Philip Lee, Senior staff specialist, Palliative medicine, Westmead Cancer Care Centre, Westmead Hospital, Sydney
The third edition of Therapeutic Guidelines: Palliative Care has been prepared by an expert group of experienced palliative care clinicians. This book is an excellent source of concise information about common palliative care problems encountered by health workers who are involved in the care of patients with a life threatening and terminal illness. It is a useful guide for those currently working in the field of palliative care, those undertaking training and clinicians who may occasionally provide palliative care for a patient.
The first few chapters present an easy to read overview of palliative care principles, the holistic approach to providing palliative care and a description of the multidisciplinary team approach to modern palliative care. There are chapters which cover the emotional, ethical, and communication challenges which face all those who care for patients at the end of life. This also includes a chapter on the emotional care of health professionals in a field in which burnout and stress are all too common. An excellent chapter 'Pertinent practical points' gives expansive answers to frequently asked questions.
The largest part of the book deals with clinical management of common problems and gives an excellent overview of frequently used drugs. These drugs can be challenging to clinicians who primarily work outside palliative care. There are a number of drugs used 'off-label' and some unregistered drugs, such as cyclizine and levomepromazine, are obtained through the Special Access Scheme of the Therapeutic Goods Administration.
The final chapters cover the most common symptoms that patients present with, including pain, fatigue, gastrointestinal, respiratory and psychiatric symptoms. The approach of assessing and managing each symptom is systematic and well described.
This book is an excellent, succinct source of reliable palliative care information. It is also available in an electronic version, which includes all the supporting references.
