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9780721628448

Comprehensive Respiratory Care

by ; ;
  • ISBN13:

    9780721628448

  • ISBN10:

    0721628443

  • Format: Hardcover
  • Copyright: 1995-01-01
  • Publisher: W B Saunders Co
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List Price: $74.95

Summary

Here is the first book to combine the essentials of respiratory care with practical discussions of critical care! 74 authorities - from educators and RRTs to pulmonary and critical care physicians - offer state-of-the-art insights into all aspects of respiratory care. This all-in-one resource provides in-depth coverage of specific diseases and conditions, and background information on cardiopulmonary science - enabling readers to diagnose and react to clinical signs and symptoms quickly and easily. Plus, it features up-to-the-minute discussions of clinical applications and the newest respiratory therapy technologies - helping readers to minimize patient discomfort using today's most effective respiratory care techniques.

Table of Contents

SECTION I FUNDAMENTALS OF ANATOMY AND PHYSIOLOGY
Lung Anatomy and Development
1(17)
David R. Dantzker
Evolutionary Development
3(3)
Embryology
4(2)
Anatomy of the Lung and the Airways
6(12)
The Lungs
8(2)
The Airways
10(3)
The Blood Vessels
13(1)
The Alveolar-Capillary Interface
14(1)
Neural Innervation
15(2)
Summary
17(1)
Lung Mechanics
18(14)
Jonathon Truwit
Pressure Gradients
18(1)
Respiratory Muscles
18(2)
Impedances
20(1)
Compliance
20(2)
Resistance
22(4)
Work of Breathing
26(4)
Pressure-Time Index
30(2)
Summary
31(1)
Respiratory Muscles
32(23)
David R. Dantzker
Anatomy
32(4)
The Diaphragm
33(1)
Intercostal Muscles
34(1)
Abdominal Muscles
35(1)
Diaphragmatic Blood Flow
36(1)
Tests of Respiratory Muscle Function
37(9)
Static Voluntary Tests
38(2)
Dynamic Voluntary Tests of Respiratory Muscle Endurance
40(1)
STATIC Motivation-Independent Tests of Nerve and Muscle Stimulation
41(2)
Dynamic Motivation-Independent Tests
43(3)
Management of Respiratory Muscle Dysfunction
46(9)
Nutritional Repletion
47(1)
Conditioning and Training
47(1)
Weaning From Mechanical Ventilation
48(1)
Rest of the Ventilatory Muscles
49(1)
Positive Pressure Ventilation
50(1)
Pharmacologic Manipulation
50(1)
Summary
51(4)
Dyspnea: Pathophysiology and Clinical Evaluation
55(15)
Evelyn Shearer-Poor
Peter S. Kussin
Definition of Dyspnea
55(1)
Central Nervous System Control of Respiration
55(3)
Cortical Influences
56(1)
Chemical Control of Respiration as Related to Dyspnea
56(1)
Brain Stem
57(1)
Sensory Receptors
57(1)
Chest Wall Muscle Apparatus and Dyspnea
58(1)
Measurement of Dyspnea
58(2)
Psychophysical Parameters
59(1)
Physiologic Correlates of Dyspnea
60(3)
Contribution of the Upper Airway
61(1)
Chest Wall Mechanics
61(1)
Dyspnea and Exercise Testing
62(1)
Clinical Causes of Dyspnea
63(4)
Psychiatric
63(1)
Upper Airway
63(1)
Lower Airway Obstruction
64(1)
Parenchymal Disease
64(1)
Pulmonary Vascular Disease
65(1)
Pleural Disease
66(1)
Cardiac Disease
66(1)
Neuromuscular Disease
66(1)
Chest Wall-Associated Disorders
67(1)
Other Disorders
67(1)
Clinical Evaluation of the Patient With Dyspnea
67(3)
Summary
68(2)
Acid-Base Disorders and Electrolyte Imbalance
70(28)
Catherine S. Thompson
Acid-Base Physiology
70(2)
Acid-Base Disorders
72(6)
Metabolic Acidosis
73(4)
Metabolic Alkalosis
77(1)
Respiratory Acid-Base Disorders
78(3)
Respiratory Acidosis
79(1)
Respiratory Alkalosis
80(1)
Disturbances of Osmolarity: Hyponatremia and Hypernatremia
81(4)
Hyponatremia
81(3)
Hypernatremia
84(1)
Disorders of Serum Potassium
85(4)
Hypokalemia
86(2)
Hyperkalemia
88(1)
Disorders of Serum Calcium
89(3)
Hypocalcemia
90(1)
Hypercalcemia
91(1)
Disorders of Serum Magnesium
92(1)
Hypomagnesemia
92(1)
Hypermagnesemia
93(1)
Disorders of Serum Phosphorus
93(5)
Hypophosphatemia
93(2)
Hyperphosphatemia
95(1)
Summary
96(2)
Pulmonary Gas Exchange
98(21)
David R. Dantzker
The Gas-Exchanging Unit of the Lung
98(2)
Oxygen and Carbon Dioxide Transport in Blood
100(3)
Abnormal Pulmonary Gas Exchange
103(16)
Reduction of the Inspired PO2
103(2)
Hypoventilation
105(1)
Abnormal Diffusion
106(2)
Ventilation-Perfusion Inequality
108(5)
Shunt
113(2)
Nonpulmonary Factors
115(1)
Summary
116(3)
Ventilatory Control
119(12)
David R. Dantzker
The Respiratory Controllers
120(1)
The Sensors
121(3)
Central Chemoreceptors
121(1)
Peripheral Chemoreceptors
122(1)
Other Receptors
122(2)
Effectors
124(1)
Tests of Ventilatory Function
124(4)
Abnormal Ventilatory Patterns
128(3)
Summary
130(1)
Cardiovascular Anatomy and Physiology
131(25)
David J. Frid
Stuart Sheifer
Functional Anatomy of the Heart
131(6)
Inflow Vessels
131(2)
Atria
133(1)
Ventricles
133(1)
Outflow Vessels
133(1)
Atrioventricular Values
133(2)
Semilunar Values
135(1)
Anatomic Position of the Heart
135(1)
Protection Around the Heart
135(1)
Blood Supply to the Heart
135(2)
Heart's Electrical System
137(1)
Pressure, Flow, and Volume During the Cardiac Cycle
137(2)
Factors With An Impact on the Heart's Pumping Function
139(1)
Pump Failure
140(1)
Relationship of Pump Functioning to Peripheral Oxygen Demand
140(1)
Clinical Manifestation of Pump Failure
141(15)
Types of Heart Failure
141(2)
Clinical Findings in Heart Failure
143(7)
Precipitants of Heart Failure
150(1)
Clinical Manifestations in Heart Failure Secondary to Various Cardiac Diseases
150(1)
Summary
150(6)
Tissue Oxygen Delivery
156(19)
David R. Dantzker
The Metabolic Requirement for Oxygen
156(3)
Oxygen Transport
159(1)
Tissue Oxygen Diffusion
160(2)
Regulation of Oxygen Utilization
162(4)
Monitoring the Adequacy of Tissue Oxygenation
166(9)
Summary
171(4)
SECTION II DIAGNOSTIC TECHNIQUES
Physical Examination
175(13)
Arthur S. Banner
Inspection
175(5)
Respiratory Pattern
175(4)
Other Signs of Respiratory Disease Evident on Inspection
179(1)
Palpation
180(1)
Percussion
180(1)
Auscultation
180(4)
Sounds at the Mouth
181(1)
Lung Sounds
181(3)
Cardiac Examination
184(1)
Diagnosis of Conditions Associated with Dyspnea
184(4)
Obstructive Lung Disease
184(1)
Asthma
185(1)
Acute Pulmonary Edema
185(1)
Pulmonary Vascular Disease
185(1)
Neuromuscular Disease
186(1)
Summary
186(2)
Conventional Chest Radiography
188(17)
Paul W. Burrowes
Carl E. Ravin
Airspace Diseases
188(8)
Atelectasis
190(1)
Pneumonia
191(1)
Pulmonary Edema
192(2)
Pulmonary Embolism
194(2)
Extra-Alveolar Air
196(4)
Pneumothorax
196(2)
Interstitial Emphysema
198(2)
Pneumomediastinum
200(1)
Evaluation of Support and Monitoring Equipment
200(5)
Endotracheal and Tracheostomy tubes
200(1)
Chest Tubes
201(1)
Central Venous Catheters
202(1)
Swan-Ganz Catheter
202(1)
Intra-aortic Balloon Pump
202(1)
Nasogastric Tube
203(1)
Transvenous Pacemakers
203(1)
Summary
203(2)
Newer Imaging Techniques in the Thorax
205(9)
Edward F. Patz, Jr.
Computed Tomography
205(2)
Magnetic Resonance Imaging
207(4)
Positron Emission Tomography
211(3)
Summary
213(1)
Hemodynamic Monitoring
214(29)
Charles G. Durbin, Jr.
Clinical Assessment of the Circulatory System
214(1)
Arterial Blood Pressure Measurement
214(2)
Oxygen Delivery: Role of the Heart
216(5)
Preload in Cardiac Performance
217(2)
Afterload
219(1)
Contractility
220(1)
Estimating Preload
220(1)
Cannulation of a Central Vein for Pressure Monitoring
221(9)
Venous Cannulation Complications
222(3)
Pressure Measurement
225(1)
Radiologic Assessment of Catheters
225(1)
Catheter Management
226(2)
Pressure Waveforms
228(1)
Respiratory-Induced Pulmonary Artery Wedge Pressure Changes
229(1)
Determination of Cardiac Output
230(3)
Hemodynamic Variables
233(1)
Other Monitors of Ventricular Performance
233(5)
Ultrasound and Doppler Techniques for Evaluating Cardiac Function
235(1)
Pressure-Volume Loops
236(1)
Monitoring of Mixed Venous Oxygen (Sv02)
237(1)
Hemodynamic Patterns in Common Pathologic Conditions
238(1)
Myocardial Ischemia
238(1)
Acute Pulmonary Embolism
239(1)
Putting It Together
239(4)
Summary
241(2)
Respiratory Monitoring
243(23)
Morris I. Bierman
Basic Measurements
243(8)
Respiratory Motion
243(1)
Pressure
244(4)
Airflow
248(1)
Lung Volume
249(2)
Derived Variables
251(4)
Airway Resistance
251(2)
Respiratory System Compliance
253(1)
Work of Breathing
254(1)
Noninvasive Monitoring of Arterial Blood Gas Parameters
255(4)
Measures of Arterial Oxygenation
255(2)
Measures of Arterial Carbon Dioxide
257(2)
Measures of the Efficiency of Gas Exchange
259(7)
Efficiency of Oxygenation
259(2)
Efficiency of Ventilation
261(1)
Summary
262(4)
Neurologic Monitoring
266(12)
John M. Luce
Serial Measurement of Vital Signs and Repeated Physical Examinations
266(1)
Assessment of Central Nervous System Anatomy
267(1)
Cerebrospinal Fluid Analysis
268(1)
Electroencephalography
268(1)
Evoked Potential Recording
269(1)
Measurement of Cerebral Perfusion Pressure
269(3)
Evaluation of Arterial Blood Gas Values
272(1)
Assessment of Cerebral Oxygenation
273(1)
Measurement of Cerebral Arterial Flow
274(1)
Estimation of Cerebral Blood Flow and Metabolism
274(4)
Summary
276(2)
Electrocardiography
278(37)
Steven J. L. Evans
Stephen Blumberg
Electrical Properties of the Cardiac Muscle Cell
278(2)
Electrical Conduction System of the Heart
280(1)
P Wave, QRS Complex, and T Wave
281(6)
Electrodes and Leads
281(2)
Rhythm and Rate
283(2)
Electrical Axis
285(2)
Complexes, Intervals, and Segments
287(4)
P Wave
287(1)
PR Interval
288(1)
QRS Complex
288(1)
ST Segment
289(1)
T Wave
290(1)
QT Interval
290(1)
U Wave
291(1)
TP Segment
291(1)
RR Interval
291(1)
Chamber Enlargement
291(3)
Left Ventricular Hypertrophy
291(1)
Right Ventricular Enlargement
292(1)
Right Atrial Enlargement
293(1)
Left Atrial Enlargement
293(1)
Bundle Branch Block
294(1)
Atrioventricular Block
294(3)
First-Degree Atrioventricular Block
295(1)
Second-Degree Atrioventricular Block
295(1)
Complete Heart Block or Third-Degree Atrioventricular Block
296(1)
Hemiblocks, Bifascicular Blocks, and Trifascicular Blocks
297(3)
Hemiblock
297(1)
Bifascicular and Trifascicular Block
297(3)
Extrasystoles
300(2)
Premature Atrial Complexes
300(1)
Premature Ventricular Complexes
301(1)
Premature Junctional Complexes
302(1)
Supraventricular Tachycardia
302(2)
Atrial Flutter
303(1)
Atrial Fibrillation
303(1)
Atrial Tachycardia
304(1)
Ventricular Tachycardia
304(3)
Ventricular Fibrillation
307(1)
Accelerated Idioventricular Rhythm
307(1)
Pre-Excitation
308(1)
Ectopic Supraventricular Rhythms
308(1)
Junctional Rhythm
309(1)
Accelerated Junctional Rhythm
309(1)
Wandering Pacemaker
309(1)
Ectopic Atrial Rhythms
309(1)
Sinus-Related Arrhythmia
309(2)
Sinus Tachycardia
309(1)
Sinus Bradycardia
309(1)
Sinus Arrhythmia
310(1)
Sinoatrial Block
310(1)
Sick Sinus Syndrome
310(1)
Myocardial Ischemia and Infarction
311(4)
Myocardial Ischemia
311(1)
Myocardial Infarction
312(1)
Summary
313(2)
Pulmonary Function Testing
315(20)
Jane Luchsinger
Harry Steinberg
Normal Values
315(1)
Lung Volumes
316(4)
Definitions
316(1)
Methods of Measurement
317(2)
Interpretation
319(1)
Expiratory Flow Rates
320(4)
Definitions
320(1)
Methods of Measurement
320(2)
Spirometry and Flow-Volume Loop Interpretation
322(1)
Assessment of Airway Reactivity
323(1)
Sources of Spirometry and Flow-Volume Loop Error or Artifact
324(1)
Diffusing Capacity
324(1)
Definitions
324(1)
Methods of Measurement
324(1)
Interpretation
325(1)
Distribution of Ventilation
325(2)
Methods of Measurement
325(2)
Interpretation
327(1)
Control of Ventilation
327(1)
Definitions
327(1)
Methods of Measurement
327(1)
Compliance
327(1)
Definitions
327(1)
Methods of Measurement
327(1)
Interpretation
328(1)
Airway Resistance
328(1)
Definitions
328(1)
Methods of Measurement
328(1)
Interpretation
328(1)
Maximal Inspiratory and Expiratory Pressures
328(1)
Definitions
328(1)
Methods of Measurement
329(1)
Interpretation
329(1)
Exercise Testing
329(2)
Methods of Measurement
329(2)
Preoperative Evaluation
331(1)
Neonatal and Pediatric Pulmonary Function Testing
332(3)
Summary
333(2)
Clinical Application of Laboratory Examinations
335(20)
Suzanne M. Burns
Complete Blood Count
335(3)
Red Blood Cell Count (Erythrocyte Count)
335(3)
White Blood Cell Count (Leukocyte Count) and Differential
338(4)
White Blood Cell Count
338(1)
Differential
339(2)
Platelet Count (Thrombocytes)
341(1)
Coagulation Studies
342(3)
Prothrombin Time and Partial Thromboplastin Time or Activated Partial Thromboplastin Time
344(1)
Disseminated Intravascular Coagulation and Associated Laboratory Tests
344(1)
Electrolyte Studies
345(6)
Sodium (Na+)
345(1)
Potassium (K+)
346(1)
Chloride (Cl-)
347(1)
Serum Bicarbonate (HCO3, CO2 Content, and Serum CO2)
347(1)
Glucose
348(1)
Calcium, Magnesium, and Phosphorus
348(2)
Blood Urea Nitrogen and Creatinine
350(1)
Bilirubin
350(1)
Enzymes
351(4)
Creatine Kinase (Creatine Phosphokinase) and Isoenzymes
351(1)
Lactate Acid Dehydrogenase
351(1)
Serum Glutamic-Oxaloacetic Transaminase (Aspartate Aminotransferase) and Serum Glutamic-Pyruvic Transaminase (Alanine Aminotransferase)
352(1)
Alkaline Phosphatase and Acid Phosphatase
352(1)
Amylase and Lipase
352(1)
Summary
352(3)
Blood Gas and Acid-Base Measurement
355(50)
George H. Hicks
Invasive Measurement Techniques
355(32)
Indications for Invasive Sampling and Analysis
355(1)
Knowledge of the Patient's Condition
356(2)
Blood Sampling Techniques
358(11)
Blood Sample Analysis: Measured and Derived Values
369(11)
Ensuring the Accuracy of Invasive Blood Analysis
380(7)
Noninvasive Monitoring
387(18)
Transcutaneous and Transconjunctival Blood Gas Monitoring
388(2)
Pulse Oximetry
390(2)
Capnometry and Capnography
392(4)
Summary
396(9)
SECTION III THERAPEUTIC TECHNIQUES
Cardiopulmonary Resuscitation
405(17)
Nicholas G. Bircher
Emergency Airway Control
405(2)
Manual Methods Without Equipment
405(1)
Manual Methods with Equipment
406(1)
Emergency Ventilation and Oxygenation
407(2)
Ventilation Patterns
407(1)
Mouth-to-Mouth or Mouth-to-Nose Ventilation
407(1)
Mouth-to-Adjunct Ventilation
408(1)
Bag-Value-Mask Ventilation with Oxygen
408(1)
Mechanical Ventilators
408(1)
High-Frequency Jet Ventilation
409(1)
Emergency Circulation
409(5)
Causes of Cardiac Arrest
409(1)
Recognition of Cardiac Arrest
409(1)
Closed-Chest Cardiopulmonary Resuscitation
410(1)
Combinations of Ventilations and Chest Compressions
411(1)
Monitoring the Effectiveness of Cardiopulmonary Resuscitation
412(1)
Mechanical Cardiopulmonary Resuscitation
413(1)
Pharmacology
414(8)
Routes for Drugs and Fluids
414(1)
Drugs
414(4)
Summary
418(4)
Bronchial Hygiene
422(17)
Eric D. Bakow
Respiratory Mucus
422(3)
Postural Drainage Therapy
425(7)
Turning
426(2)
Postural Drainage
428(2)
Cough
430(2)
Positive Expiratory Pressure
432(7)
Hypoxemia
433(1)
Hemodynamic Effects
434(1)
Neurologic Effects
434(1)
Wheezing
434(1)
Pulmonary Hemorrhage
434(1)
Summary
435(4)
Mechanical Ventilatory Support
439(16)
Neil R. MacIntyre
Ventilatory Failure and the Need for Ventilatory Support
439(1)
Conventional Mechanical Ventilator Design Principles
439(4)
Gas Delivery System
440(2)
Subsystem of Mechanical Ventilators
442(1)
Effects of Positive Pressure Ventilation
443(3)
Alveolar Ventilation and Ventilation Distribution
443(3)
Complications of Positive Pressure Ventilation
446(5)
Hazards Associated with Endotracheal Tubes
446(1)
Mechanical Malfunctions
447(1)
Patient-Ventilator Dyssynchrony
447(1)
Air Trapping or Intrinsic Positive End-Expiratory Pressure
447(1)
Barotrauma
448(2)
Infections
450(1)
Cardiovascular
450(1)
Noninvasive Techniques for Ventilatory Support
451(4)
Negative Pressure Approaches
452(1)
Positive Pressure Mask Approaches
452(1)
Summary
453(2)
Oxygenation Support
455(11)
Neil R. MacIntyre
Techniques to Increase PA02
455(2)
Techniques to Improve Alveolar-Arterial Oxygen Transport
457(5)
Manipulation of Baseline of Expiratory Pressures
457(3)
Manipulation of the Positive Pressure Breath to Improve V/Q Mismatch and Shunt
460(2)
Nonrespiratory Support Techniques to Improve Oxygen Transport
462(2)
Patient Position
462(1)
Reduce Oxygen Consumption
462(2)
Increase Oxygen-Carrying Capacity
464(1)
Improve Alveolar Stability Through Surface-Active Material
464(1)
Summary
464(1)
Goals of Oxygenation Support
464(2)
Unconventional Support Techniques for Ventilation and Oxygenation
466(11)
Neil R. MacIntyre
R. Alan Leonard
High-Frequency Ventilation
466(4)
Mechanisms of Gas Transport
467(2)
Applications
469(1)
Complications
469(1)
Apneic Ventilation and Oxygenation
470(1)
Liquid Lung Ventilation
471(1)
Extracorporeal Systems
471(6)
Venoarterial Bypass
471(3)
Venovenous Bypass
474(1)
Intravascular Oxygenation
475(1)
Summary
475(2)
Nosocomial Respiratory Tract Infection: Perspectives for Prevention and Respiratory Care
477(22)
Donald E. Craven
Kathleen A. Steger
Epidemiology
477(1)
Etiologic Agents
478(1)
Diagnosis
479(1)
Pathogenesis
480(3)
Pulmonary Aspiration and Intubation
480(1)
Colonization of the Oropharynx
480(2)
Gastric Colonization
482(1)
Immune Defenses in the Lung
483(2)
Antibiotic Prophylaxis Against Colonization
485(1)
Aerosolized Antibiotics
485(1)
Antibiotic Prophylaxis
485(1)
Infection Control
486(1)
Devices and Procedures
487(12)
Tracheal Suctioning
487(1)
Endotracheal Tube
487(1)
Nasogastric Tube Use and Tube Feeding
488(1)
Resuscitation Bags
488(1)
Spirometers and Oxygen Analyzers
489(1)
Wall Oxygen Humidifiers
489(1)
Nebulization Equipment
489(1)
Mist Tents
490(1)
Mechanical Ventilators With Heated Humidifiers
490(1)
Tubing Colonization and Condensate
491(1)
Humidifier Colonization
491(1)
Heat and Moisture Exchangers or Hygroscopic Condenser Humidifiers
492(1)
Small-Volume Nebulizers
492(1)
Outflow Traps and Filters
493(1)
Summary
493(6)
Oxygen Therapy
499(21)
Rich Malloy
Margarete Pierce
Oxygen: History and Chemistry
499(1)
Manufacture of Oxygen
499(1)
Oxygen Cylinders and Regulators
499(1)
Cylinders
499(1)
Regulators
500(1)
Flowmeters
500(2)
Oxygen Analyzers
502(1)
Clinical Oxygen Therapy
503(5)
Basic Concepts
503(2)
Clinical Indications
505(2)
Goals of Therapy
507(1)
Weaning From Oxygen
507(1)
Adverse Effects
508(2)
In the Patient With Chronic Obstructive Pulmonary Disease
508(1)
Oxygen Toxicity
509(1)
Cellular Toxicity or the Free Radical Theory
509(1)
Other Adverse Effects
509(1)
Low-Flow Devices
510(6)
Nasal Catheter
511(1)
Nasal Cannula
511(1)
Venturi Masks
512(1)
Simple Oxygen Mask
512(1)
Partial Rebreathing and Nonrebreathing Masks
513(1)
Humidification
514(1)
Special Oxygen Delivery Alternatives
514(1)
Elongated Cannulas
514(1)
Oxygen Concentrators
515(1)
Portable Liquid System
515(1)
Reservoir Cannulas
515(1)
Demand Systems
515(1)
Transtracheal Oxygen Therapy
515(1)
Monitoring the Patient on Oxygen
516(1)
Home Oxygen Therapy
516(1)
Managing the Patient on Oxygen Therapy
517(3)
Branching Logic
517(1)
Open Loop or Care Plan
517(1)
Summary
518(2)
Hyperbaric Oxygen Therapy
520(19)
Richard E. Moon
Principles of Hyperbaric Oxygen Therapy
520(1)
Indications
521(3)
Gas Bubble Disease
521(1)
Carbon Monoxide
521(2)
Infections
523(1)
Ischemic Wounds
524(1)
Osteoradionecrosis and Soft Tissue Radiation Necrosis
524(1)
Other Conditions
524(1)
The Hyperbaric Environment
524(3)
Altered Gas Physical Properties
525(1)
Increased Partial Pressure of Nitrogen
525(1)
Increased Partial Pressure of Oxygen
526(1)
Hyperbaric Chamber Operations
527(12)
Ventilators
529(2)
Monitoring
531(3)
Intravenous fluid Administration
534(1)
Atmosphere Control
535(2)
Summary
537(2)
Aerosol Therapy
539(22)
Dean Hess
Factors Affecting Aerosol Penetration and Deposition
539(1)
Nebulizers
540(4)
Technical Aspects
540(1)
Effectiveness of the Small-Volume Nebulizer
541(1)
Clinical Application
542(2)
Inhalers
544(5)
Technical Aspects
544(1)
Effectiveness of Metered Dose Inhalers
545(1)
Clinical Application of Metered Dose Inhalers
546(1)
Metered Dose Inhalers With Auxiliary Spacing Devices
547(2)
Dry Powder Inhalers
549(1)
Choice of Aerosol Delivery Device in Adult Ambulatory Patients
549(3)
Aerosol Administration to Infants and Children
552(1)
Aerosol Delivery During Adult Mechanical Ventilation
552(2)
Use of Small-Volume Nebulizers in Intubated Patients
552(2)
Use of Metered Dose Inhalers in Intubated Patients
554(1)
Aerosol Delivery for Parenchymal Lung Disease
554(7)
Ribavirin
555(2)
Pentamidine
557(2)
Summary
559(2)
Airway Management
561(28)
Michael S. Gorback
Airway Anatomy
561(3)
Upper Airway
561(2)
Lower Airway
563(1)
Airway Management
564(25)
Simple Maneuvers to Relieve Airway Obstruction
564(1)
Artificial Airways
565(2)
Intubation
567(16)
Cricothyroidotomy
583(1)
Changing Endotracheal Tubes
584(1)
Summary
584(5)
SECTION IV CLINICAL PROBLEMS
Nutrition
589(14)
James R. Mault
Nutritional Assessment
589(8)
General Survey of Baseline Nutritional State
589(2)
Measurement of Energy Metabolism
591(6)
Measurement of Protein Metabolism
597(1)
Strategies of Nutritional Management
597(6)
Composition, Route, and Timing of Nutritional Support
598(1)
Balance of Nutrition
599(1)
Summary
599(4)
Myocardial Ischemia
603(8)
James R. Bengston
J. Peter Longabaugh
Mark E. Hamer
Pathophysiology of Myocardial Ischemia
603(1)
Myocardial Ischemia Syndromes
603(1)
Stable Angina
604(1)
Unstable Angina
604(1)
Myocardial Infarction
604(1)
Approach to the Patient with Myocardial Ischemia
604(7)
Antiplatelet Agents
605(1)
Antithrombotic Agents
606(1)
Nitrates
607(1)
Beta-Adrenergic Blockers
607(1)
Calcium Channel Antagonists
607(1)
Thrombolytic Therapy
608(1)
Cardiac Catheterization and Percutaneous Transluminal Coronary Angioplasty
609(1)
Coronary Artery Bypass Surgery
609(1)
Summary
609(2)
Acute Renal Failure
611(19)
John D. Wagner
Physiology and Pathophysiology
611(7)
Prerenal Failure
614(1)
Intrinsic Renal Failure
615(2)
Postrenal Failure
617(1)
Diagnosis
618(3)
History
618(1)
Physical Examination
619(1)
Laboratory Testing
619(2)
Management
621(9)
General Approach
621(1)
Uremia
622(1)
Dialysis
622(1)
Hemodialysis
623(1)
Hemofiltration
623(2)
Peritoneal Dialysis
625(1)
Choosing a Dialytic Therapy
626(1)
Renal Recovery
627(1)
Summary
628(2)
Trauma
630(22)
Michael Rhodes
Epidemiology
630(1)
Prehospital Care
630(3)
Resuscitation
633(4)
Airway
633(1)
Ventilation
634(1)
Circulation
635(1)
Monitoring
636(1)
Diagnostic Imaging
637(1)
Surgery
638(1)
Critical Care
639(5)
Oxygen Transport
639(2)
Ventilatory Support
641(2)
Tracheostomy Versus Prolonged Endotracheal Intubation
643(1)
Nutrition
643(1)
Additional Strategies
644(1)
Specific Injuries
644(3)
Head Injury
644(1)
Thoracic Injury
645(1)
Abdominal Injury
646(1)
Pelvis and Extremities
646(1)
Spine
647(1)
Outcome
647(5)
Summary
648(4)
Barotrauma in Mechanical Ventilation
652(21)
Wayne M. Samuelson
David K. Handshoe
William K. Fulkerson
Background
652(2)
Incidence of Barotrauma
654(1)
Anatomic Considerations
655(1)
Forms of Barotrauma Other Than Pneumothorax
655(4)
Identifying Impending Barotrauma
659(2)
Structural Events in the Development of Barotrauma
661(2)
Effects of Barotrauma at the Cellular Level
663(3)
Adult Respiratory Distress Syndrome
666(1)
Positive End-Expiratory Pressure
667(2)
Therapy for Pulmonary Barotrauma
669(4)
Summary
670(3)
Atelectasis: Pathophysiology and Treatment
673(19)
Eric D. Bakow
Pathophysiology
673(6)
Risk Factors
679(1)
Routine Preoperative Spirometry Testing
680(1)
Clinical Findings
680(1)
Clinical Sequelae
681(1)
Treatment
682(10)
Summary
688(4)
Obstructive Lung Disease
692(22)
David R. Dantzker
Upper Airway Obstruction
692(2)
Treatment
693(1)
Lower Airway Obstruction
694(20)
Pathophysiologic Principles
694(2)
Specific Entities
696(7)
Treatment
703(8)
Summary
711(3)
Congestive Heart Failure
714(12)
Scott L. Roth
Compensatory Mechanisms
714(2)
Pathophysiology
716(3)
Diagnostic Approach
719(3)
Management of Acute Pulmonary Edema
722(4)
Summary
725(1)
Respiratory Failure
726(9)
David R. Dantzker
Ventilatory Pump Failure
727(1)
Diaphragmatic Weakness and Paralysis
727(1)
Spinal Cord Injury
727(1)
Guillain-Barre Syndrome
728(1)
Myasthenia Gravis
728(1)
Kyphoscoliosis
728(1)
Obesity
728(1)
Management of Ventilatory Pump Failure
728(3)
Diagnosis
728(1)
Treatment
729(2)
Inefficient Pulmonary Gas Exchange
731(4)
Diagnosis
731(1)
Treatment
732(2)
Summary
734(1)
Weaning Mechanical Ventilatory Support
735(8)
Neil R. MacIntyre
Who Needs Weaning?
735(1)
Currently Available Partial Support Modes (Weaning Modes)
736(3)
Spontaneous Breathing Trials Alternating With Total Support (T Tube Weaning)
736(1)
Intermittent Mandatory Ventilation
737(1)
Pressure-Supported Ventilation
738(1)
Spontaneous Breathing During Pressure-Controlled Inverse Ratio Ventilation
738(1)
Comparing Approaches
739(1)
Initiating and Monitoring Weaning
739(4)
Summary
741(2)
Gastrointestinal Emergencies in the Intensive Care Unit
743(25)
Isaac Raijman
Larry D. Scott
Acute Abdominal Pain
743(2)
Jaundice
745(2)
Nausea and Vomiting
747(1)
Abdominal Distention
747(4)
Intestinal Distention
748(1)
Ascites
749(2)
Gastrointestinal Bleeding
751(2)
Diarrhea
753(1)
Esophageal Perforations
754(1)
Gastrointestinal Disorders
755(1)
Peptic Ulcer Disease
755(1)
Disorders of the Biliary Tract and Pancreas
755(4)
Acute Cholecystitis
756(1)
Acute Suppurative Cholangitis
757(1)
Acute Pancreatitis
757(2)
Hepatic Failure
759(2)
Hepatorenal Syndrome
761(1)
Acute Colonic Diverticulitis
761(1)
Mesenteric Ischemia
762(6)
Summary
764(4)
General Management Principles of Poisoning and Overdose
768(16)
R. Phillip Dellinger
Toxicities
768(1)
Differential Diagnosis
768(1)
Clinical Presentation
769(1)
Initial Management
769(2)
Clinical Pearls
771(1)
Specific Poisoning and Overdose Problems
772(12)
Cocaine
772(1)
Carbon Monoxide
773(1)
Antidepressants
774(1)
Opioids
775(1)
Beta-Adrenergic Blockers
775(1)
Calcium Channel Blockers
776(1)
Hydrocarbons
776(1)
Phencyclidine
776(1)
Theophylline
777(1)
Organophosphates
777(1)
Barbiturates
778(1)
Methanol and Ethylene Glycol
778(1)
Acetaminophen
779(1)
Salicylates
779(1)
Toluene
780(1)
Amphetamines
780(1)
Benzodiazepines
781(1)
Warfarin Compounds
781(1)
Summary
782(2)
Pulmonary Thromboembolic Disease
784(20)
Gilbert E. D'Alonzo
Deep Venous Thrombosis
785(1)
Pathophysiology of Pulmonary Embolism
786(1)
Diagnosis of Pulmonary Embolism
787(5)
Signs and Symptoms
787(1)
Arterial Blood Gas Measurement
788(1)
Chest Radiography
789(1)
Electrocardiography
789(1)
Ventilation-Perfusion Lung Scanning
789(1)
Detection of Lower Extremity Venous Thrombosis
790(1)
Pulmonary Angiography
791(1)
Diagnostic Work-Up
791(1)
Prevention and Treatment of Venous Thromboembolism
792(5)
Complications of Acute Thromboembolic Disease
797(1)
Other Forms of Pulmonary Embolism
797(7)
Venous air Embolism
797(1)
Fat Embolism
798(1)
Amniotic Fluid Embolism
799(1)
Septic Embolism
800(1)
Other Embolic Processes
800(1)
Summary
801(3)
Sleep and Sleep-Disordered Breathing
804(15)
Karl Yang
Normal Sleep Physiology
804(1)
Respiratory Physiology During Sleep
805(3)
Sleep Apnea
808(11)
Obstructive Sleep Apnea
808(7)
Central Sleep Apnea
815(2)
Summary
817(2)
Respiratory Tract Infections
819(16)
Victor F. Tapson
Peter S. Kussin
Community-Acquired Pneumonia
819(5)
Etiology and Predisposing Conditions
819(2)
Clinical Presentation and Diagnostic Approach
821(2)
Treatment
823(1)
Pneumococcal Vaccine
824(1)
Nosocomial Pneumonia
824(11)
Pathogenesis and Risk Factors
825(1)
Etiology
826(1)
Clinical Presentation and Diagnostic Approach
827(4)
Treatment
831(2)
Summary
833(2)
Aspiration Pneumonia
835(11)
Amal Jubran
Pathophysiology
835(1)
pH and Non-pH Effects
835(1)
Bland Versus Infected
836(1)
Inert Substances
836(1)
Clinical Features
836(1)
Predisposition
837(1)
Treatment
838(2)
Local Therapy
838(1)
Antibiotics
838(1)
Corticosteroids
839(1)
Supportive Care
840(1)
Approach to Preventing Aspiration
840(2)
Drowning and Near-Drowning
842(4)
Pathophysiology
842(1)
Clinical Features
842(1)
Treatment
843(1)
Summary
844(2)
Cough
846(21)
Leonard J. Rossoff
Physiology of Cough
846(1)
Cough: A Reflex Defense Mechanism
847(1)
Ineffective Cough: A Compromised Reflex Defense Mechanism
848(2)
Cough: An Index of Air Pollution
850(1)
Cough: A Sign of Disease
851(6)
History
851(4)
Physical Examination
855(1)
Diagnostic Clinical Approach
856(1)
Common Causes of Cough
857(2)
Postnasal Drip
857(1)
Asthma
857(1)
Gastroesophageal Reflux
858(1)
Chronic Bronchitis
858(1)
Other Causes of Cough
859(1)
Neuropsychological Causes
859(1)
Pneumonia
859(1)
Bronchiectsis
860(1)
Neoplasm
860(1)
Treatment of Cough
860(7)
Specific Therapy
860(1)
Nonspecific Therapy (Cough Suppression)
861(2)
Cough Induction and Enhancement (Protussive Therapy)
863(1)
Summary
863(4)
Cor Pulmonale and Pulmonary Hypertension
867(12)
David R. Dantzker
Physiologic Considerations
867(4)
Pulmonary Hypertension
871(1)
Specific Causes of Pulmonary Hypertension
872(2)
Chronic Obstructive Pulmonary Disease
872(1)
Hypoventilation Syndromes
872(1)
Restrictive Lung Diseases
872(1)
Pulmonary Vasculitis
873(1)
Primary Pulmonary Hypertension
873(1)
Pulmonary Thromboembolism
874(1)
Signs and Symptoms of Pulmonary Hypertension
874(1)
Treatment of Pulmonary Hypertension
874(5)
Oxygen Therapy
875(1)
Vasodilators
875(1)
Other Drugs
876(1)
Lung Transplantation
877(1)
Summary
877(2)
Neuromuscular Disorders
879(30)
Michael A. DeVita
Sunil Hegde
Effects of Neuromuscular Disorders on Muscles
879(1)
Primary Disorders of Neuromuscular Function
880(11)
Disorders of the Central Nervous System
881(4)
Disorders of the Peripheral Nervous System
885(3)
Disorders of the Neuromuscular Junction
888(2)
Disorders of the Muscles
890(1)
Respiratory Management of Patients With Neuromuscular Weakness
891(11)
Assessment
892(1)
Electrodiagnostic Studies
893(1)
Mechanical Ventilatory Assistance
894(1)
Intermittent Positive Pressure Ventilation
894(1)
Continuous Positive Airway Pressure
895(1)
Respiratory Muscle Training
896(1)
Rest and Noctural Ventilation
896(2)
Mask Ventilation
898(1)
Negative Pressure and Body Ventilation
898(1)
Home Mechanical Ventilation
899(1)
Diaphragm Pacing
900(2)
Diaphragmatic Inotropic Support
902(1)
Ethical Issues in Neuromuscular Disease
902(7)
Summary
904(5)
Pleural Effusion
909(16)
Rodolfo Morice
Physiology of the Pleural Space
909(1)
Clinical Considerations
909(1)
Diagnostic Procedures
910(3)
Specific Entities
913(12)
Transudative Pleural Effusions
913(1)
Exudative Pleural Effusions
914(8)
Summary
922(3)
Pulmonary Rehabilitation
925(24)
Nelson E. Leatherman
Definition of Pulmonary Rehabilitation
925(1)
Mechanisms of Functional Deterioration in Chronic Lung Disease
926(1)
Goal of Pulmonary Rehabilitation
927(1)
Program Structure
927(2)
Intensive Program
928(1)
Graduate Program
928(1)
The Sequence of Pulmonary Rehabilitation
929(14)
Patient Selection
929(1)
Patient Assessment
930(7)
Implementing the Program
937(6)
Evidence That Pulmonary Rehabilitation Programs Reverse Functional Deterioration
943(2)
Psychological Changes
944(1)
Physiologic Changes
945(1)
Mechanisms Whereby Pulmonary Rehabilitation Accomplishes the Reversal in Functional Deterioration
945(4)
Exercised Training
946(1)
Increased Motivation
947(1)
Decreased Hyperventilation
947(1)
Increased Efficiency
947(1)
Summary
948(1)
Home Care
949(23)
Susan McInturff
Benefits and Goals
949(1)
Patient Selection
950(4)
The Discharge Process
951(1)
The Home Environment
951(1)
Reimbursement Issues
952(1)
Customizing the Program
953(1)
Equipment Selection
954(14)
Oxygen Therapy
954(4)
Oxygen-Conserving Devices
958(3)
Aerosol Therapy
961(3)
Ventilatory Assistance Devices
964(4)
Patient Assessment and Long-Term Care
968(4)
Plan of Care
969(1)
Summary
970(2)
Respiratory Care Pharmacology
972(32)
E. Neil Schachter
Theodore J. Witek, Jr.
Beta-Adrenergic Agonists
972(3)
Mechanism of Action
972(3)
Clinical Utility of Adrenergic Agonists
975(1)
Methylaxanthines
975(4)
Mechanisms of Action
976(1)
Clinical Utility of Methylxanthines
977(2)
Antimuscarinic Agents
979(4)
Mechanism of Action
980(1)
Clinical Utility of Antimuscarinic Agents
981(2)
Glucocorticoids
983(3)
Mechanisms of Action
983(1)
Clinical Utility of Glucocorticoids
984(2)
H1-Receptor Antagonists and Other Mediator-Modifying Agents
986(1)
H1-Receptor Antagonists
987(1)
Mechanism of Action
987(1)
Clinical Utility of Antihistamines
987(1)
Mediator-Modifying Compounds
988(1)
Mechanism of Action
988(1)
Clinical Utility of SCG
988(1)
Mucokinetic Agents and Antitussives
989(4)
Antimicrobial Agents
993(11)
Mechanism of Action
993(2)
Clinical Utility of Antimicrobials
995(6)
Summary
1001(3)
Pediatric Respiratory Care
1004(29)
Shekhar T. Venkataraman
A. Saville
Drew Wiltsie
John Frank
Charles W. Boig, Jr.
Developmental Issues
1004(1)
Physiology of Inflation and Deflation
1005(1)
Mechanical Ventilation of Infants and Children
1006(4)
Indications for Mechanical Ventilation
1006(1)
Principles of Pediatric Mechanical Ventilation
1006(4)
Unconventional Modes of Mechanical Ventilation
1010(5)
Pressure Support Ventilation
1010(1)
Independent Lung Ventilation
1010(1)
High-Frequency Ventilation
1011(1)
Extracorporeal Cardiorespiratory Support
1012(3)
Special Techniques of Respiratory Support
1015(1)
Altering Inspired Oxygen and Carbon Dioxide Concentration
1015(1)
Helium-Oxygen Mixture
1016(1)
Inhaled Nitric Oxide
1016(1)
Aerosol Therapy
1016(6)
A Dosing Paradigm
1016(2)
Delivery Devices
1018(1)
Aerosols Delivered Through Ventilators
1019(3)
Interhospital Transports
1022(3)
Indications
1022(1)
Composition of the Transport Team
1023(1)
Utility of a Therapist During Transport
1023(1)
Responsibility of the Respiratory Therapist During Transport
1024(1)
Training
1024(1)
Home Care
1025(8)
Indications for Home Respiratory Care
1026(1)
Home Location and Atmosphere
1027(1)
Medical Support and Caretaker Training
1028(1)
Equipment and Supplies
1028(1)
Summary
1029(4)
Pathophysiology-Based Approach to Neonatal Respiratory Care
1033(57)
Jon N. Meliones
Barbara G. Wilson
R. Alan Leonard
Alan R. Spitzer
Neonatal Respiratory Development
1033(4)
Fetal Lung Fluid
1036(1)
Developmental Considerations
1037(1)
Respiratory Rate
1037(1)
Tidal Volume
1037(1)
Inspiratory Flow
1037(1)
Total Respiratory Compliance
1038(1)
Total Respiratory Conductance
1038(1)
Respiratory Interventions
1038(31)
Inhaled Medical Gases
1038(2)
Classification of Positive Pressure Ventilators
1040(14)
Nonconventional Modes of Ventilation
1054(11)
Surfactant Replacement Therapy
1065(1)
Extracorporeal Membrane Oxygenation in the Neonate
1066(2)
Liquid Ventilation
1068(1)
Respiratory Evaluation of the Neonatal Patient
1069(2)
Noninvasive Evaluation
1069(2)
Invasive Evaluation
1071(1)
Respiratory Support for Specific Neonatal Syndromes
1071(10)
Initial Care and Stabilization of the Infant With Respiratory Disease
1072(2)
Initiation of Ventilatory Assistance in the Symptomatic Neonate With Respiratory Distress (Continuing Care Phase)
1074(1)
Mechanical Ventilation
1074(2)
Goals of Respiratory Support
1076(1)
Application of Positive Pressure Ventilation
1077(4)
Complications of Respiratory Interventions
1081(4)
Oxygen Toxicity
1081(1)
Retinopathy of Prematurity
1082(1)
Barotrauma
1083(1)
Bronchopulmonary Dysplasia
1084(1)
Weaning From Positive Pressure Ventilation
1085(5)
Noninvasive Monitoring
1085(1)
Physiology of Weaning
1086(1)
Criteria for Weaning
1086(1)
Ventilator Adjustments
1086(2)
Failure to Wean
1088(1)
Summary
1088(2)
Prehospital Respiratory Care
1090(29)
Jay A. Johannigman
Indications for Airway Management
1091(3)
Absolute Indications
1091(1)
Strong Relative Indications
1092(1)
Relative Indications
1093(1)
Simple Techniques for Airway Management
1094(1)
Oxygen Administration
1095(3)
Oxygen Therapy
1095(3)
The Assisted Airway
1098(5)
Mouth-to-Mouth Ventilation
1099(1)
Mouth-to-Mask Ventilation
1099(1)
Bag-Value-Mask Ventilation
1099(1)
Esophageal Obturator Airway
1100(1)
Pharyngotracheal Lumen Airway
1100(3)
Advanced Airway Techniques
1103(3)
Endotracheal Intubation
1103
Needle Thoracentesis and Chest Thoracostomy
1005(101)
The Pharmacology of Airway Control
1106(1)
Capnography
1107(1)
Transport Ventilation
1107(12)
Operational Characteristics
1108(5)
Summary
1113(6)
SECTION V RESPIRATORY THERAPY DEPARTMENT MANAGEMENT
Managing Organizational Change
1119(13)
Delorese Ambrose
External Driving Forces for Change
1120(1)
Technology
1120(1)
Competition and Marketplace Trends
1120(1)
Legal and Regulatory Pressures
1120(1)
Internal Driving Forces for Change
1120(2)
Rising Costs and Decreasing Profits
1120(1)
Reorganization for Greater Efficiency and Effectiveness
1121(1)
Employee Activism
1121(1)
Demographic Trends
1121(1)
What Is ``Organizational Change''?
1122(1)
Developmental Change
1122(1)
Transformational Change
1122(1)
Systemic Barriers to Change
1123(2)
The Philosophy Behind the Change
1124(1)
The Structure and Resources that Support the Change
1125(1)
Human Barriers to Change
1125(1)
Reducing Resistance to Change
1126(2)
Managing Planned Organizational Change
1128(4)
Stage One: Awareness
1129(1)
Stage Two: Proaction (Planning)
1129(1)
Stage Three: Action (Implementation)
1130(1)
Stage Four: Reaction (Feedback)
1130(1)
Summary
1130(1)
Unfreezing
1130(1)
Transitioning
1130(1)
Refreezing
1131(1)
Managing Quality in Health Care
1132(21)
Philip B. Crosby
Thomas H. Breedlove
Ann Parks Linn
The Need for Quality Management
1132(1)
Progress Report
1133(1)
Administration's Fresh Look at Systems Reduces Overtime $50,000 / Month; Receivables Down by 10 Days
1133(1)
Progress Report
1134(1)
Purchasing Communication Buys Pacemaker Savings
1134(1)
What is Quality?
1134(1)
Progress Report
1135(1)
Respiratory Therapy Eliminating Outdated Procedures Saves Dollars, Improves Care
1135(1)
Total Commitment to Quality
1136(1)
Progress Report
1137(1)
Pharmacy Brainstorming Sessions Result in Reduction in Medication Errors
1137(1)
What Are The Customers' Requirements?
1138(1)
Progress Report
1139(1)
Seniors Served Required Diet on Time and `Right the First Time'
1139(1)
Progress Report
1139(1)
Emergency Room Diversion Hours Drop from 350 to Zero in 1 Year
1139(1)
The Road to Wellness
1140(2)
Progress Report
1142(1)
Short-Stay Surgery Updating Charging Procedure Results in Six-Figure Savings
1142(1)
A Common Focus
1143(1)
Progress Report
1144(1)
Radiology Measurement Helps Film Library and Staff Shine
1144(1)
Common Knowledge
1145(1)
Quality Management Strategy
1145(1)
Commitment of Top Management
1146(1)
Progress Report
1146(1)
CEO's Office Show `Em Responsibility Starts at the Top
1146(2)
Education
1148(1)
How Much Does It Cost To Do Things Wrong?
1148(1)
Progress Report
1149(2)
Cardiology Clinic Identifying PONC Brings Attention to Patient No-Show Problem
1149(1)
Summary
1150(1)
Progress Report
1151(2)
Hospital-wide Employee Recognition Puts on a Happy Smile
1151(2)
Ethics and Patient Care
1153(29)
Joseph E. Vincent
Stephen E. Lammers
Ethical Theories
1153(2)
Teleologic Theories and Utilitarianism
1153(1)
Deontologic Theories
1154(1)
Ethical Principles
1155(3)
Respect for Persons-Autonomy
1155(1)
Nonmaleficence
1155(1)
Beneficence
1156(1)
Justice
1157(1)
Professional and Patient Issues
1158(10)
Medical Uncertainty, including Risk-Benefit Assessments
1158(1)
Truthfulness
1159(1)
Informed Consent
1160(2)
Surrogacy
1162(1)
Advance Directives
1163(2)
Confidentiality
1165(1)
Belief Systems
1166(1)
Professional Roles and Team Membership
1166(1)
Patient Advocacy
1167(1)
Selected Topics
1168(9)
Brain Death
1168(1)
Persistent Vegetative State
1169(2)
Judgments of Futility and Hopeless Illness
1171(1)
Withholding and Withdrawing Medical Therapy
1171(1)
`Do Not Resuscitate' Orders
1172(1)
Withholding and Withdrawing Ventilator Therapy
1173(1)
Witholding and Withdrawing Artificial Nutrition and Hydration
1174(1)
Resource Allocation
1175(1)
Euthanasia
1176(1)
Experimentation on Human Beings
1177(1)
Significant Court Cases
1177(5)
Quinlan
1177(1)
Bartling
1178(1)
Satz vs. Perlmutter
1179(1)
Cruzan
1179(1)
Summary
1180(2)
Legal Aspects of Clinical Care
1182(9)
Vincent F. Maher
History
1182(1)
Governmental Structure
1182(1)
Professional Accountability
1183(1)
Legal Framework for Practice
1183(1)
Contract Law
1183(2)
Negligence
1185(1)
Assault and Battery
1186(1)
Informed Consent
1187(1)
Durable Power of Attorney-Health Care Proxy
1187(1)
Staffing
1187(1)
Defamation
1187(1)
Privacy
1188(1)
Acquired Immunodeficiency Syndrome
1188(3)
Summary
1190(1)
Patient, Community, and Staff Education
1191(27)
David D. Rice
Why Education is an Essential Professional Skill
1191(3)
Education Is An Essential Component of Professional Life
1191(1)
Education Is An Essential Component of Clinical Practice
1192(1)
Education is a Central Component of Organizational Life
1192(1)
Education is An Essential Component of Personal Development
1193(1)
Conclusion-Education Should Not Be Left to the Specialists
1193(1)
How Learning Occurs
1194(11)
Change of Behavior
1194(1)
Stimulus-Response and Chaining
1194(2)
Behavioral Theory
1196(1)
Systems Theory
1197(1)
Communication Theory
1198(3)
Adult Learning Theory
1201(2)
The Methodology-Pedogogy, ``Androgogy,'' and ``Appropriogogy''
1203(2)
Classifying Learning Outcomes
1205(6)
The Cognitive or Intellectual Skills Domain
1206(1)
The Psychomotor Domain
1207(2)
The Affective Domain
1209(2)
How Teachers Influence Learning
1211(7)
Common Elements of Significant Models
1211(2)
Recommendations for Establishing the Conditions for Learning
1213(1)
Summary
1214(4)
Management Principles
1218(18)
Eric D. Bakow
Health Care in the 1990s
1218(1)
Health Care Finances
1219(8)
Productivity
1223(2)
Budgeting
1225(2)
Leadership
1227(3)
Management Style
1230(6)
Research and Statistics for the Clinician
1236(39)
Robert L. Chatburn
Dean Hess
Science and the Scientific Method
1236(1)
Why Clinicians Need to Know About Research Methodology
1237(1)
Research Methodology: Components of Clinical Research
1238(8)
Generate an Idea
1238(1)
Develop the Study Question
1239(1)
State the Null Hypothesis
1239(1)
Search the Literature
1239(1)
Consult An Expert
1240(1)
Design the Experiment
1240(3)
Write the Protocol
1243(1)
Obtain Permission
1244(1)
Collect the Data
1244(1)
Reject or Concede the Hypothesis
1244(1)
Write the Paper or Abstract
1245(1)
Incorporate the Findings into Practice
1246(1)
Perform Another Study
1246(1)
Basic Statistics for Data Analysis
1246(1)
Descriptive Statistics
1247(8)
Inferential Statistics
1255(20)
Summary: Communicating the Research Results
1270(5)
Index 1275

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