Cardiopulmonary Physical Therapy: Management and Case Studies, Second Edition is a unique and succinct textbook for the classroom that blends clinical notes on assessment and management together with case-based instructional approaches to cardiopulmonary care for acute and ambulatory care patients. This one-of-a-kind text describes current approaches that cover traditional physical therapist management strategies and includes evidence-based chapters on early mobilisation and exercise training on a wide range of cardiopulmonary patient groups. The updated Second Edition presents twenty-four cases that were designed to complement each chapter topic and represent the most common pulmonary, cardiac, and neurological conditions that are typically managed in cardiopulmonary care. These cases have been carefully selected and developed over several years to illustrate a spectrum of clinical issues essential for the preparation of the entry-level therapist. The very interactive nature of the case history approach is engaging and provides the opportunity to work through many of the steps of the clinical decision-making process. Cardiopulmonary Physical Therapy: Management and Case Studies, Second Edition also includes answer guides for the questions posed in the assessment and management chapters, as well as for the twenty-four cases. New in the Second Edition: Twenty-four carefully selected evidence-based cases designed to go "hand-in-hand" with chapter topics An international perspective that is relevant to physical therapy practice in several countriesDetailed chapter on non-invasive ventilation and mechanical ventilationSeveral chapters describe early mobilisation and exercise training for a range of cardiopulmonary patient groups including those admitted to an intensive care unitFaculty will benefit from the "Talk Me Through" PowerPoint slides, which provide a great opportunity for independent learning and complement classroom teaching The two-fold evidence and case-based learning approach used by Dr. W. Darlene Reid, Frank Chung, and Dr. Kylie Hill allows for a more engaging experience. The inclusion of interactive materials will allow students to learn and develop skills to prepare themselves for their professional transition while clinicians can use the text as a reference tool.

This symposium on cerebral and coronary vascular disorders and infarcts is probably the first attempt to hold a joint discussion in this field. Despite many difficulties we feel that it has been successful and we hope that it will stimulate further interest and investigations. To hold such a meeting with scientists from far away was possible only with the assistance of Bundesminister fUr Jugend, Familie und Gesundheit, Minister fUr Hissenschaft und Forschung des Lan des Nordrhein-Westfalen, Max-Planck-Gesellschaft zur Forderung der Wissenschaften e.V., Deutsche Forschungsgemeinschaft, to whom we are very grateful. Moreover the pharmaceutical industry gave assistance in the organization and the transcript of the pro ceedings. Dr. G TZE of Springer-Verlag, was, as we will explain later, the original promotor of the idea for such a meeting. We should like to thank Springer-verlag for the excellent layout and quality of this book. Koln, Spring 1977 K.J. ZULCH, W. KAUFMANN K.-A. HOSSMANN, V. HOSSMANN Contents Welcome K.J. ZULCH xv Introduction W. KAUFMANN ............................................... XIX Coronary Circulation with Special Remarks on the Extra vascular Component of Resistance and on Collateral Flow W. LOCHNER, H. P. DIEMER, and J. WICHMANN. With 5 Figures .."

New findings involving the brain in traumatic and septic shock and after brain injury are reported in this book, including pathophysiological and pathohistological results. An experimental and clinical approach to treatment is presented together with specific results obtained from the encephalogram and from histopathological study with regard to the immunohistochemistry of toxic lipid peroxidant products. The latest results of clinical and experimental pathophysiology in inflammatory processes after traumatic brain injury and the therapeutic effects of hypertonic fluid therapy are also discussed.

It is a great honor and pleasure for cerebral infarction have been carried me to have Springer-Verlag publish out. Dr. Yoshimoto hoped that the this volume entitled "Treatment of results of research done in our depart Cerebral Infarction." I am much in ment over the last sixteen years con debted to my colleagues for my success cerning cerebral infarction could be in publishing this book. published. Moved by his enthusiasm, I have engaged in clinical work in my colleagues took their share in writ the field of neurosurgery for these few ing each article. I suggested to them decades and I have performed more that this volume should cover primarily than 5,000 major operations of intra the results of our own research, but that cranial surgery. Throughout this time, at the same time it should also include it has been my privilege to conduct a 2- the results of related work done by neurosurgical experts throughout the hour-morning research seminar in our department every Wednesday and to world. Therefore, I hope that this book supervise a great deal of research. At will interest many investigators who these seminars my fellow research have devoted themselves to research in workers and I have exchanged many the field of neuroscience. ideas about the study of neurosurgery My colleagues acknowledge that and we have designed many animal our research has been stimulated and experiments."

The birth of a baby is the culmination of months of anticipation and plan ning. Most often, mother and infant are healthy and readily able to estab lish close contact-a bond. However, in some situations either mother or baby or both present complications. The more prompt and rational the treatment, the sooner the normal parent-infant relationship will commence. This book is devoted exclusively to the first days following birth. In its 15 chapters, postpartum and postnatal physiology and pathophy i: .;logy are reviewed by 18 specialists. Normal and abnormal development of mother and child is correlated with proven means of clinical management. Chapters 1 through 3 cover maternal postpartum developments and complications. Chapter 4 stresses the importance of a normal parent newborn relationship, a concept of increasing concern in modern society. The following ten chapters discuss neonatal physiology and pathophysi ology; the effects of obstetric anesthesia on infant behavior, pulmonary function measurements in the postnatal period and treatment of the sick newborn are discussed in detail. The final chapter reviews maternal and perinatal mortality; the data, based on extensive surveys in New York City, indicate that current management is effecting an overall decline in mortality."

During the last decade, the effects of anaesthetics on cerebral blood flow, cerebral metabolic rate of oxygen and intracranial pressure have been studied experimentally and clinically. In this review studies of CBF and CMRO2 during craniotomy have been performed with the classical technique described by Kety and Schmidt. In chapter 1 general considerations concerning the effects of anaesthetics on cerebral blood flow and metabolism are reviewed. In chapters 2 and 3 the effects of inhalation agents and hypnotics on flow and metabolism are considered. Chapters 4 and 5 cover the effects of central analgetics, and neuromuscular blocking agents. In chapter 6 the effects of other drugs in common use in neuroanaesthetic practice are summarized. Chapter 7 considers the effects of drugs used for controlled hypotension. In chapter 8 the application of Kety's method in studies of CBF and metabolism is reviewed, the studies of cerebral circulation and metabolism during nine different techniques of anaesthesia for craniotomy are presented, and other studies of cerebral circulation during neuroanaesthesia are reviewed. In chapter 9 considerations concerning central and cerebral hemodynamics during anaesthesia in the sitting position are considered. This review is primarily addressed to anaesthetists, but it will also be of interest to those working within neurosurgery, neuroradiology and clinical neurophysiology.

When someone has successfully completed a Standard First Aid Course, they often have a desire to extend their knowledge of first aid. The aim of this book is to give the holders of a Standard First Aid Certificate the opportunity to study the principles of first aid in greater detail. It is not intended to convert the first aider into a highly trained paramedic - so a discussion on the use of intra venous fluids, defibrillators etc., is beyond the scope of this book. It is hoped that the book will provide a useful in-depth study for demonstrators, instructors and first aiders likely to be involved in ambulance duties. I am very grateful to Brigadier D.O. O'Brien, Chief Medical Adviser, British Red Cross Society and Mrs. R.H. Smith, Assistant Branch Director (Training), Leicestershire Branch of the British Red Cross Society for their helpful comments and encouragement. I acknowledge the use of illustrations from the Clinical Symposia Series by CIBA on the "Heimlich Manoeuvre" to form the basis of Figures 3.7,3.8 and 3.9."

The terrorist use of diseases as bioweapons has been one of the major security concerns in recent years, particularly after the anthrax letter attacks in the USA in 2001. This uncertain threat of intentional outbreaks of diseases exists side by side with the constantly changing very real threat from diseases, epidemics and pandemics as recently illustrated by the H1N1 influenza pandemic, SARS, and H5N1 bird influenza events. This publication contains case studies on the public health planning for (un)usual disease outbreaks for 11 large and small countries with a focus on South Eastern Europe. In many countries, military entities traditionally play an important role in emergency response to disease outbreaks. In smaller countries, very little exists, however, in terms of specific biopreparedness efforts (in both the military and civilian area), which is at least partly due to a relatively low bioterrorism threat perception, and serious resource constraints. The uncertainty associated with the bioterrorism threat makes public health preparedness planning for such events politically and financially very difficult. The similarity of responding to bioterrorism events and natural disease outbreaks from a public health point of view suggests the merit of looking at biopreparedness as a part of overall health emergency planning, not as a separate effort.

Covers the immediate assessment and management of common plastic and reconstructive surgery emergencies and referrals. A companion for junior doctors starting within plastic surgery, the Plastic Surgery for \Trauma provides succinct and clear presentation together with up to date guidelines on the common plastic surgery emergencies. With clear descriptions of difficult trauma scenarios, illustrated with numerous figures, and updated guidelines for each step of practice, this book will ensure that the reader can access all the information required to help gain confidence and experience .Be the readers passing through a plastic surgery rotation on their way to some other career goal or beginning within plastic surgery and keen to make a strong start with a view to progressing in the speciality, this book provides the support to allow rational and confident clinical decision making from the start. Essential reading for all non-specialists and trainees.

Orthopedic Trauma Call for the Attending Surgeon is a clinically focused book that will help guide the orthopedic surgeon through the most commonly encountered injuries when on call. Drs. David J. Hak, Kyros R. Ipaktchi and Steven Morgan are joined by over 50 leading experts to provide a succinct and quick review of the key points that will allow you to provide patients with expert and immediate care. Inside Orthopedic Trauma Call for the Attending Surgeon each chapter is written in an easy to read bulleted format that will allow for a quick review of the key facts you need to know while taking call. Chapters also cover emergent and definitive management and provide guidelines for when to consider referral to a higher level of care. The authors also share their tips and tricks for successful outcomes, while highlighting potential pitfalls and how to avoid them. Since it can be difficult to find time to read a traditional textbook or review article, Orthopedic Trauma Call for the Attending Surgeon is perfect for orthopedic surgeons, physician assistants, extenders who cover ER call, and orthopedic trainees.

The expense of critical care and emergency medicine, along with widespread expectations for good care when the need arises, pose hard moral and political problems. How should we spend our tax d'ollars, and who should get help? The purpose of this volume is to reflect upon our choices. The authors whose papers appear herein identify major difficulties and offer various solutions to them. Four topics are discussed throughout the volume: First, encounters between patients and health professionals in critical situations in general, and where scarcity makes rationing necessary; second, allocation and social policy, including how much to spend on preventive, chronic or critical care medicine, or for medicine in general compared to other important social projects; third, conflicts between or ranking of important goals and values; and fourth, conceptual issues affecting the choices we make. Since these topics are raised by the authors in almost every essay, we did not divide the papers into separate sections within the volume. Warren Reich begins the volume with a parable illustrating a key problem for contemporary medicine and two very different approaches to its solution. His story begins with the "delivery" of three indigent, critically ill, foreign patients to the emergency room of a large American private hospital. Although the hospital is legally bound to care for these patients, providing long term, high cost care for them and others soon becomes a major financial strain.

The true story of an A&E doctor that became a huge word-of-mouth hit. Forget what you have seen on Casualty or Holby City, this is what it is really like to be working in A&E. Dr Nick Edwards writes with shocking honesty about life as an A&E doctor. He lifts the lid on government targets that led to poor patient care. He reveals the level of alcohol-related injuries that often bring the service to a near standstill. He shows just how bloody hard it is to look after the people who turn up at the hospital door. But he also shares the funny side - the unusual 'accidents' that result in with weird objects inserted in places they really should have ended up - and also the moving, tragic and heartbreaking. It really is an unforgettable read.

PATIENT FLOW: Reducing Delay in Healthcare Delivery is dedicated to improving healthcare through reducing the delays experienced by patients. One aspect of this goal is to improve the flow of patients, so that they do not experience unnecessary waits as they flow through a healthcare system. Another aspect is ensuring that services are closely synchronized with patterns of patient demand. Still another aspect is ensuring that ancillary services, such as housekeeping and transportation, are fully coordinate with direct patient care. Past experience shows that effective management of healthcare delays can produce dramatic improvements in medical outcomes, patient satisfaction, and access to service, while also reducing the cost of healthcare. The 15 chapters of this book exposes the healthcare community of researchers, practitioners and administrators to a set of techniques and strategies that can be used by clinicians and administrators to substantially reduce delays in healthcare delivery. It is the first book treatment to have reduction in patient delay as its sole focus, and therefore, provides the foundation by which hospitals can implement change. Reflecting the highly interdisciplinary and practitioner nature of this book, the chapters have been written by doctors, nurses, industrial engineers, system engineers and geographers, and thus, these perspectives provide the comprehensive view needed to address the problem of patient delay.

The book provides a "hands-on" discussion and methods for solving a variety of problems that inhibit prompt and swift health care delivery. Some examples are:

• presents a set of breakthrough strategies that use "real-time" monitoring systems for continuous improvement;
• offers techniques for scheduling staff needs to match patterns in patient demand, and thus reduce predictable delays;
• utilizes simulation modeling techniques for both healthcare design and process improvement;
• provides methods for forecasting the demand for healthcare on a region-wide basis;
• presents queueing theory as a general method for modeling patient waits in healthcare;
• outlines rapid delivery of medication in the event of a catastrophic event, such as a pandemic or terrorist attack;
• demonstrates the importance of optimizing care as patients transition from one care setting to the next care setting with an emphasis on clinical outcomes and the business case;
• provides project management tools to guide the implementation of patient flow projects.

Severe head injuries are a frequent occurrence in the life of every emergency care specialist, traumatologist, neurosurgeon, and rehabilitation specialist. For example, between 30.000 to 40.000 severe head injuries occur in Germany each year. Over 75.000 Americans die each year after having suffered a severe head injury. Nevertheless, treatment is not always optimal. Survival and longterm outcome depends not only on the type of injury but also on timely and appropriate diagnosis and treatment. Thus, all physicians involved must be aware of the current procedures in the management of severe head injuries. This reference book, based on the experience of international experts, provides an up to date and practical guideline.

The Yearbook compiles the most recent developments in experimental and clinical research and practice in one comprehensive reference book. The chapters are written by well recognized experts in the field of intensive care and emergency medicine. It is addressed to everyone involved in internal medicine, anesthesia, surgery, pediatrics, intensive care and emergency medicine.

Crib death (SIDS) is the most frequent cause of death for infants during the first year. A systematic study of the autonomic nervous system and cardiac system has been performed on a large number of infants and fetuses who died suddenly and unexpectedly, as well as in age-matched control cases. The neurological and cardiac findings are described here, and the relationship between SIDS and unexplained fetal death is discussed.

"Antiepileptic Drugs, Pharmacopoeia" provides a concise guide to the properties and clinical applications of all antiepileptic drugs (AED) currently used in the prophylactic treatment of epileptic seizures. The presentation of each AED follows a clinically orientated template. This is in accordance with the FDA Package insert and the EMA Summary of Product Characteristics, supplemented with recent published reports and expert clinical advice. This pocket-sized, user-friendly guide will be a valuable resource for all those involved in the care of patients with epileptic seizures.

Synthesizing insights from psychiatry, social psychology, and anthropology, this important work sets out a framework for therapy that is as culturally informed as it is productive. An international panel of 23 therapists offers contextual knowledge on PTSD, coping skills, and other sequelae experienced by the survivors of traumatic events. Case studies from Egypt to Chechnya demonstrate various therapeutic approaches. Authors explore the balance of inter- and intrapersonal factors in reactions to trauma and dispel misconceptions that hinder progress in treatment.

To be asked to prepare a second edition of a book is heartening for any author or editor. Apart from the opportunity to make the corrections and amendments which are inevitable in a practical manual there is also the possibility to make additions which enhance its usefulness. Above all a further edition usually means that the book has been found to be accept able to a large number of readers and has fulfilled a need. This is indeed the case with Offshore Medicine, which in its description of the medical aspects of offshore work has provided a unique guide to the occupational health of a new industry. The rapid development of offshore exploration for gas and oil which began in the 1960s created a whole new range of related industries. Most attention was focused on the problems of deep diving in the North Sea because of the great expansion of the diving industry, its technological advances and the high mortality of divers in the early years. Diving, however, is only a fraction of the total endeavour concerned with the offshore industry. The much larger population of workers offshore who man the rigs and barges, the toolpushers, helicop ter pilots, crane drivers, scaffolders and roustabouts, geologists and so on, so sympathetically described by A. Alvarez in his recent book Off shore, A North Sea Journey, and the harsh and difficult conditions in which they often have to work are sometimes forgotten."

Provision of efficient resuscitation is mandatory to the success ful functioning of all hospital wards and departments. Failure to provide such a service increases morbidity and mortality. Resuscita tion falls largely into the domain of the anaesthetist. However, an anaesthetist is not always instantly available and resuscitation has to be initiated by those in other specialities who have had little or no for mal training in resuscitation techniques. The purpose of this book is to guide those involved in resuscitation in the indications and methods of resuscitation. Its creation and con tents were stimulated by noting the difficulties encountered in both teaching centres and provincial hospitals. 'Basic' is included in the title to emphasize that, with the exception of 'the acid-base laboratory', the apparatus is simple and available in all hospitals. Furthermore, 'basic' indicates the authors' intention to limit their discussion on resuscitation to that involved in the first hour following the start of treatment. Successful treatment during these 60 minutes, and very often the first few minutes, is often vital in the sav ing of life. Further management can then be decided by the ap propriate specialist.

This volume is published with a triple aim: to take a look back over the advances during the ten years of the Mediterranean Burns Club and mark its anniversary; to follow up and strengthen the successful twin ning of burns as a clinical, individual illness problem and fires as a societal, disaster management problem; and to look ahead at the per spectives of burn care and fire prevention in the fast-approaching new century. The occasion also marks the tenth annual presentation of the prestigious G. Whitaker International Burns Prize, to which the Mediterranean Burns Club acts as the scientific fulcrum. The award is now established as the most distinguished recognition in burns science worldwide, and it is gratifying that the contributions of many of the renowned recipients will be found in this book. This is a sequel to The Management of Mass Burn Casualties and Fire Disasters, which contained the Proceedings of the First International Conference on Burns and Fire Disasters. The book and the conference have fully justified the authors' initial concept that burn specialists, con stantly combatting burn disease and promoting rehabilitation of the victims, especially in mass casualty situations, had for too long remained separate from that other essential sector, the fire-fighting authorities and fire prevention systems, whose aim is also the protection of the individual and the promotion of safety. This long overdue synergism has now become reality, and the present volume strengthens this desirable trend."

Cardiology Emergencies covers the presentation, investigation, and management of acute cardiac problems that require speedy diagnosis and management. Created as a resource for residents and students, as well as an easy reference guide for physicians, this handbook is organized for quick access and learning. It is divided into three sections: the first provides acute presentations for quick diagnosis, the second addresses specific conditions, and the third offers clear descriptions of how to perform common practical cardiac procedures. Packed with concisely written summaries and bullet-point information, it is the ideal guide to the practical management of cardiac emergencies.

Substantialfundamental workhas been undertaken inthe different aspects of impact biomechanics over the past three decades. Much of this has been motivated and undertaken bythe automotive industry intheirefforts to improve transport safety. More recently, however, it has become app- ent that themultidisciplinary synergies which are realisedby interactions between engineers, scientists and clinical practitioners will ultimately lead to a greater understanding of the complex interacting phenomena withinthe human bodyafter it has sustained an impact. In turn, this greater depth of knowledge will provide more fundamentalinsights into the analysis, d- gnosis, treatment and prevention ofimpact injuries across a broader sp- trum of accident environments. Thescienti?c focus of this IUTAM symposium istoaddress those t- ics that are centrally important to the biomechanics ofimpact. These can be groupedinto those that are concerned with the different causes of - cidents (e. g. , transport, occupational and sports injuries), themechanics - volvedinaccident analysis (e. g. , accident investigation, computational m- elling techniques), the different types of resulting traumatic injuries (incl- ing musculoskeletal, organ, spinal and head injuries), methods of asse- ing the extent of injury (e. g. , injury assessment, injury criteria, constitutive laws for human tissue), and providing protection during an impact (e. g. , injury prevention, energy absorption materials, and safety devices).

Coronary artery disease is the most commonly encountered problem in adult cardiology in the world. Echocardiography is the most commonly used imaging modality encountered in cardiology practice in the world. Even though there are many Acute Coronary Syndrome (ACS) reference books and echocardiography reference books, there is no single practical book so far in the literature with focus on the combined topics. The authors believe that this will be the first book to provide information on how echocardiography can be used in, prevention, diagnosis and treatment of ACS.

Re-EngineeringoftheDamagedBrainandSpinalCord isdedicatedtoTetsuoKanno, M. D. ProfessorofNeurosurgery Bypresenting theoriginal papers thatmakeupthis thefeaturesofthelocalmedicallandscapeinthe- third supplement we wish to make a further contri- gionswheretheyareenacted. Whatismore, progr- bution to the issue of functional rehabilitation, this sivenew?ndingsmustbealsosubjectedtoafrequent soimportantandfascinatingmodernareaofresearch revision. Ontopofthis, itshouldnotbeforgottenthat inthe?eldofneurosciences. Thecongresspaperswe even when committal therapy guidelines are c- haveselectedconstituteagoodre?ectionofthetrans- sistentlyapplied, thereareconsiderablevariationsin disciplinary objectives. The literature references are therangeofpotentialcomplicationsandintheo- designedasaguidetoleadtheinterestedreadertoa comeofprospectivecontrolledmulti-centreandmul- deeperandmoredetailedunderstandingoftheindi- nationalstudiesontheissueofqualitymanagement. vidualissues. Functionalrehabilitationhasbeenanoriginaltask The demand for ''evidence-based medicine'' is well ofneurosurgeryfromtheveryoutset. The1990shave justi?ed; however, it rapidly comes up against the enteredtheannalsofbrainresearchasthe''Decadeof limitsoffeasibility, especiallywherecontrolledthe- theBrain''. Sincethentherehasbeenaneverstronger peuticstudiesareconcerned. TheCochrancollection growthofneuroscienti?cinterestworldwide, accom- of high-quality evidence-based healthcare databases paniedbysubstantial?nancialengagement. Thishas hasthusfarbeenofnohelptousindrawingupthe- primarily resulted in advances in basic neuro- peutic recommendations for the re-engineering of biologicalandneurophysiologicalresearchandalsoin brain and spinal-cord lesions. Today as ever, the thegrowthofneuroscienti?cknowledgeaboutbasic opinion of experts and empirically based medical mechanismsformotor control, paincontrol, aware- treatment and posttraumatic neurorehabilitation ness, cognition, learning and memory. The conse- continuetooccupyanindispensablepositionforthe quencemustbetoensurethattheadvancesmadeinthe everydayclinicalpracticeofneurosurgicalandneu- neuroscienti?cresearchareaareadequatelyexpanded traumatological therapies. Promising adjunct - intopracticalneurosurgicalcareandre-engineeringof proachesincludeneuropharmacology, forcascadesof brainandspinalcordlesionsandtoensureuponnew molecular interactions are known to be underlying approaches. Following this a fundamental path will activity-dependent plasticity and skills learning, as resultinanimprovedandmoree cientpreventionin many of these processes involve the major tra- thefuture, themeasuresthatstandrightatthefore- mitters. Furthermore, biologicalinterventionsby- front of all rehabilitation principles, meaning that ingendogenousneuronsandgliaaswellasexogenous conventionalconceptsmustbemodi?edtokeeppace stemcells, bone-marrowcells, macrophages, andother withthemoretask-speci?c, intensive, andprogressive types may promote the regeneration of nerve cells, demands. In this connection a series of guidelines, tissue, and neural circuitry. Class one studies have recommendations, and expert opinions and also beenmade, andnowclasstwostudieshavebeeni- algorithms have been elaborated by national and tiated, for example in connection with acute spinal international expert panels and multidisciplinary as- cord injury (SCI). The clinical application of fu- sociationsfortheacutemedicalcareofpatients."