THE
MEDICAL CARE OF TERMINALLY ILL PATIENTS
Second Edition
Robert
Enck
 |
The Johns Hopkins
University Press, 2002
ISBN 0-8018-6766-5
226pp
RRP $US31.50 £21.50 
|
This book is described as “the effort of a clinician writing for other clinicians.”
Not a handbook, not an all-encompassing textbook, but a review of clinical studies that are applicable to the management of the dying patient at the bedside.
The book is divided three sections - Management of Symptoms, Management of Pain, and Management of Symptoms During the Last Few Days.
The first two sections cover the treatment of pain and the common symptoms in terminally ill patients.
The discussion of these problems is based on the results of relevant clinical studies from the literature. Enck has an unhurried way of introducing
the information from these studies, giving a little more of the background detail and making it more of a discussion than a lecture. In general, these
are up to date and adequately referenced, although there are a few topics, such as the COX-2 specific inhibitors, that are omitted. The section on
the neurosurgical treatment of pain (now largely replaced by pharmacological spinal therapy) is a bit dated.
The third section of the book is about management of patients during the last few days of life.
This section is more focused and conveys considerable clinical experience and insight.
This Second Edition, coming eight years after the first, demonstrates the enormous advances that have
been made in the understanding of the treatment of the terminally ill. It provides the clinician with a clear, readable and practical guide to managing
clinical problems at the end of life. It does not aim to compete with comprehensive textbooks of palliative care, but would be an excellent introduction
for junior doctors and others who are involved only occasionally with the terminally ill.
Roger
Woodruff
Past Chairman, International Association for Hospice and Palliative Care (IAHPC)
Director of Palliative Care, Austin & Repatriation Medical Centre, Melbourne , Australia
(April 2002)
Author
information
Robert Enck is Clinical Associate Professor, University of Pennsylvania School of Medicine, Philadelphia
, Pennsylvania , USA
.
TABLE
OF CONTENTS
1. The Prognostication of Survival 1
Part I - The
management of symptoms common among dying patients
2. General symptoms of dying patients 13
3. Other problems of patients with with cancer 59
4. Other problems of patients with nonmalignant diseases
73
5. Palliative surgery 88
Part II - The
management of pain
6. An overview of pain management 99
7. Opioids 113
8. Adjuvant analgesic drugs 141
9. Complications of pharmacologic therapy 146
10. Bone pain 156
11. Surgery and other non-pharmacological interventions to
manage pain 161
Part III - The
Management of symptoms during the last few days
12. The final moments 171
13. Issues concerning the sustaining of life 185
References 197
Index 219
