-d-ot cafdkrespimtory care Equipment by David H Eubanlrs and Roger C Bone. Mosby (distributor - Times Mirror lnkKnetionelPubSishsrsW,Londonrn), 1994 (ISBN 0 8016 7448 4). lllus 394 peges. f3z

This practical informative text contains details of respiratory care equipment from both clinical and technical perspectives. Each chapter reviewa a Wemnt areaofrespiratory equipment with clearly defined objectives, objective informative diagrams and comprehensive referenee lista

Chapter 1, covering the generation, storage and control of medical gases would be of particular interest to re@ratory technicianafphysiologista and other professionals responsible for the maintenance and supply of medical gasea It should also be of general interest to phyeiotherapiets involved with patients involving oxygen therapy who wish to further their technical knowledge d the equipment their patients u8e.

Chapter 2 goes on to discuee the ‘Administration of oxygen and other medical gases’. Under the broad headings of oxygen administration devices, other medical gas therapies and the hazards and complications of axygen administration, each method of administration, including hyperbaric oxygen therapy, is described and the relative merits of each d i d . The indications and clinical applications of Heliox and Carbogen m also included.

Chapter 3 reviews the subject of ‘Humidity and aerosols’. Areas discussed are the generation of aerosols, the physica of aerosol delivery, and the clinical indications for humidity and aerosol therapies incorporating their w e as drug delivery devices. The deacriptiom of each device and the principles of delivery, both clear and com- prehenaihle, help in selecting the most appropriate device for an individual patient. Also included within this section is the use of metered dose inhaler holding chambers. In addition to this chapter, there is a suegeeted reading list and appended are the AARC Clinical Practice Guidelines on

brought to readers’ attention in chapter 4 and the ‘Manual resus- citators, mechanical ventilators and breathing circuits’ in chapter 5. The latter contains detailed specifications of a number of mechanical ventilators but, although BipAP is discuseed as an alternative mode of ventilation, NIPPV and SPPB are not included as a mode of delivery. The chapter goes on to describe the effect of artificial ventilation on the work of breathing and gas exchange. which is of clinical significance to practising physio- therapists.

Chapter 6 on “onconventional mechanical ventilation’ looks at high frequency jet ventilation, extra- corporeal membrane oxygenation, intravascular oxygenation and diaphragmatic pacing. Again the subject matter under discussion, although specialist in nature, would be of interest to physiotherapists, particularly those working in apecialist units, involved in the management of critically ill patients.

Chapter 7. ‘Cardiopulmonary bedside monitoring’ and Chapter 8 on ‘Laboratory instrumentation’ would supplement any prospective respiratory research project. Listing cardiopulmonary parameters and the mechanisms available for their

foundation for their use, these chapters conclude an extremely comprehensive text.

On the whole I found this book extremely informative, covering aspects of cardiorespiratory care equipment that previously have been gleaned from a variety of sources. Many of the specific items of equipment featured are of American origin, but the principles and dia- grams included are appropriate to all similar products and therefore this does not detract from their usefulness.

The text, aimed at American respiratory therapiih, would serve as a useful reference for any physio- therapy department in which members were involved in the management of critically ill patients. So far as undergraduate readers

are concerned, this is a specialist text, but would supplement any human cardiorespiratory physiology library and act as an iqformative guide to the respiratory equipment in use in the clinical environment. As a source of information regarding the ‘principles and applications of cardiorespiratory care equipment’ I regard this book as a ‘technical manual with a difference’ and can recommend its purchase as a smialist reference text.

determination, together with the physical principles and physiological Diana oaVis GradDipphys M ~ S P

Excellent Care For Older People 1982-1993 A West MMlands Perspective

with the service and some of the aceounts tend to be rather subjective.

It is interestine to read the earlv available from Mrs Rae Williams, West Midlands Institute of Geriatric Medicine and Gerontology, M o s e l e y Hall Hospital, Aloester Road, Mosley, Birmingham 813 SJL. Undated. 94 pages. f9.

In 1982 the West Midlands Insti- tute of Geriatric Medicine and Gerontology set up a competition. Entrants were required to submit essays on some aspect of care of elderly people which they were involved with and which they felt was an example of good practice.

The competition is now held every two years and there is a financial award for the winner. Entrants must also include details of how they would develop the project if euceeesful.

... submissions which were then con- sidered innovative but would now be considered basic practice, eg implem- entation of reality orientation.

The more recent submissions make more interesting reading. They include the setting up of a bath service for community patients, the provision of activity organisers on continuing care wards, a hospital at home scheme for people recently discharged following a fractured femur, and a ‘Live at Home Scheme’ which describes the co-ordination of a volunteer service to support elderly people in their own home.

For therapists working with older people the report provides insights

‘Humidification during mechanical %is report contains the eesays of into service developments in another ventilation’ and ‘selection ofaerosol the successfu~ entrants from part of the country and it is always delivery device’. 1982-1993. ~ 1 1 the esBBys 81e written interesting to make comparisons.

by a member o~staffclosely involved Anna Smith MCSP ‘Artificial airways and tubes’ are