Analysis of blood gas can be a daunting task. However, it is still one of the most useful laboratory tests in managing respiratory and metabolic disorders. Busy medical students have struggled ineffectively with Hasselbach's modification of the Henderson equation, been torn between the Copenhagen and the Boston schools of thought; and lately, been confronted with the radically different strong-ion approach. In modern medical practice, the health provider's time is precious: it is crucial to retain focus on those aspects of clinical medicine that are of key importance. Adoption of an algorithm-based approach in the study of topics that are hard to understand (particularly those that are rooted in clinical physiology) can be extremely advantageous. Handbook of Blood Gas/Acid-Base Interpretation, 2nd edition, is organized in a logical sequence of flow charts that introduce concepts and gradually build upon them. This approach facilitates understanding and retention of the subject matter. Medical students, residents, nurses, and practitioners of respiratory and intensive care will find it possible to quickly grasp the principles underlying respiratory and acid-base physiology, and apply them effectively in clinical decision making.

Physicians, nurses, and safety experts comprehensively review sedation and analgesia to provide a completely new reference guide to safe sedation practices consistent with existing guidelines. Starting with an integrated review of the basic physiology and neurobiology of the sedated state, the authors proceed through clinical guidelines and practices, and conclude with an examination of quality-outcome measures and processes. They also review current mandates for safe sedation practices and address the key clinical issues of pharmacology, monitoring, and recovery. Special tables and figures throughout the book summarize protocols, regulatory requirements, recommended dosages, monitoring requirements, and quality assurance tools.

Millions of procedures, surgical and non-surgical, are performed around the world each year. Management of perioperative pain is of great importance to patients, and a critical management issue for physicians and other health professionals who provide perioperative care. Healthcare facilities and national accrediting organizations have established standards surrounding proper management of perioperative pain. There is now an increased burden on every hospital and training program to ensure that healthcare providers understand the essentials of pain management and are able to recognize and treat pain in a timely fashion. Poorly controlled pain leads to patient dissatisfaction and contributes to increased morbidity and mortality, such as myocardial infarction, pneumonia, and emotional effects. Proper management, including appropriate pharmacologic management and regional analgesic techniques, can improve function and shorten length of hospital stay. Patients who are undergoing procedures under sedation or anesthesia need to receive adequate pain relief with drugs or regional anesthetic techniques. In the recovery room following the procedure, the staff taking care of the patient needs to be properly trained to diagnose and treat post-procedural pain. Part of the Oxford American Pain Library, this concise, evidence-based clinical guide serves as a tool for every clinician who wishes to understand the basic mechanisms, pharmacology, invasive and noninvasive treatment modalities, guidelines and development of pain management protocols. The authors address new technologies, chronic pain issues, running an acute pain service, opioid and non-opioid pharmacology (including newly approved drugs), epidural and other regional anesthesia, and special populations such as pediatric patients, the elderly, and patients with a co-existing disease.

Anesthesiology: A Comprehensive Review for the Written Boards and Recertification is a high-yield, streamlined study aid. It contains more than 1000 updated, realistic multiple-choice questions tailored to the question content of recent American Board of Anesthesiology (ABA) exams. To maximize reading efficiency, key messages are repeated and highlighted in the bullets. While focusing on most-frequently tested keywords by the ABA, this book also covers new "emerging" topics such as patient safety, statistics, and ethics. Well-chosen illustrations and graphs are used to enhance the learning experience. Also novel is a high-yield summary of the 60 most frequently tested topics and concepts to be reviewed just before taking the boards. With this book as guidance, readers will be able to efficiently prepare for the written primary certification or recertification anesthesiology board exam.

This book helps prepare anesthesiology residents for safe practice of pediatric anesthesia. It features 26 index cases, which are classic clinical scenarios - all covering a spectrum of pediatric anesthesia, neuro-anesthesia, cardiac anesthesia, regional anesthesia, and anesthesia and critical care medicine. Chapters are divided into case-based formats with each chapter containing a scenario layout, useful equipment, major teaching points for an after simulation debrief, and a learner evaluation form. This tiered education method will assist learners in working though essential team building skills, increasing their knowledge base and finally having concrete items in which to further their professional skills. Each chapter starts with a learning objective and presents the simulation case before launching into the case progression, detailing how the simulated patient's vital signs, physical exam findings, and clinical picture change over the course of the simulation. They are concluded with a master checklist of items the learner should accomplish during the course of the simulation along with a section summary and important teaching points. Pediatric and Adult Anesthesiology Simulation Education is designed to be used by both academic programs and private practice groups. It is beneficial to anesthesiology residents who are currently in training as well as those who have recently graduated and are preparing for board exams.

The understanding of pain has undergone extraordinary development over the last 25 years. Half of all medical visits are initiated because of pain. The need for all clinicians and trainees to have a foundational knowledge of pain has become more critically important than ever. Not surprisingly, most books on pain medicine are almost all written by "pain management doctors," physicians who've trained in "pain medicine" and devote their lives to treating pain. However, the burden of pain extends to all doctors, not just those who treat it every day. Managing Pain: Essentials of Diagnosis and Treatment offers a fundamental guide on the diagnosis and therapy of frequently encountered pain conditions for non-pain physicians and clinicians. Written using easily-accessible language, this book first reviews the basics of opioids and other therapies, including psychotherapy and complementary modalities. The second part of the book presents clinically-relevant cases chosen to reflect those conditions most frequently encountered by primary care providers. Edited by world-renowned experts in pain medicine, with many chapters written by non-pain physicians who are experts in their respective specialties, Managing Pain: Essentials of Diagnosis and Treatment is a useful guide for the non-pain-trained healthcare provider who is on the frontlines treating chronic pain.

Essentials of Palliative Care is a to-the-point, clinically oriented resource for all members of the multidisciplinary palliative care team and trainees. It covers practical clinical topics, including assessment of the patient and pain and symptom management, and practical non-medical topics central to providing effective palliative care, including psychological management, guidance on how to help patients and their families through the many healthcare decision points they face, and sensitivity to the goals and culture of the patient. Review questions, with detailed answers, provide a convenient way for readers to test their knowledge.

Features:

. Concise, comprehensive, clinically focused

. Multiple choice review questions, with detailed answers

. Expert contributors from leading institutions

. Coordination of care by palliative care team a major focus

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Brain Injury is the second volume in the book series, Molecular and Cellular Biology of Critical Care Medicine. In this volume, a group of internationally regarded experts in important areas of neuroscience and neurointensive care research address the molecular and cellular basis of acute brain injury. This text covers acute brain injury within a context relevant to the care of patients with critical neurologic injuries such as cardiac arrest, trauma and stroke. It includes recent data pertaining to established pathways such as neurotransmission, exitotoxicity, ionic-mechanisms, oxidative stress, inflammation, and cerebral vascular injury. In addition, rapidly developing areas such as cell signaling, adenosine pharmacology, apoptosis, mitochondrial dysfunction, neurocytoskeletal changes, and the role of trophic factors are reviewed from the level of in vitro modeling to human data. Other topics covered that are highly clinically relevant include the effect of genetic background and gender differences in outcome after brain injury, preconditioning, and the effects of currently used anesthetics and sedative agents in patients with brain injury.

Opioid treatment for chronic pain has been popularized over the past few decades, and opioid usage has increased several-fold. Opioid treatment of chronic pain increased for several reasons: a sense that chronic pain had previously been undertreated; strong underwriting of medical education by drug companies anxious to sell new "designer" opioids; lifting of the stigma associated opioids, particularly as pain advocacy reestablished opioids as necessary and appropriate treatment for acute and cancer pain. What has emerged is that there are several limitations to chronic opioid treatment. What has become clear in this unfortunate history is that non-specialists were persuaded to prescribe opioids before they could possibly understand the complexity of the treatment. So great were the pressures to prescribe, from drug companies, advocates, and many well-meaning people who saw opioids as the panacea for suffering, opioids were prescribed indiscriminately. It became almost impossible to deny opioids without seeming inhumane. What we learned though, is that while carefully selected and managed opioid therapy can benefit certain patients, casual use fails in several respects. What is needed then is a vast educational effort to help clinicians understand some of the complexities of opioid therapy, and in particular, how to select patients, and subsequently manage and monitor so as to achieve continued efficacy without losing control of pain and drug use. While no one educational effort can solve the whole problem, this book aims to provide clinicians with expert opinion on how to manage certain common scenarios involving opioid management of chronic pain. It will provide the reader not only with an easy reference to the management of common clinical scenarios where opioids are involved, but also with in depth analysis of the difficult issues surrounding a treatment that is both uniquely effective and potentially harmful.

Those who do not feel pain seldom think that it is felt. SAMUEL JoHNSON, The Rambler, no. 48 (September 1, 1750) Who among us has not experienced the suffering of a patient with chronic disease, who in addition to the vicissitudes of fatigue, anxiety, and frustration, must also deal with the suffering of pain? Who among us has not considered, and then reconsidered, whether a patient's complaints are worthy of a narcotic and thence worried about the social and legal implications of chronic use? Who among us has not refused pain medications to our patients for fear that use was turning into abuse? Finally, who among us would not have liked a clinical guide to a myriad of syndromes, all of which have pain as their common denominator, in the hopes of developing some strategy to prioritize treatment. Our purpose in preparing The Pain Management Handbook is to provide the informa tion needed by clinicians to develop strategies that optimize pain management. It is the goal of the editors and authors that the present handbook, above all else, will be clinically useful. Its aim is to provide practical information regarding the diagnosis and treatment of disorders causing pain, along with tables and graphics to provide the busy practitioner with rapid access to relevant data.

Over the last thirty years, the concern of Pain Medicine practitioners about the potential for their patients to develop a dependence on opioids has left opioid therapy as a largely underutilized treatment. While there is no simple answer to chronic pain, opioids remain the only class of drugs capable of providing relief to patients experiencing serious pain. Opioid Therapy in the 21st Century, Second Edition fills a dearth of clinical knowledge about analgesics to aid practitioners in weighing the risks versus the benefits of opioid therapy for their chronic pain patients. Part of the Oxford American Pain Library, this concise guide serves as a practical, user-friendly reference for physicians across the range of primary care and medical specialties. It includes an overview of appropriate clinical applications of opioids, covering such topics as opioid pharmacology, route selection, and individualization of therapy, as well as strategies for managing and mitigating the risk of abuse, addiction, and diversion. There are also special sections dedicated to the unique needs of pediatric, geriatric, and palliative care patient populations. This second edition discusses opioids approved for use since publication of the first edition, such as Butrans (buprenorphine patch); fentanyl patch and nasal spray; abuse resistant version of Oxycontin; and Embeda (morphine sulfate). Approved indications for older opioids as well as clinical trial information have also been updated.

Thousands of articles and many books have been published on the acquired immunodeficiency syndrome (AIDS). There are, however, no studies or case reports and only several articles published on the anesthetic considerations for a person with AIDS or in pain with AIDS. There is no literature on the pain management of AIDS patients. Writing on this subject must be considered trailblazing. The reason anesthesiologists should know about AIDS has rapidly extended from concern over transmission of infection to anesthetic and analgesic considerations. The anesthesiologist may also be part of a pain management team on either an acute or a chronic pain service. The requirement may be to treat an HIV -positive or AIDS patient acutely postoperatively or in consult to a psychiatric, medical, or surgical service. In a pain clinic setting, the anesthesiologist may be concerned with diagnosis, treatment, or referral for other multidisciplinary consultation. The earlier question of central nervous system involvement in AIDS is now moot, rapidly replaced with the knowledge that the eNS, if not primarily infected, is so shortly thereafter. Protected by the blood-brain barrier, the eNS becomes both a sanctuary and reservoir for HIV. Because neurologic complications of HIV are common, and since knowledge of the nervous system is essential for anesthetic and pain management, it is important to review HIV infection of the nervous system.

This book provides a comprehensive overview of current standards of anesthesia and intensive care in neonates and children, with a view to promoting standardization in clinical practice.

The first part of the book, devoted to issues in intensive care, opens by considering scoring systems for the assessment of sick children. The diagnosis, prevention, and management of ventilator-associated pneumonia are then discussed, and the roles of high-frequency oscillatory ventilation and noninvasive respiratory support are reviewed. Further chapters address procedural sedation and analgesia in children, the progress toward open ICUs with liberal visiting policies, and advances in long-term home mechanical ventilation.

In the second part of the book, a range of important topics in anesthesia and perioperative medicine are discussed. After a review of safety issues, current trends in pediatric regional and locoregional anesthesia are described and a synopsis is provided on current knowledge regarding the use of central blocks in infants and children. Subsequent chapters are devoted to awareness monitoring, single-lung ventilation techniques, anesthesia in the context of severe prematurity, and emergence delirium.

"Pediatric Anesthesia, Intensive Care and Pain: Standardization in Clinical Practice" will be an extremely useful source of information for both novices and more experienced practitioners in the field."

The administration of intravenous fluids is one of the most common and important therapeutic practices in the treatment of surgical, medical and critically ill patients. The international literature accordingly contains a vast number of works on fluid management, yet there is still confusion as to the best options in the various situations encountered in clinical practice. The purpose of this volume is to help the decision-making process by comparing different solution properties describing their indications, mechanisms of action and side-effects according to physiologic body water distribution, electrolytic and acid-base balance, and to clarify which products available on the market represent the best choice in different circumstances. The book opens by discussing in detail the concepts central to a sound understanding of abnormalities in fluid and electrolyte homeostasis and the effect of intravenous fluid administration. In the second part of the monograph, these concepts are used to explain the advantages and disadvantages of solutions available on the market in different clinical settings. Body Fluid Management: From Physiology to Therapy will serve as an invaluable decision-making guide, including for those who are not experts in the subject.

At the turn of the century it is appropriate to take stock of this relatively young but rapidly developing subject. For the first time, this book brings together information on the status of obstetric regional analgesia in many parts of the globe, and on the intriguing variability of maternal attitudes towards it. Advances in the field over the last decade in new applications, new drugs and techniques and new research tools are also reviewed. Controversial topics such as the effects of regional analgesia on the progress of and outcome of labour, the indications, contraindications and complications, and the place of regional anaesthesia for operative delivery are discussed by numerous experts in the field. The problem of consent and medicolegal aspects are also addressed. Regional Analgesia in Obstetrics should be read by all those involved in the medical care of women in childbirth. Professor Felicity Reynolds is Emeritus Professor of Obstetric Anaesthesia, St Thomas' Hospital, London, UK.

Previously only available as part of "Stux"'" Acupuncture" "-" "Textbook and Atlas," the selector is now available in a package together with three new posters which depict the most important acupuncture points topographically. Photographs of the human skin were deliberately not used, as they do not allow the structures directly beneath the surface to be portrayed. To ensure a clear and exact representation, the bones have been drawn in the background. The selector presents the various categories of acupuncture points in tabular form, enabling the user to recognize the most important points of a meridian at a glance. An indispensable aid for every acupuncturist.

When a person suffers from advanced, progressive illness, palliative care -- treatments that improve the physical and psychological quality of life of patients and their families -- can be just as important as treatments that aim to slow or prevent disease progression. Aimed at general practitioners and trainees in the field, Palliative Care in Clinical Practice offers an accessible and practical introduction to palliative medicine, including a chapter devoted to each of the key areas of symptom management. Clearly and concisely written and fully illustrated throughout, it will be a useful resource for all healthcare professionals who wish to gain an understanding of this important aspect of medicine.

Back pain is one of the most common reasons cited by patients seeking medical help, and it is a leading cause of time off work and long term disability. Causes of back pain are complex and many health care professionals devote a substantial amount of their time dealing with it. The initiating event leading to back pain is often compounded by other factors leading to maladaptive behaviour and prolongation of pain. This pocketbook will summarise the current literature on management of back pain and provide evidence-based, practical guidelines for clinicians.

Focused on rotations in regional anesthesia and chronic pain, this book provides a structured review of the concepts covered in the American Board of Anesthesiology in-training exam. The first section of the book covers regional anesthesia with dedicated chapters on basic science, acute postoperative pain, and nerve blocks for neuraxial, lower and upper extremity blocks, and head and neck. The second section on chronic pain includes chapters on basic science and common pain conditions - including craniofacial pain, CRPS, neuropathic pain, and cancer pain. This section closes on multimodal analgesia and other treatment approaches. Each chapter presents a common clinical topic and is organized by indications, preparation, technique, complication, prevention, clinical pearls, and related ABA key points. Highlights must-know information in bold throughout the text. Concise, practical, and easy-to-read, this book will aid anesthesiology residents, certified nurse anesthetists, and medical students in their study regarding patient care practices on regional anesthesia and chronic pain. The book will also be useful to residents going into regional anesthesia and pain medicine subspecialties during the year of their anesthesiology training.

It has been estimated that 60 million Americans suffer from pain. There has been an explosion in pain research, new pharmaceuticals, the recognition of complementary and alternative therapies, interventional techniques and surgery, professional pain societies and providers with expertise in pain management. The most common condition seen in primary care settings and in pain clinics is lower back pain. Several studies indicate that primary care providers feel ill-prepared to deal with pain issues. Back and neck pain, myofascial pain, whiplash and fibromyalgia are particularly challenging and troublesome for this group. There are multiple reasons for this discomfort, including lack of training, absence of guidelines, concerns about addiction risk and many other issues. As part of the Oxford American Pain Library, this practical handbook is designed to serve as a concise yet authoritative resource on diagnosing and treating back and neck pain. Co-authored by two primary care physicians and a nurse practitioner with extensive expertise in pain medicine and management, the book is tailored to the needs of busy health care professionals treating patients in the primary care setting, and focuses on essential clinical information for physicians, nurse practitioners, and physician assistants in family practice, and internal medicine. In addition to covering all aspects of diagnosis, treatment-both pharmacological and non-pharmacological, and ongoing management of back and neck pain, the handbook also features a section dedicated to similar conditions of myofascial pain, whiplash and fibromyalgia. In addition to covering traditional clinical areas such as pathogenesis, co-morbidities, pharmacologic and non-pharmacologic treatments, the book also presents an array of practical tools and features such as screening tools for easy diagnosis, disability assessment tools, tips on best questions to ask, useful checklists and additional patient resource information. The pocket-sized format, concise chapters, multiple charts and graphs and bulleted highlights are ideal for all providers needing a quick, easily accessible, portable reference on back and neck pain.

Managing Cancer Breakthrough Pain is a comprehensive review of cancer breakthrough pain (cBTP) and rapid-onset opioids (ROO), the only treatment approved for cBTP episodes. The book was originally commissioned due to the current rapid growth of the ROO market and the epidemic of ROO abuse. This book will review the historical background and definitions of cBTP and ROOs, assessment methods to determine types of cBTP, US- and EU-approved ROOs, case studies (which will provide practical applications of ROO treatment options), ROO abuse and screening methods, and the FDA-mandated TIRF REMS Access program (Transmucosal Immediate Release Fentanyl Risk Evaluation and Mitigation Strategies Access program). Busy healthcare professionals who have a basic understanding of cancer pain but want to learn more about cBTP and ROOs will benefit from this concise guide that will help them quickly understand the complexities of cBTP episodes and ROOs.

The First International Symposium on "Pain and Kampo (Japanese Herbal Medicine)" took place in Tokyo in October, 1992. More than 700 registrants participated, with 12 registrants from seven overseas countries. This book contains summaries of the presentations at this meeting and is published in order to provide up-to-date information to a much wider audience. In China, traditional herbal medicine has been used for more than 3000 years while in Japan, its use has been documented for more than 1000 years, albeit with some changes to the original Chinese formulations. Recently there has been a revival of interest in herbal medicines for several reasons. There is a rapid growth in the number of senior citizens who frequently require the attention of modern medicine. In particular, there has been an increase in the number of patients who suffer from chronic diseases which are difficult to treat, e.g., arteriosclerosis, Alzheimer's disease, chronic pain syndromes, etc. It has become evident that traditional Oriental herbal medicines could playa role in the management of these and other conditions.

Hyperbaric oxygen application has now become a useful technique for both diagnostic and therapeutic purposes in CNS, cardiovascular and respiratory diseases, as well as in soft-tissue and orthopaedic pathologies and haematologic disorders. With a specific didactic approach, supported by numerous illustrations and tables, this volume aims to present all aspects of oxygen application under pressure not only to resolve some clinical problems, but also to improve recovery or to modify a negative illness evolution. Both scientists and practitioners will find this work a useful and updated reference book.