How to Survive in Anaesthesia, 5th ed.

Abstract

Embarking on a career in anesthesia is undoubtedly an intimidating experience. The undergraduate exposure to anesthesiology can be limited and provides only a small glimpse into the specialty. New residents have a large knowledge gap to fill to understand how to provide safe anesthesia. How to Survive in Anaesthesia is a quick reference text designed with this in mind. It aims to equip new residents with the necessary coping skills and empirical knowledge to survive their first weeks of training. It is also relevant for medical students with an interest in anesthesiology, nurse anesthetists, and practicing anesthesiologists involved in medical education. This book is appropriate for the beginner in terms of structure and content. It is the fifth edition of the book, which is indicative of its popularity among residents. Changes from the fourth edition include 6 new chapters and a slightly reformatted layout. The preface, “Let’s Start at the Very Beginning,” which details the inner workings of an operating theater department, demonstrates the authors’ sensitivity in meeting the most practical needs of the intended audience. The book is divided into 5 sections that are intuitively arranged starting with the absolute essentials: the airway and anesthesia equipment in section I (“Nuts and Bolts”) and anesthesia emergencies (“Crises and Complications”) in section II. Section III, “Passing the Gas,” deals with anesthesia for a range of different surgical specialties, including abdominal, gynecological, urological, dental/ENT (ears, nose, and throat), orthopedic, and day care surgery. Chapters covering laparoscopic surgery and obstetric anesthesia are welcome new additions because residents are often exposed to these areas at an early stage. Notable omissions are the more complex subspecialties cardiothoracic surgery and neurosurgery; but we think that these editorial choices seem appropriate given the target audience and the intention of the text. Section IV, “Walking the Walk,” is a new addition to the book concerning the role of an anesthetist outside the operating theater. This reflects the variety of modern anesthesia practice and the expanding role of anesthesiologists as perioperative physicians. A chapter that would be particularly well thumbed is the one titled “Anaesthetic Aphorisms.” It provides eminently practical advice based on the extensive experience of the authors. This demonstrates the authors’ balanced approach to the subject and would appeal to those who appreciate that there is as much art as science in the expert practice of anesthesiology. Each chapter is succinct, providing direct and practical explanation of the relevant principles, which very much aids with the assimilation of material. The contents are clear and well presented, making each topic easy to locate within the comprehensive index. The information is made even more accessible with the use of a well-judged number of attractive illustrations, tables, and figures. Some useful emergency algorithms are included, such as basic life support, advanced cardiac life support, adult tachycardia, adult bradycardia, and pediatric basic life support. There are some important omissions, too, including those published by the Difficult Airway Society. This is unfortunate because it may result in junior residents being unaware of relevant and important updates. The book is written in British English, with a few notable differences in terminology, specifically suxamethonium versus succinylcholine and gas cylinder coding. This has been a persistent criticism of the earlier versions and does represent a potential safety issue. Explanation is provided at a basic level throughout the book, with the authors stating clearly from the outset that “full explanations have been left for proper textbooks.” The accessible nature of the text would prevent the enthusiastic yet anxious beginner from becoming overwhelmed; however, its simplicity may frustrate readers who are looking for further detail. A useful adjunct may be to include a list of “further reading” resources at the end of each chapter. The authors have clearly paid heed to holding the attention of younger readers with the engaging style of writing and occasional humor peppered throughout. Additional supplementary resources such as podcasts and/or online references would be welcome inclusions, lending further appeal to the technologically literate intended audience. This book is light and easy to carry for the busy, mobile, new resident. In terms of cost, it currently retails at $54.99 for the paperback version and $44.00 for the eBook. This is not insignificant, as the main utility of this book pertains largely to the first 4–6 weeks of training. Is it a justifiable cost? Yes, we think that How to Survive in Anaesthesia very much meets its goal of building a solid foundation of knowledge for the beginner in anesthesiology in an accessible and attractive format. Sinead M. O’Shaughnessy, MBBCh, MSc, FCAIAbigail M. Walsh, MBBCh, MRCP, FCAI, FJFICMIDepartment of Anaesthesia and Intensive Care MedicineSt Vincent’s University HospitalElm Park, Dublin[email protected]