Abstract
K. G. Allman, A. K. McIndoe & I. H. Wilson , eds Oxford University Press , 2005 . 475 pp , ISBN 0-19-852099-9 . £19.95 Life-threatening emergencies can cause the heart of anyone involved in the care of anaesthetised patients to sink. Written in the familiar Oxford Handbook style, this pocket-sized book aims to provide a succinct and up-to-date guide to managing anaesthetic emergencies. Chapters are arranged by speciality and subdivided into common problems. Each emergency is dealt with in a systematic fashion under the headings Definition, Presentation, Immediate and subsequent management, Investigations, Risk factors, Exclusions, Special considerations and Further reading. Topics are also indexed at the back making them easy to find in a hurry. In addition to the traditional specialities, thoracic surgery, regional anaesthesia and neurosurgery are covered. Particularly useful to the non-specialist are the sections on management of airway injury, bleeding and obstruction, problems during one-lung ventilation, suggestions of when to stop anticoagulants before performing regional techniques, treatment of raised intracranial pressure, globe perforation and retrobulbar haemorrhage. Also included are chapters covering equipment and postoperative problems, practical procedures and an emergency drug formulary. Stepwise suggestions regarding the treatment of severe postoperative pain and postoperative nausea and vomiting are particularly useful. Oesophageal Doppler monitoring is well presented with real-time waveforms to help identify correct positioning and appearance in different clinical situations, such as hypovolaemia and heart failure. The drug formulary, although useful in that it suggests how to dilute and infuse drugs, cautions about using an unfamiliar drug in an emergency setting. I found the coding of urgency of treatment particularly useful to the trainee. For example, postoperative hypoxia is life-threatening and requires urgent assessment and treatment, whereas confusion requires careful assessment but is not life-threatening. This book should be used as an aide-memoire and guide only – not as the bible for dealing with anaesthetic emergencies. Due to its compact size, details such as pathophysiology and the evidence base that help us understand management are not included. For these, established anaesthetic texts and journals should be consulted. My only other criticism is that this book is not yet available as a program on a handheld computer. Overall, I found this book clear, easy to use and a handy aid to jog my memory. It offers good value for money and beautifully complements the sister book Oxford Handbook of Anaesthesia, edited by two of the editors of this book. I would highly recommend it to anyone, from the novice to the expert, who is involved in the care of anaesthetised patients.
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