Trauma nursing from resuscitation through rehabilitation V D Cardona, P D Hum, P J B Mason, A M Scanlon, S W Veise-Berry (eds)

W. B. Saunders, Philadelphia, 920pages. price 268

Trauma care is a relatively new topic, commanding wide interest but generating high costs. It is this eco- nomic dilemma that has generated fierce discussion as to whether it is right that health care should con- centrate on the acute phase of care at the expense of accident prevention. It is, therefore, surprising that, apart from one short paragraph in Part 1 and occa- sional brief references in various chapters, a book on trauma nursing should ignore such an important aspect in what is seemingly, a major part of the nurse's role. Putting this criticism aside, this text does ' trauma' itself extremely well.

The book is divided into four parts, the first part forming an introduction to the general concept of trauma care, the last three concentrating exclusively on the care of the patient. It is a comprehensive and detailed account ofaU aspects of trauma care, covering the entire range of traumatic injuries and ensuing problems. It is, generally, consistent in its thoroughness of the disordered physiology at both gross and cellular level of the injuries, systems failure and complications.

Three chapters focus exclusively on the rehabilita- tive processes, from both a family and individual per- spective. While these chapters address the main issues; spinal injury; permanent brain damage; amputation and disfigurement; I would have expected greater depth in a book claiming to be about resuscitation through rehabilitation, with more emphasis on inte- gration of the patient back into the community and the support systems that exist there. As many of these subjects are politically and culturally determined, and constantly changing, to have them included in one book on trauma would probably dramatically shorten its shelf-life and, as this is an American text, would be wasted on the British audience.

It is written totally from an American perspective, which is hardly surprising as this, as previously stated, is an American text and this is where the concept of Advanced Trauma Life Support (ATLS) originated in the late 1970s, being introduced into this country in 1988. As a result the first part, explores the origins of trauma care and developments on the other side of the Atlantic with no mention of trauma care in England or any other Western country. Administrative, eco- nomic and legal issues, whilst having similarities to this country, are based on American health care systems. An English nurse would need to supplement his or her reading to discover what developments and initia- tives there are in this country.

There is very little on the place of nursing theory in trauma care. No suggestions are put forward as to suitable models of care and whilst primary nursing is mentioned there is no discussion as to how this could be achieved. The various authors hint at an adaptation model, but never fully explore it. There is

a chapter on nursing practice but it coasts around the issue as to who is responsible for the management of the trauma patient from resuscitation through reha- bilitation. As trauma care is predominantly medically directed, it is vital that nursing texts on trauma care grasp this uncomfortable nettle or they will merely serve to educate the perfect doctor's assistant rather than develop a true primary trauma nurse.

The cost of this book would probably put it out of reach of most nurses but it would form an excel- lent reference text for those studying both at diploma and degree level. It would need to be sup- plemented with texts which concentrate on the other aspects of trauma care, such as the sociology and psychology of trauma, accident prevention, trauma surgery and rehabilitation. It would probably be of interest to anyone working in the field of trauma care in the acute phase but would probably not meet the needs of those working in related areas, i.e. pre-hospital care, theatre and rehabilitation units.

The strength of this book is in its detailed expla- nation of the underlying disordered physiology of traumatic injuries. To expect one text to cover the entire gamut of trauma care would probably be expecting too much of any one book..

A N N E FERGUSON RGN, RNT, RCNT

Care of people with diabetes T Dunning

Blackwell Scientific, Oxford, 1994. 188pages. Price ~, 14.99

This book is designed to be a quick reference source for the nursing care required by those who have dia- betes mellitus. Although it is aimed to be used 'at the bedside or as an academic resource', it is disappoint- ing in its theoretical content.

The book is written by an Australian clinical nurse consultant in diabetes education, and appears to be based solely upon practical clinical experience. The further reading at the end of each chapter is sparse and out-dated, as many of the references are at least 10 years old. Much of the content describes how clinical procedures (such as blood glucose mon- itoring) should be carried out.

If the reader requires a foundation in insulin ther- apy, hypoglycaemic agents and dietary requirements of those with diabetes, then this book would be use- ful. However, if the reader is interested in the sub- stantive evidence which supports the recommended care, then she/he will be disappointed.

There is one chapter concerning the care of those with diabetic cardiac disease and another chapter which outlines the care of an individual with dia- betic nephropathy. Given the high incidence of car- diac and renal disease in those with diabetes, it would have appeared much more appropriate to concentrate more fully on the possible prevention of

these complications. T h e chapter which describes the types of renal

replacement therapy which those with diabetic nephropathy may be offered is confusing and some- times inaccurate. Intraperitoneal administration of insulin for patients on peritoneal dialysis is assumed

Intensive and Critical Care Nursing (I 995) I I , 300-302 © 1995 Pearson Professional Ltd