Book reviews

Essentials of AnaestheticEquipment. 2nd EditionBaha AI-Shaikh and Simon StaceyChurchill Livingstone, 2002

This book contains a lot of useful

practical information in a surprisingly

compact form. It achieves this by the

successful combination of very good

quality photographs, clear diagrams,

tables which are not burdensome, well

thought out text in the form of num-

bered lists of information, and concise

boxed summaries at the end of each

topic covered. These features certainly

characterised the first edition, but the

authors have successfully managed to

revise a number of sections without

losing this clarity. A crucially useful

inclusion in this edition is the list of

targeted multiple-choice questions and

answers with detailed explanations at

the end of each chapter. There is also an

additional chapter on electrical safety,

with the emphasis on recognizing sym-

bols related to safety.

Because of the essentially practical

nature of the information in this book, it

is useful for an understanding of the day-

to-day use of anaesthetic equipment.

It will therefore appeal to all who use

such equipment, including anaesthetists,

operating department practitioners,

nurses and technicians. However,

anaesthetic trainees will not find expla-

nations of basic physical principles, and

it is a shame that some aspects of this

subject are relegated to the glossary;

however, this may be precisely in order

to have an appeal beyond mere anaes-

thetists, as well as maintain brevity. The

text format follows a pattern of ‘com-

ponents’, ‘mechanism of action’, and

‘problems in practice and safety

features’. These headings allow the

numbered list format, referred to earlier,

to be very concise. However, there are

times when the material appears to

border on clinical anaesthetic practice

rather a discussion of the equipment

(i.e. indications for PA catheter, indi-

cations and contra-indications for intra-

aortic balloon pump); certainly useful

information, but somewhat unexpected

in such a concise text on equipment. It

is gratifying that the authors, as before,

include a description of equipment

related to pain relief and intensive care

as well as anaesthesia itself. The new

chapter on electrical safety glosses over

the basics of electricity, which many

trainees without a physics background

find difficult, and would benefit from

some of the excellent diagrams to

indicate these principles and those of

safety. The appendices provide excel-

lent updates on the Association of

Anaesthetists’ checklist for anaesthetic

equipment, and on recommendations

for standards of monitoring. The

appendix on monitoring comes closest

to an open discussion than any other

part of the book.

In conclusion, this is a very well

written and illustrated book on equip-

ment which will have wide appeal.

However, I think anaesthetic trainees

taking the FRCA exam may want to

improve their understanding of physical

principles of anaesthesia, anaesthetic

equipment, and clinical measurement

with other texts before using this as a

revision text for equipment.

Patrick Magee,

Royal United Hospital,

Bath, UK

Notable names in anaesthesiaEdited by J. Roger MaltbyThe Royal Society of Medicine PressLtd., 2002, 240 pp. Price: £19.50

Roger Maltby, Professor of Anaesthesia

at the University of Calgary, Canada,

has edited a delightful book that sheds

light on those many eponyms related to

anaesthesia. Those who have long

wondered, or who keep being asked

by cantankerous elderly anaesthetists,

‘who was Magill and what did he make?’

or ‘who was Tuohy?’ can buy this book

and rest easier in their minds; the

answers lie within this slim paperback.

As Professor Maltby states in his Preface,

the ability to place an eponym accurately

was of great value in medical studentship

in the 60 s and 70 s in the UK and this

has gradually diminished in latter years.

Names are still linked with anaes-

thesia apparatus, however, and today’s

trainee is often amazed to know that

Lack is still alive and well in Southern

England and that Bain was not a 19th

Century physiologist from Vienna!

Professor Maltby has enlisted the

help of several other writers in the

production of this book and their

contributions are universally excellent.

The majority of these are written by

those whose names are immortalised by

their contributions so that there are

sections by Aldrete (postanaesthesia

scoring systems), Cormack and Lehane

(laryngoscopy grades), Mapleson

(breathing system classification) and

Swan (Swan-Ganz catheter) to highlight

but a few. The majority of the sections

(56 out of 75) are written solely or

partially by Roger Maltby and are the

result of months of painstaking research

in Canada, the USA and the UK.

Each section provides a vignette of an

individual’s life together with descrip-

tions of their contribution to the

speciality. Not all the sections are

related to apparatus and notable lectures

(John Snow, Gaston Labat and Joseph

Clover), museums relating to anaesthe-

sia (Geoffrey Kaye Museum, Charles

King Collection and Wood Library-

Museum) and even anaesthetic techni-

ques (The Liverpool technique) find a

place within the book. The book is

beautifully illustrated and well refer-

enced and in addition there is a

comprehensive index. Set out in alpha-

betical order it is easy to find ones way

around and can be ‘dipped into’ or read

from cover to cover.

Professor Maltby freely admits that

the book is not exhaustive and invites

practitioners to send in further names

for perhaps a second volume. What he

has written is interesting, amusing,

historically accurate and a pleasure to

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1150 � 2002 Blackwell Publishing Ltd1150 � 2002 Blackwell Publishing Ltd

read. It should be found in every

departmental library and anyone with

an interest in the history of our

speciality should rush out and buy their

own copy. All those who are not quite

such enthusiasts for history should buy

one too as it will provide many hours of

pleasurable reading and also an un-

equalled source of irritating questions

to trainees during long surgical proce-

dures! ‘Now tell me, who was?’

David J. Wilkinson

Boyle Department of Anaesthesia,

St Bartholomew’s Hospital,

London, UK

Pulse oximetryJohn T. B. Moyle

This is more than a book on pulse

oximetry. It covers a significant amount

of cardiovascular and respiratory phys-

iology as well as providing a historical

background to the development of the

oximeter.

The book begins with a rather dry

historical account of prototype oxime-

ters and then progresses to optical

principles, spectrophotometry and an

in-depth explanation of the workings of

a pulse oximeter. The content is

detailed and often technical, but simple

diagrams and graphs are used to good

effect and facilitate the understanding of

quite complex text (for those of us less

technically inclined!). At times an

assumption of prior knowledge is made,

but in general the text is easy to follow

and the physics is well explained. A

detailed section on in vivo and in vitro

calibrations of pulse oximeters and

accuracy will appeal to those physics-

lovers amongst us. The physiology of

oxygen transport is core knowledge for

anaesthetists and is a commonly asked

question in both the Primary and Final

FRCA, the intricacies of which are

not always well explained in larger

textbooks. This section in Pulse Oxime-

try, however, is well set out and is dealt

with in a clear and thorough fashion. I

enjoyed the section on pulse oximetry

at high altitude as this combined the

application of knowledge of the oxi-

meter with interesting physiology in a

clinical setting, albeit it a different

scenario to the one where we usually

encounter oximeters.

The book also provides a fairly

exhaustive list of clinical applications

of the pulse oximeter which includes

the expected medical conditions such as

asthma and COAD, but also discusses its

use in surgical conditions such as the

assessment of a threatened limb and in

obstetrics to assess fetal wellbeing during

labour. I thought this clinical section in

the book was particularly well thought

out and thorough. A significant amount

of background physiology and patholo-

gy is included as well as a brief discus-

sion of the correct management of each

of the different conditions. Topics of

particular relevance to anaesthetists in-

clude postoperative hypoxaemia in re-

covery, the effect of pre-oxygenation

and the different methods by which it

may be achieved and specific conditions

such as obstructive sleep apnoea. Im-

portantly, the book contains a chapter

on the limitations of pulse oximetry. In

order to ensure safe practice and limit

morbidity, it is vital to have a thorough

understanding of a device that is used by

anaesthetists and nurses on a daily basis

and which is considered to be an

essential monitor during anaesthesia.

The book is well set out with clear

and appropriate headings. Boxes are

used to highlight points and summarise

lists of causes which was useful as they

stand out visually. Good use was made

of diagrams and graphs to explain some

of the complex physics. Each chapter

contains up-to-date evidence-based

material to substantiate the text and this

is well referenced at the end of each

chapter. The index is thorough and a

specific topic may be looked up with

ease.

In summary, I think Pulse Oximetry is

an excellent book. It is a good read for

any anaesthetist, but I would partic-

ularly recommend it to anaesthetic

department libraries, anaesthetic SHO’s

attempting the Primary and any anaes-

thetist with an interest in physics.

Lauren Barker

SpR South-West School of Anaesthesia

� 2002 Blackwell Publishing Ltd 1151

Anaesthesia, 2002, 57, pages 1150–1151 Book reviews......................................................................................................................................................................................................................