Clinical Management Notes and Case Histories in Cardiopulmonary Physical Therapy.

Clinical Management Notes and Case Histories in Cardiopulmonary Physical Therapy Reid WD, Chung F. Thorofare, NJ 08086, Slack Inc, 2004, paperback, 304 pp, illus, ISBN: 1-55642-568-6, $34.95.

This book is divided into 4 sections, including a section devoted to answer guides and another containing 5 appendixes. Section 1 is titled "Cardiopulmonary Assessment and Management," and contains information on clinical decision making, chart reviews and patient interviews, physical examination, and a number of examination techniques (eg, auscultation, arterial blood gas interpretation, laboratory investigation, and electrocardiogram interpretation). The management portion covers a number of techniques, including breathing exercises, airway clearance, and mechanical ventilation. This section also includes overview chapters on respiratory conditions, cardiopulmonary conditions, and surgical interventions. The chapters in this section cover some of the most common respiratory, cardiovascular, and surgical conditions seen by physical therapists and are organized by etiology, pathophysiology, clinical presentation, and disease course. Information on medical and physical therapy interventions also is included. The interventions are very brief outlines that can be used as guidelines for treatment.

The chapters in section 2, "Case Histories," discuss several cases dealing with surgical and medical conditions, chronic respiratory conditions, chronic respiratory conditions with an acute exacerbation, and respiratory and cardiac conditions. The chapters in section 2, "Case Histories," discuss several cases dealing with surgical and medical conditions, chronic and acute respiratory conditions, and conditions involving both the cardiovascular and pulmonary systems. The case histories in this section are a rich source of information on many of the most common cardiac and pulmonary conditions likely to be treated by a physical therapist.

Section 3 provides the answers to the questions posed in the assessment (ie, examination), management, and intervention chapters, as well as questions generated from the case histories.

Section 4, the final section, contains 5 appendixes. Each appendix presents evidence-based information in the form of critical reviews of the literature on clinical trials of various physical therapy techniques. For example, reviews of clinical trials on positioning, exercise programs, and secretion removal in patients with cystic fibrosis can be found in this section.

Overall, this is a very interesting text, loaded with valuable, well-referenced information. The authors have ranked the various techniques they present by level of evidence. Normal values for heart rate, respiratory rate, oxygen saturation, and blood pressure can be found, along with information on normal and abnormal breath sounds. Although each chapter presents some information in narrative form, a significant amount of factual material is organized in tabular and chart form, making this a very user friendly text. Normal arterial blood gas values, pulmonary function test values, sputum culture information, contraindications and precautions for exercise, graded exercise test protocols, and optimal postural drainage positions also are found throughout this text. This book has something to offer both the new and experienced clinician as well as the student and the teacher. Students and instructors should find the case histories and evidence-based format particularly useful.

John P Sanko, PT, EdD

University of Scranton

Scranton, Pa

Dr Sanko is Associate Professor and Chair of the Department of Physical Therapy. He teaches cardiovascular and pulmonary physical therapy, research, and sports physical therapy.