Description: This book provides practical information regarding the early recognition, prevention, and management of a variety of medical comorbidities and complications that may occur in patients receiving care in formal rehabilitation programs.
Purpose: The purpose is to provide a practical, useable reference for clinicians, primarily physical medicine and rehabilitation physicians who are providing inpatient care, to enable them to prevent, recognize, and treat a variety of common medical conditions in people who are undergoing inpatient rehabilitation for disabling conditions. These are important objectives, in view of the frequency and impact of these complications and the critical role that the managing physiatrist or rehabilitation physician plays in the management of these secondary or accompanying conditions.
Audience: This book is written primarily for physicians in physical medicine and rehabilitation, but it could be used by physicians in other specialties who provide either primary management or specialty consultation for patients on inpatient rehabilitation units. This book may have considerable value for nurse practitioners, physician assistants, nurses, and allied health professionals who are involved in the care of patients with multiple medical comorbidities or acute medical conditions on a rehabilitation unit. The authors are primarily from the University of Miami Miller School of Medicine, which has a highly credible rehabilitation program. Most importantly, the authors reflect a unique collaboration between professionals in physical medicine and rehabilitation and physicians in multiple other relevant specialties who provide care to rehabilitation patients.
Features: The organization of the book is unique and interesting, divided between a set of chapters describing common rehabilitation diagnoses (and their complications), and a set of chapters describing specific medical complications such as fever, chest pain, pulmonary dysfunction, and common laboratory abnormalities. Although this format can lead to repetition, it also provides an effective way for readers to more easily access topics of interest by a variety of means either by rehabilitation diagnosis or medical problem. Most of the chapters on rehabilitation diagnoses provide a brief description of the condition and its rehabilitation, followed by brief reviews of the complications. For example, the musculoskeletal disorders section starts with a review of the various conditions and major rehabilitation principles, and then offers a list of common secondary complications such as pressure ulcers, infections, bone and joint problems, venous thromboembolism, pain, and nerve injuries. Similarly, the spinal cord injury chapter provides brief background on the epidemiology and etiology of spinal cord injury, and then more detailed descriptions of expected complications such as genitourinary, gastrointestinal, pulmonary, musculoskeletal, and others. A unique and important component of the book is the group of chapters written by medical specialists on specific medical conditions, with perspectives on evaluation and treatment of these problems. Particularly useful are the chapters on fever, laboratory abnormalities, osteomyelitis, and clostridium difficile colitis, which constitute common and challenging problems in rehabilitation patients. The writing is clear and, by design, relatively succinct. Tables that appear throughout the book are useful, but surprisingly relatively few in number. More figures would have been helpful, as well. The chapters on the individual medical conditions in the latter portion of the book tend to have substantially more tables and figures. The book is very well referenced.
Assessment: This is a useful resource for clinicians involved in the care of patients on inpatient rehabilitation units, primarily physiatrists, but also other physicians and nonphysician professionals. It provides accessible, succinct, and practical summaries on the prevention, assessment, and management of medical conditions encountered among patients who are hospitalized on a rehabilitation unit, from the perspectives of both physiatrists and medical specialists. By design, it is not meant to provide thorough, in-depth reviews of the topics, but rather to offer summaries for how to approach the conditions. It will be particularly useful as a resource on inpatient rehabilitation units.