BOOK REVIEWS

A Manual of Cardiac Surgical Intensive Care

R Millner and J Pepper Edward Arnold, London, 1990, 123 pages. Price f16.50

Although this book is likely to prove a useful pocket reference for junior medical staff, it will be of limited use to critical care nurses due to its focus on the purely medical management of adults in the cardiac surgical intensive care unit. As someone involved with the in-service training of critical care nurses I would recommend it as supplementary reading material. In fairness, these points are made by the authors in their introduction.

The book is divided into three parts. Part One starts with a brief history of cardiac surgery, followed by a detailed coverage of anatomy and physiology, basic pharmacology and nutrition, and then a review of preoperative assessment, transfer to the cardiac care unit and surgical techniques.

Part Two deals with postoperative complications and uses an interesting method of presentation - ‘trouble-shooting’ algorithms. However, these lack sufficient clarity - the more liberal use of headings, bold print and an improved layout would have helped. The lack of reference to the UK Resuscitation Council guidelines in the treatment of ventricular fibrillation was worrying.

Part Three comprises normal values and useful drugs.

In essence, a useful quick-look reference book, though as a nurse I would opt for a more holistically orientated tome should I have any spare cash in my book budget!

RUTHPCOWELL

SRN, JBCNS 100, ENB 998

Guillaio-Bard Syndrome A H Ropper, E F M Wijdicks, B T Truax F A Davis Company, Philadelphia, 1991, 369 pages. Price f33.75

Guillain-Barre patients are fascinating to nurse. To the novice, the onset of symptoms is mysterious and arcane, arriving out of nowhere and usually dis- appearing thence.

To effectively nurse a fully symptomatic patient requires both knowledge and insight. Both can be found in this panoramic and exhaustive book.

The authors start with the work of eponymous physicians and their antecedents, characterising this often annoyingly inconsistent disease. They describe

how, after a commonly innocuous disease the ravages of inflammatory demyelination ensue. The descrip- tion of symptoms, the parasthesia, the deep muscle pains and the ascending loss of muscle power are all well executed. To make these more vivid, the authors report the first hand accounts of fellow physicians, and this humanistic attitude illuminates these sections.

For the nurse, the middle chapters are perhaps too academic, but the pace soon ‘hots up’, when discussing clinical features. There follows a whistlestop tour of the often disparate symptoms, that will be of great use to the neurological and intensive care nurse. The effectiveness of the specific treatments is concisely discussed, and leaves the reviewer wondering why our medical colleagues subject our patients to the trauma of plasma exchange, or steroid therapy for such paltry gains.

The final sections on care, respiratory failure and rehabilitation are clear and direct.

They highlight the importance of good hygiene in preventing opportunistic infections, and the problems of reduced mobility, in particular thrombi. Attention is given to pain control which is subjectively of great importance to these patients. The reference section is excellent and vast.

This book deserves a place on any unit or ward involved in the care of Guillain-Barre patients.

PETERNORRIE

RGN, HND, MIB, PGCE

ABC of Major Trauma By David Skinner, Peter Driscoll and Richard Earlam

teds) BMA, London, 1991, 1 I7 pages. Price S12.95

This book is a collection of articles first published in the British Medical Journal. It is a welcome addition to the excellent ABC series.

All immediately life-threatening injuries are con- sidered, which provides an extensive guide to the early management of the multiple injured patient. Support- ing chapters include ‘Transport of injured patients’, ‘Handling distressed relatives and breaking bad news’, and ‘Scoring systems for trauma’.

Each chapter is written by experts in a particular field of trauma medicine. Information is presented in a logical format moving from initial patient assessment through to investigations, and provides a rationale for the management of injuries. The factual information is enhanced by the use of photographs, X-rays, drawings and tables allowing quick and easy reference to specific points. However, few reference sources are

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