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Cupid's Bow
Author(s) -
Lord David J
Publication year - 1998
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1998.tb126779.x
Subject(s) - citation , snapshot (computer storage) , library science , history , computer science , operating system
Experienced members of The Royal Melbourne Hospital Acute Stroke Unit, one of the first established in Australia, provide an enormous amount of practical information in this timely book. Their style is informal. They cover the pathology, risk factors and medical management of stroke well, although some technical terms may be incomprehensible to those outside the direct area of stroke care. There are good explanations of appropriate management strategies. Headings and sub-headings enhance understanding, but key facts could be emphasised more by highlighting. In the section on acute medical and team management of the patient during the acute phase of stroke, the authors emphasise continuity between acute care and rehabilitation. Good organisation in acute stroke care saves lives not necessarily because of sophisticated treatment but by attention to details, such as hydration, positioning and swallowing ability, and by the prevention of complications. I was particularly impressed with the strategies to compensate for communication difficulties and cognitive impairment. The section on resuming driving is particularly good. This is often a problem in clinical practice, where guidelines are usually unclear at best. There are some minor omissions which I hope will be rectified in future editions. The selective serotonin reuptake inhibitors (SSRIs), such as sertraline, are probably now the preferred drugs for the treatment of depression and emotional lability. The section on planning for discharge from hospital should discuss such aspects as sexual activity, a significant concern for many patients. The manual is mainly targeted at nursing staff, but it could also benefit junior medical staff and paramedical practitioners. It provides a good basis for the development of stroke units and clinical care pathways in other Australian hospitals, and I believe it will be an invaluable resource for the care of stroke patients in hospitals. At $20 it is good value for money. David Dunbabin Senior Lecturer in Medicine, Department of Medicine University of Tasmania, Hobart, TAS