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Pulmonary/Respiratory Therapy Secrets, 2nd Edition FREE TO VIEW

Mary Ann Kosinski
Chest. 2003;124(4):1625-1626. doi:10.1378/chest.124.4.1625-a
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By Polly E. Parsons, MD, and John E. Heffner, MD, FCCP, eds. Philadelphia, PA: Hanley & Belfus, Inc, 2002; 539 pp; $39.95

I’ve got a secret. It is a practical and contemporary book; too big to be considered a pocket manual but a wannabe paperback reference that won’t weigh down your backpack or briefcase.

The cover will produce anxiety…. QUESTIONS YOU WILL BE ASKED ON ROUNDS, IN THE CLINIC, ON ORAL EXAMS … EEEK … but as you flip through the pages you will truly appreciate the 18 areas of interest, the 83 topics, the > 120 contributors. This is the second edition of Pulmonary/Respiratory Therapy Secrets, edited by Polly E. Parsons, MD, and John E. Heffner, MD. The 83 topics are 3 to 12 pages each, in question-and-answer format, dotted with charts, graphs, and images. The first few sections address pulmonary patient care in general, including bedside evaluation, laboratory and diagnostic assessment, and procedures. The bulk of the book (50 topics) discusses the various diseases and disorders. The litany includes the following: airway, infectious, vascular, interstitial, environmental, occupational, and chest wall diseases; AIDS; and neoplasms. The disorders encompass those that are vascular, immunologic, ventilatory, and pleural. There are sections devoted purely to respiratory failure, to special considerations (ie, pregnancy and pulmonary manifestations of systemic disease), and to surgical considerations. This edition also includes a new look at interventional pulmonology.

You get expert opinion, current practice, popular theory, and entertaining controversies with an updated bibliography for each topic along with an accurate index. Any health-care provider who is in training or is providing training would find this book exciting, especially fellows, residents, interns, physician assistants, pulmonary nurse practitioners, respiratory therapists, nurses, allied health educators, pulmonary clinic dwellers, and Sputum Bowl participants.

I found my favorite secrets to be those covered in the chapters on smoking cessation, oxygen therapy, sleep apnea syndromes, noninvasive ventilation, and lung transplantation. Patient families frequently ask questions about smoking. I embraced the smoking cessation chapter because it gave me evidence-based answers about weight gain, pharmacologic adjuncts, and long-term benefits of quitting. The oxygen therapy section had fresh ideas about commercial air travel with oxygen, oxygen-conserving devices, cost comparisons, and reimbursements. Sleep apnea syndromes awakened me to a more detailed picture of patients who I traditionally placed into a more narrow-minded category of sleep apnea. It was obvious that the authors of the noninvasive ventilation topic have done numerous labor-intensive applications of these devices and were not biased to any one particular apparatus. The lung transplantation section used clever charts highlighting the dateline for complications. The final talk about life-after-transplant was hopeful and was a great way to end the book. I was grateful for every chart, graph, flow diagram, and image that captured the essence of the 83 topics.

Future editions might benefit from the presence of more images and higher resolution images in all of the topics concerning imaging. Defining all abbreviations would also be helpful. The use of independent lung ventilation, high-frequency ventilation, and combination therapies, including prone positioning and nitric oxide as alternate invasive techniques for managing ARDS, are more prevalent than this text implies. Also, the mention of representative clinical monitoring tools in this section, such as lung injury severity scoring and oxygenation index, would enhance understanding. I would recommend creating a separate topic for ventilator graphics, thus providing the more focused attention this subject deserves.

What results can you expect from purchasing this book? You will have a better sense of current pulmonary issues. You may incorporate some of the information you read into your assessment style, the protocols you write, the care plans you devise, the explanations you give to patients and families, and the procedures you perform with confidence. It can serve as a mirror to judge the weaknesses and strengths of your clinical practice.

You may even keep Pulmonary/Respiratory Therapy Secrets, second edition, on the top shelf of your ICU supply cabinet and share it with the rest of your team. The curled up edges, coffee-stained margins, and highlighted bibliographies … a quiet thank you for the secrets of many.




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