Screening Notes: Rehabilitation Specialistʼs Pocket Guide.

Screening Notes: Rehabilitation Specialist's Pocket Guide. Gulick D. Philadelphia, Pa, F A Davis Company, 2006, softcover, spiral-bound, 213 pp, $24.95. Screening Notes is 1 of 7 in the series of Davis's Notes “pocket guides” from F A Davis. Others include OrthoNotes, DermNotes, MedNotes, PsychNotes, ECGNotes, NutriNotes, and the recently released RehabNotes, each of which comes as a concise, portable, spiral-bound, pocket-sized, 3″ × 5″ volume with waterproof, wipe-off, reusable forms and worksheets that could be very useful for collecting patient screening information. While targeted to and obviously valuable for physical therapists—it includes references to the Guide to Physical Therapist Practice—Screening Notes, by Dawn Gulick, PT, PhD, CSCS, ATC, could also be useful for any health care provider. As with any medical screening resource, this pocket guide helps to identify disease processes that fall outside of the physical therapist's scope of practice. Screening Notes begins with a section on alerts/alarms, and the remainder book follows a lifespan approach, including tabbed sections on pediatrics, adolescents, adults, pregnancy, and geriatrics. The book ends with a reference section and an index. Red flags, defined by the author as “a sign or symptom that is a strong predictor of pathology” for each body system (musculoskeletal, neuromuscular, cardiovascular, pulmonary, integumentary, gastrointestinal, hepatic, endocrine and urologic), are the prime focus in each section. In addition, each section delves into cancer screening, visceral screening, normative values, standardized screening tools, and pain referral patterns. The section on alerts/alarms is an impressive, concise source of medical screening information, including general screening questions, generalized systemic red flags, emergency signs and symptoms, and a chart of vital signs across the lifespan. Descriptions of visceral palpation, pulmonary and cardiac auscultation, general red flags for cancer, and signs and symptoms of specific organ pathology for all the major organs are also included, as well as a brief chart of potential causes for abnormal lab values and a chart of Body Mass Index classifications. The pediatrics section includes normal growth charts for head circumference, height, and weight, and a very helpful chart of pediatric vital sign norms by age. The developmental reflexes, developmental milestones, and development of gait are summarized in tables. The book also provides the Pediatric Balance Scale tool, an immunization schedule and summary of contagious childhood diseases (some with photos), signs and symptoms of common pathology of musculoskeletal and other major symptoms in pediatrics, red flags for autism, and a chart of pediatric neoplasms. The adolescents section begins with a table of blood pressure norms for adolescents ages 10-17 and then provides a helpful summary of signs and symptoms of common adolescent pathology, particularly musculoskeletal, gastrointestinal, and urogenital disorders, and sexually transmitted diseases (STDs). Highlights of the adults section include the Ottawa Knee, Ankle, and Foot Rules for orthopedic screening, a chart of arthritic changes comparing osteoarthritis, rheumatoid arthritis, and gout, and a summary of sign and symptoms and demographic features for the major neuromuscular and cardiovascular and pulmonary pathologies in adults. Screening for myocardial infarction and deep vein thrombosis (DVT) is outlined well. The table of integumentary pathology in adults contains a wonderful summary of important points and is well illustrated with photographs. The pregnancy section includes a table that summarizes the physiological changes with pregnancy, precautions during pregnancy, and red flags when exercising during pregnancy. A listing of potential pregnancy-related complications in each body system is followed by a discussion of STDs and a scale for screening postnatal depression. Finally, the geriatrics section is a very helpful resource beginning with a concise table of age-related physiologic changes and expected lab value changes with age. A discussion of fall risk is followed by these specific tools: Gait Abnormality Rating Scale-Modified, Berg Balance Scale, Tinetti Assessment, Timed Up & Go Test, and a home safety checklist. A list to assist in screening for elder abuse is also included. The charts on neuromuscular pathology, integumentary, and endocrine disorders in geriatrics are valuable summaries. Overall the handbook's organization and the content are excellent. There are a few instances of redundancy (eg, arthritic changes and DVT information appear in both the adult and geriatric sections) that could be eliminated with cross-referencing. The ability to take patient notes directly on the pages and later wipe them clean with alcohol for re-use is both novel and convenient. The author states that the purpose of the pocket guide is “to help the health care provider complete a thorough medical screening, identify red flags, and determine if the patient's needs are within the practitioner's scope of practice or if a referral would be appropriate.” Screening Notes would be useful to students and physical therapists as a reference and quick summary of important screening information in clinical practice. The resource would also be useful to students as they review for the National Physical Therapy Examination. I highly recommend the Screening Notes pocket guide as a supplementary resource. Dennis W Fell PT, MD Associate Professor and Chair Department of Physical Therapy College of Allied Health Professions University of South Alabama Mobile, AL

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