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Understanding Lung Sounds, Third Edi- Structive Pulmonary Disease to Oxygen Ther- Fectious Processes, and the List of Infectious Tion

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Understanding Lung Sounds, Third Edi- Structive Pulmonary Disease to Oxygen Ther- Fectious Processes, and the List of Infectious Tion BOOKS,FILMS,TAPES,&SOFTWARE tion in the text. The editors used art spar- material. I found that the book is supportive style of a traditional textbook. The reader ingly and wisely, where needed; for of the current National Institutes of Health can pause and formulate his or her own an- example, flow volume tracings and other recommendations for treating acute respira- swers before proceeding to the text’s an- graphics to illustrate pulmonary functions. tory distress syndrome. I was also encour- swers. In practice it is easy to disseminate The illustrations will greatly enhance the aged to see a discussion on multiple-organ the required information, which adds to this reader’s understanding, and there are excel- dysfunction syndrome, as well as informa- text’s utility as a reference. The design of lent illustrations in many chapters, such as tion on risk factors, morbidity, and mortal- the text stimulates the evaluation of a prob- the chapters “Mediastinoscopy” and “Gen- ity. Another nice facet of this book is its lem and the formulation of creative, effec- eral Approaches to Interstitial Lung Dis- discussions of current controversies in acute tive solutions for patient care. Teaching crit- ease.” The radiographs and computed to- respiratory distress syndrome management. ical thinking in this way creates better mography images, though not abundant, In the section on mechanical ventilation clinicians, which benefits our patients. adequately demonstrate specific and impor- there is an informative discussion on the Overall, Pulmonary/Respiratory Ther- tant clinical findings. Image quality is im- basics of mechanical ventilation, as well as apy Secrets is informative, enlightening, portant to illustrate points effectively, and I an interesting discussion on the mechanisms and interesting. I integrated the book’s in- found the images to be of high quality and of permissive hypercapnia. In the section formation into my daily routines and found easy to view. The references are complete titled “Alternative Invasive Ventilatory it to be a convenient reference. Of particular and current for each chapter. The table of Strategies,” I found some unusual ideas that note is the union of older interesting ideas contents is clearly organized and the index I have not heard much about in recent years, with exciting new ones. The text is not an is comprehensive. including thoracic gas insufflation, inverse instructional work, but rather a resource for The organization of the subject matter ratio ventilation, proportional-assist ventila- clinicians seeking answers to questions departs from the traditional division of man- tion, and partial liquid ventilation. Though about management, pathophysiology, and agement and pathophysiology. Disease pro- these ventilation methods are fraught with the theories behind what we do. I found the cesses are presented categorically and in- pitfalls, they are also thought-provoking al- format refreshing and supportive of our roles clude comprehensive corresponding ternatives for those times when we need to as investigators in the clinical setting. chapters on treatment. This approach works pull a proverbial “rabbit out of our hat.” nicely, as the reader can move quickly from Pulmonary/Respiratory Therapy Se- Fred M Goglia RRT readings on respiratory failure to ventila- crets covers a comprehensive list of topics Respiratory Care Program tory strategies and weaning. An example is in pulmonary medicine. In addition to the Seattle Central Community College the section “Airway Disease,” in which the topics in critical care and mechanical ven- Seattle, Washington chapters flow from asthma and chronic ob- tilation, an entire section is devoted to in- Understanding Lung Sounds, third edi- structive pulmonary disease to oxygen ther- fectious processes, and the list of infectious tion. Steven Lehrer MD. Philadelphia: WB apy and smoking cessation. processes is impressive. This section re- Saunders. 2002. Soft cover, illustrated, 145 The book’s ease of use and convenient mains true to the rest of the text in that each pages plus audio CD (operates with Win- size create a text that is valuable in the clin- chapter is current and contains valuable, up dows or Macintosh operating systems), $49. ical as well as didactic setting. The versa- to date, and interesting information for the tility of the text and the wide variety of clinician. The chapters revolve around the Listening is a magnetic and strange thing, a subject matter make this a good reference current standards of practice but they also creative force. The friends [and caregivers] for frequent use in various patient care set- open up some interesting debates. One nice who listen to us are the ones we move to- tings. An entire chapter devoted to proce- example is the controversy over tracheal as- ward. When we are listened to, it creates us, dures in pulmonary medicine adds a lot of pirate versus bronchoalveolar lavage, dis- makes us unfold and expand. utility to the reference as a whole. The au- cussed in the section on nosocomial pneu- —Karl Menninger MD thors provide instructions for and clarify monia. Though the gamut of pulmonary many points about specific procedures such infections receives a lot of attention in the Understanding Lung Sounds is de- as bronchoscopy, and they address ques- section on infectious disease, it’snicetosee signed to provide background on chest aus- tions such as “What are the indications for an informative chapter on pneumonia pre- cultation and interpretation skills to medical bronchoalveolar lavage?” and “What are vention. There is also extensive reference to and allied health students and practitioners. palliative bronchoscopic therapies?” Posing lung cancer, vascular disease, interstitial dis- The book is divided into 5 chapters, the first these questions with succinct and current ease, and other topics too numerous to list three of which comprise half of the 124 answers offers respiratory therapists a better here. For each disease category the book pages of the text; these 3 chapters review understanding of the procedures we see ev- provides pertinent information on diagno- (1) fundamentals of pulmonary anatomy and ery day and aids residents when asked for a sis, radiographic and clinical presentation, physiology, (2) the physics of sound, hear- consult. and treatment. ing, and the stethoscope, and (3) history and A critical care reference must contain The question-and-answer format teaches physical examination. The final 2 chapters sound advice, and this text uses current stan- practitioners to ask the right questions about provide detailed discussion on normal and dards of evidence-based practice. With all patient care—one of the primary goals of adventitious breath sounds. The accompa- the current excitement surrounding acute re- thetext.Thisisanicealternativetothe nying audio compact disc contains 22 tracks spiratory distress syndrome in critical care, standard textbook format. The arrangement of lung sounds described in the text, as well naturally this was the first section I read, of questions allows the introduction of new as 6 tracks to test the listener’s skills. At the considering the contemporary nature of the concepts and text without the cumbersome end of each chapter a series of questions 1272 RESPIRATORY CARE • DECEMBER 2003 VOL 48 NO 12 BOOKS,FILMS,TAPES,&SOFTWARE review the content, and several of the ques- tation by Victor McKusick and David ures that further describe the types and rel- tions are of the critical-thinking type. The Cugell, discussing phonopneumograms ative incidence of crackles in diagnosis. chapters are referenced and there is a bib- from the standpoint of teaching auscultation Wheezes receive similar treatment. How- liography, a section with the answers to skills. That research led to techniques such ever, the author makes no distinction be- chapter questions, a glossary, and an index. as time-expanded waveform analysis, later tween (and there is little discussion about) Chapter 1 begins with a very brief over- promoted by Raymond Murphy, in which high-pitched wheeze (sibilant rhonchus) and view of pulmonary anatomy and physiol- adventitious sounds are stored by a com- low-pitched wheeze (sonorous rhonchus). ogy and concludes with a section on pul- puter and replayed slowly. The chapter The section on wheezing does not seem to monary disorders, including paragraphs on briefly discusses subtraction and automated have as much review of potentially associ- atelectasis, emphysema, consolidation, phonopneumography, which has been em- ated pathologies as does the section on crack- pneumothorax, and pleural fluid problems. ployed by Dennis O’Donnell and Steve Kra- les. This chapter includes a paragraph on Although the content in this section is ex- man. These techniques involve multiple re- stridor and hoarseness, with a review of pos- tremely basic, readers without this funda- cordings of lung sounds made from various sible causes of each. The section on adven- mental information would probably not be locations on the chest wall and have re- titious sounds concludes with brief discus- able to connect the pathologies to specific vealed the areas of loudest sound transmis- sions on pleural friction rub, mediastinal lung sounds. sion and the relative nonuniformity of sound crunch, bronchial leak squeak, and the in- Chapter 2 provides an introduction to the intensity across the chest. Information on spiratory squawk. There is a brief review of basic physics of sound, describing the char- the latest computer-based
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