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As new research and experience broaden our knowledge, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on their own experience and knowledge of the patient, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the Editors assumes any liability for any injury and/or damage to persons or property arising out or related to any use of the material contained in this book. The Publisher Working together to grow The libraries in developing countries publisher’s policy is to use paper manufactured www.elsevier.com | www.bookaid.org | www.sabre.org from sustainable forests Printed in China CONTRIBUTORS Alison Aldridge MCSP Principal Respiratory Physiotherapist, Hampshire Primary Care Trust, Lymington Valerie Ball MSc, MCSP Lecturer, School of Health and Rehabilitation, Keele University, Keele Mary-Ann Broad MSc (Critical care), BSc (Physiotherapy), MCSP Clinical Specialist Physiotherapist, University Hospital of Wales, Cardiff Alison Carter MCSP C linical Lead Acute Inpatient Paediatrics, Evelina Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London Lorraine Clapham BSc (Hons), MCSP Principal Clinical Lead Physiotherapist, Wessex Neurological Unit, Southampton Nell Clotworthy MCSP, MSc C linical Specialist Respiratory Physiotherapist, South Devon Healthcare NHS Foundation Trust, Torbay Hospital, Torquay Dr Jane Cross EdD, MSc, Grad Dip Phys, MCSP Senior Lecturer in Physiotherapy, Univestity of East Anglia, Norwich Rachel Devlin Grad Dip Phys, MCSP C linical Specialist Physiotherapist, General Intensive Care, Southampton University Hospitals NHS Trust, Southampton Elaine Dhouieb MCSP, MSc R espiratory Clinical Specialist, Physiotherapy Department, Royal Hospital for Sick Children, Edinburgh Alison Draper MSc, MCSP, Cert HE L ecturer, Division of Physiotherapy, School of Health Sciences, The University of Liverpool, Liverpool Dr Stephen Harden MA, MB, BS, FRCS, FRCR C onsultant Cardiothoracic Radiologist, Wessex Cardiothoracic Centre, Southampton Contributors ix Bernadette Henderson MSc, MCSP A dvanced Clinical Practitioner, Cardiorespiratory Physiotherapy, Barnet and Chase Farm NHS Trust, Barnet Hospital, Barnet Carole Jones Grad Dip Phys, MCSP Superintendent Physiotherapist, University Hospital of Wales, Cardiff Sarah EJ Keilty MSc, MCSP C onsultant Physiotherapist, Respiratory & Critical Care, Guy’s and St Thomas’ NHS Foundation Trust, London Angela Kell BSc (Hons), MCSP S uperintendent Physiotherapist, United Bristol Healthcare Trust, Physiotherapy Department, Bristol Royal Infi rmary, Bristol Irelna Kruger BSc, MCSP Band 7 Physiotherapist, Royal Marsden NHS Foundation Trust, London Katharine Malhotra BSc (Hons), MCSP Superintendent Physiotherapist, Royal Marsden NHS Foundation Trust, London Matthew Quint MCSP, Grad Dip Phys, MPhil C linical Specialist Physiotherapist, Portsmouth City Teaching Primary Care Trust, Portsmouth Paul Ritson MCSP C linical Specialist Physiotherapist, Paediatric Critical Care, Royal Liverpool Children’s NHS Trust (Alder Hey), Liverpool Fiona Roberts MSc, BSc, MCSP L ecturer in Physiotherapy, Faculty of Health and Social Care, School of Health Sciences, The Robert Gordon University, Aberdeen Elizabeth Thomas MSc, Grad Dip Phys, MCSP Medical Respiratory Lead Physiotherapist, Bradford Royal Infi rmary, Bradford Sandy Thomas MEd, MCSP S enior Lecturer, University of the West of England, Bristol Zoe Van Willigan BSc, MCSP B and 7 Physiotherapist, General Intensive Care, Southampton University Hospitals NHS Trust, Southampton Ruth Wakeman BSc (Physiotherapy), MCSP Clinical Specialist Physiotherapist, Royal Brompton & Harefi eld NHS Trust, London