisms of trial design and methodology which emphasizes how much of the lung cancer literature is uninterpretabie. The most important studies are analysed in some detail and this makes the book an excellent source of reference. The two weakest chapters are those on surgery and mediastinal staging. These both produce maps of thoracic lymph nodes which disagree with each other. One of these chapters gives excessiveemphasis to transbronchial needle aspiration of mediastinal nodes, while the other dismisses preoperative staging in a few sentences and implies that preoperative scansare not really necessary. However, these chapters are balanced by excellent and thoughtful reviews of the chemotherapy of non-small cell lung cancer and the role and potential of immunotherapy. A thoracic physician’s heart may sink at the thought of reading yet another book detailing the problems and lack of progress in the treatment of lung cancer. This book does it better than most and is probably the best available at present and likely to remain so for some time. It can therefore be strongly recommended to the clinician, particularly those involved in clinical research. D. M. Geddes
Correction
The bibliographic details heading Dr P. Sherwood Burge’s review of Occupational Lung Disease in Vol. 79, p. 312, are incorrect. The correct details are: Ed. J. Bernard L. Gee Edinburgh: Churchill Livingstone. 1984. 1st edition. Pp. 254. Price $30.00