Anesthesiology Unplugged - by Gallagher et al.

[aphistis]

Anesthesia Unplugged
By Christopher Gallagher, Ricardo Martinez-Ruiz, and David Lubarsky
Reviewed by Bill Johnson, DDS

Anesthesia Unplugged is a clinical anesthesiology text written to provide “how-to” instruction for several of the various procedures commonly employed in the practice of clinical anesthesiology. Its target audience, in the authors' own words, includes medical students interested in anesthesiology, anesthesiology residents, student CRNA's, physicians in other specialties (such as internal medicine and emergency medicine) with an interest in the procedures described in the book, and ICU personnel.

Strengths:

Breadth of Scope: The authors of Anesthesia Unplugged did an excellent job of selecting procedures that will be of value to the book’s intended audience. The book is generally laid out so that for any given section, students and junior residents will likely benefit most from the earlier chapters, while more advanced providers will profit most from the later. While not an authoritative text on any one procedure, it provides technical instruction and a functional understanding for over two dozen.

Chapter Layout: This book employs an intuitive, easy-to-follow chapter layout. Eachbegins with summary lists of indications, contraindications, necessary equipment, and “philosophy of” the procedure under discussion, to help provide big-picture context, followed by a review of pertinent historical questions and physical exam findings. The remaining bulk of each chapter consists of a detailed, step-by-step technique guide (often with a separate, dedicated section detailing the same procedure on pediatric patients), a similarly stepwise demonstration using clinical photographs, and an annotated list of recommended reading.

Readability: Anesthesia Unplugged is an eminently readable text. The authors take a very lighthearted, irreverent approach toward the book, but not at the expense of instructional clarity. Each chapter includes up to a dozen sidebars—sometimes funny, sometimes educational, frequently both--placed in columns apart from the main text. While this somewhat unorthodox approach may turn some readers away, in the reviewer’s opinion it makes for a much more accessible, enjoyable study tool.

Portability: While not pocket-sized, this book will fit easily into a shoulder bag or backpack for reading during the workday. Its paperback binding allows it to bend or fold to share space with other objects without lasting harm.

Weaknesses:

Photography: Not all of the procedures included in Anesthesia Unplugged are accompanied by photographic demonstrations. The line drawings used in these instances are still helpful, but much less so than the photographed chapters. Additionally, A few chapters employ photos that have been digitally enlarged well beyond the resolution of the original pictures, resulting in significantly pixilated book images.

Editorial Polish: While this does little to detract from the book’s utility as an instructional resource, a number of spelling, punctuation, and grammatical errors will stand out to observant readers.

Readability: This aspect is intentionally repeated from above, in recognition that the book’s casual writing style, in conjunction with the problems described above, may lead some readers to question the authority of this book’s approach to teaching anesthesia procedures. Such readers are likely to find Anesthesia Unplugged book an unreliable resource, and favor other instructional texts.

Reviewer’s Impression:

First, full disclosure: I’m not a typical anesthesia resident. I’m a licensed, GPR-trained dentist currently completing an anesthesiology fellowship. That said, Anesthesia Unplugged has been an invaluable resource during my anesthesia training. From routine matters such as starting peripheral IV’s and mask ventilating, to more complicated procedures such as laryngoscopy and spinal anesthesia, on through the numerous procedures I haven’t yet attempted (and, indeed, may never), this text details a number of anesthesia procedures, both simple and advanced, in a manner that is both instructional and entertaining. Before spending the money for your own copy, I’d recommend leafing through a copy at your bookstore; if you like it there, take it home with you. You’ll be glad you did.

Contents:
Intravenous World
- The Rodney Dangerfield of Lines: The IV
- The Anesthesiologist's Party Piece: The IJ
- Root Beer Float? No, Floating a Swan
- The Surgeon's Bailiwick: The Subclavian
- The Bastard Stepchild: The Femoral

Arterial Land
- The Beat-to-Beat Faucet: The Radial A-Line
- EEEEK! Do We Dare? The Brachial A-Line
- An Ever-Present Friend in Time of Need: The Femoral

Into Thin Air
- The Mask of Zorro: Mask Ventilation
- The Zirconium Jewel of Sort-of-Intubation: The LMA
- The Vanilla Ice Cream of Intubation: Laryngoscopy
- The Crown Jewel of Intubations: Awake Fiberoptic
- Wiretapping: The Retrograde Wire Intubation
- Fix Bayonets: The Surgical Alternative

Et tu, Brute? A Stab in the Back
- Oh Good, CSF! The Spinal
- Oh Damn, CSF! The Epidural
- Mix and Match: The Combined Spinal-Epidural
- Mending Fences: The Blood Patch
- Oh, the Little Darlin's: The Kiddie Caudal

Efficiency-Ville
- Getting a Case Going at a Greater-than-Glacial Pace
- Don't Buck Up at the End of the Case: The Smooth Wake-Up
- Roomsmanship
- Nasogastric Tubes Away!
- Positioning is Everything
- Transportation Made Somewhat Less Deadly

The Regional Landscape
- Armed and Dangerous: The Arm Block
- Lego-Land: Lower Extremity Nerve Blocks
- A Sympathetic Ear and a Sympathetic Block
- Ophthalmic Anesthesia: More than Meets the Eye

Treasure Chest
- "The Lung's Not Down, You Idiot!” Lung Isolation
- Living Better with Electricity: Pacing
- Echo, Echo, Echo: Transesophageal Echocardiography

Faking It
- Simulators

- Index

[SleepIsGood]

I'm an anesthesia resident.

I will endorse the above poster's claims about the book.

Obviously, nothing beats actually doing these procedures in the OR/prep and hold of your hospital. This book is great to have because it is very easy to read. After you've done X procedure at the hospital, it's good to be able to go home and refer back to this text.

Only section I wish they expanded on this book, is the chapter on TEE.