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HOUGH’S
Cardiorespiratory Care
For Elsevier
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Fifth Edition
HOUGH’S
Cardiorespiratory Care
an evidence-based, problem-solving approach
Alexandra Hough
MSc, MCSP, DipTP
Respiratory physiotherapist and freelance lecturer
Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2018
© 2018 Elsevier Ltd. All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or
mechanical, including photocopying, recording or any information storage and retrieval system, without
permission in writing from the publisher. Details on how to seek permission, further information about the
Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance
Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher
(other than as may be noted herein).
First edition © Chapman and Hall 1991
Second edition © Nelson Thornes 1996
Third edition © Cengage Learning 2001
Fourth edition © Cengage Learning 2014
Fifth edition © Elsevier Limited 2018
ISBN 978-0-7020-7184-3
eBook ISBN 978-0-7020-7527-8
Notices
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using
any information, methods, compounds or experiments described herein. Because of rapid advances in the
medical sciences, in particular, independent verification of diagnoses and drug dosages should be made. To the
fullest extent of the law, no responsibility is assumed by Elsevier, authors, editors or contributors for any injury
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Printed in Italy
C O N T E N T S
Dedication, vi PART IV Physiotherapy for specific groups
Preface, vii of people
Acknowledgements, viii
Contributors list, ix 15 Infants, 337
About the author, x 16 Children, 365
17 Hyperventilation syndrome, 391
18 Elderly people with cardiorespiratory
PART I Physiology and pathology disease, 409
19 Palliative respiratory physiotherapy, 417
1 Physiological basis of clinical practice, 1
2 Assessment, 29
3 Respiratory disorders, 69 PART V Critical care
4 Cardiovascular disorders, 133
5 General management, 149 20 Critical care, support and monitoring, 431
21 Physiotherapy for critically ill patients, 477
22 Modifications for different disorders, 519
PART II Physiotherapy techniques
6 Physiotherapy to increase lung volume, 179 PART VI Does it work?
7 Physiotherapy to clear secretions, 199
8 Physiotherapy to decrease the work of 23 Evaluation of cardiorespiratory
breathing, 227 physiotherapy, 555
9 Pulmonary rehabilitation, 247
10 Physiotherapy for people with cardiovascular Glossary of abbreviations, definitions, symbols and
disorders, 269 values, 569
11 Cardiac rehabilitation, 277 Index, 579
PART III Surgery
12 Complications, 287
13 Physiotherapy for surgical patients, 295
14 Modifications for different types of surgery, 307
v
The book is dedicated to Veronica Bastow,
who has contributed much to humane and thoughtful respiratory care.
P R E FAC E
Good facts make good ethics. Each problem and disease also has a comprehensive list
Ashwal, 2013 of validated outcome measures. Clarity is assisted by
glossary terms highlighted throughout.
Cardiorespiratory care is an immensely satisfying The accompanying website contains full references, a
branch of physiotherapy. It challenges our intellect, bibliography, and appendices which include links and
exploits our handling skills and employs our humanity guidelines for professionals, handouts for patients and
to the full. The specialty is both art and science, but not extra case studies.
an exact science. Effectiveness depends on problem- Problem-solving requires thinking rather than expe-
solving, which requires evidence-based information, rience, hence the book is suited to physiotherapists from
provided here in the form of 5000 online references. student level to accomplished practitioner, whether they
Clinicians, students and educationists also expect work in acute or chronic settings, as well as specialist
integration of theory and practice, explanations that are respiratory nurses. The clinician will find here the
physiologically sound, and exact detail of technique. opportunity to achieve clarity of thought and develop
This book is written for such readers and for those who mastery in respiratory care.
question traditional assumptions. Clinical reasoning The fifth edition includes invaluable contributions
boxes in the text facilitate critical thinking, and case from specialists Alison Draper, Jo Sharp, Kath Ronchetti
studies at the end of each chapter aid problem-solving. and David McWilliams.
vii
AC K N OW L E D G E M E N T S
Profound thanks to the patients who have taught me much over the years. I am also indebted to
Paula Agostini and Anne Canby for their clinical expertise, Jodee Tame for her expert eye and
my editor Katie Golsby for her patience and acumen.
viii
