Reviewer: Richard I. Cook, MD (University of Chicago Pritzker School of Medicine)
Description: Targeted at residents and fellows in training, this book describes the clinical features of most gas-based, anesthesia-specific, devices and machines in common use. For these, the book is encyclopedic in content and structure. Although not explicitly intended to be, the book is certain to replace the authors' estimable Understanding Anesthesia Equipment, 5th edition (Lippincott Williams & Wilkins, 2008).
Purpose: As part of the Practical Approach series, this book aims "to give trainees basic information about the equipment they employ...daily." The authors have long been the de facto authorities on anesthesia equipment, especially breathing systems, vaporizers, and airway devices. Their previous book is the established core text in the area. But even its most recent edition is now out of date and too wordy for most current trainees to use effectively. This new book is not an upgrade, but a ground-up, new publication specifically focused on trainees.
Audience: The authors target trainees, especially residents, but the book is likely to be useful for experienced practitioners and technicians as well. The authors are widely recognized as the authorities with the broadest, most clinically relevant knowledge and experience in the area.
Features: The book covers most of the important aspects of anesthesia-specific equipment, including anesthesia delivery systems and their components, airway management devices and endotracheal and endobronchial tubes, gas supply systems, common monitors, and warming apparatus. Specific sections focus on operating room fires, cleaning and sterilization, and equipment checkout. As with the previous book, the emphasis is on equipment used to create, sustain, and monitor potent, agent-based anesthetics. The book is replete with color pictures and diagrams, many with detailed legends that allow the reader to "see" into complex equipment and processes. The numerous highlighted "clinical moments" that accompany the text are gems that long-experienced and thoughtful practitioners would provide to residents and fellows during cases — specific and narrowly focused, but, when well timed, exceptionally useful in turning a journeyman into an accomplished expert. While one might quibble about a point or two, together they represent a significant clinical contribution and will be important to both trainees and experienced practitioners. The authors have collected and transcribed not just knowledge, but real wisdom and incorporated it in the book. Anesthesia teachers would do well to integrate these clinical moments into their curricula and include discussion of them during their daily training activities. The book does not address intravenous anesthetic related equipment (e.g. infusion devices, catheter or tubing equipment) or peripheral or neuraxial blockade equipment. It also has little to say about exotic anesthesia adjuncts such as nitric oxide or the specialized ventilators required for some anesthetics. Readers interested in these techniques will have to look elsewhere. But the exclusion actually works to make this book stronger: already, at over 600 pages, it stands by itself as a major textbook in the mainstream of anesthesia practice. The book's greatest strength is its deliberate focus and rigorous tabular organization. These will certainly make this the "go to" book for potent agent-based anesthesia equipment and as a compendium of airway devices.
Assessment: Addressing the needs of trainees has become more difficult in the current environment of rapid change. New anesthetic gas delivery equipment is complicated and often microprocessor controlled. The advent of cheap imaging devices — both ultrasound and visible light — is producing a continuing stream of powerful but complex devices that promise to revolutionize anesthetic practice. The authors have provided a wonderfully organized and illustrated book that will certainly be a mainstay of many residents' understanding of the important machines and devices it covers. Every trainee and trainer should have a copy. Most practitioners will want one.
