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Video — The obstructed airway
140
printed in Greaf Brifuin
Injury (1993) 24, (2) 140
Book Reviews
A Practical Guide to Head Injury Management. P .V. Marks and C.B.D. Levy. W.B. Saunders Co. London. f9.95, 1992, 145~~. This pocket-sized handbook is a useful guide to the management of head injury. Its particular virtue is that it covers the whole spectrum of head injury from pathophysiology through to rehabilitation and prognosis, in less than 150 pages, and it does this well. The book generally follows the norms of British practice as outlined by the Glasgow Group and the DHSS Harrogate Seminar No. 8 in 1984. The strengths of the book are its readable style, small size and the excellent appendices on anaesthesia, maxillofacial management, paediatrics and rehabilitation. The book would have been improved if the authors had included more didactic recommendations about drug dosages and usage. Particularly in the anaesthesia section, the recommendations for management are quite specific, and would have been enhanced by including a list of useful analgesic, anaesthetic and sedative drugs, their dosages and a few notes about their risks and indications. This could also be done for the section on epilepsy, and for antibiotics. It is done for Mannitol. The authors have not sufficiently emphasized hypoxic/ ischaemic brain damage and the dangers of hypotension, with high ICP and consequently jeopardized cerebral perfusion pressure, as the major mechanism for secondary brain damage. This aspect is a cornerstone of head injury management and some of the ten pages allocated to the techniques of making burr holes could have been better allocated to this. In general, however, this small book makes a useful contribution to knowledge for people involved in head injury care, right throughout the referral chain from ambulance personnel to nurses in the intensive care unit. Ross Bullock FRCS
Video - The Obstructed Airway. SSVC, f 59.95.1992. This video is produced by the Services Sound and Vision Corporation, one of whose functions is to provide Training Support for HM Armed Forces all over the world. The video lasts for approximately 30 minutes. It covers all aspects of airway care from recognition to treatment of obstruction. It starts with a demonstration of a normal airway and then actors are used to demonstrate the appearances of airway obstruction, See-saw respiration and tracheal tug are welI shown but the appearance of the use of the accessory muscles of respiration is not mentioned or shown. The video then goes on to show manual methods of airway control. Each technique is accompanied by diagrammatic representation of the effects of the manoeuvre and an illustration of the reasons why failure may occur and possible complications. The use of oropharyngeal and nasopharyngeal airways are then demonstrated followed by use of the laryngeal mask airway, oral endotracheal tube, nasotracheal 0 1993 Butterworth-Heineman 0020-1383/93/020140-02
Ltd
tube and cricothyroidotomy. Each technique is demonstrated on anaesthetized patients. In general the filming is excellent although sometimes the camera angle is suboptimal. Each technique is clearly demonstrated and is accompanied by a clear and concise commentary. The only technique which could have been shown more effectively is the use of the left lateral position. The importance of potential cervical spine injury is stressed several times and the use of manual in-line traction is well demonstrated. This video gives an excellent overall view of methods of managing the obstructed airway. Although it may be too simplistic for all but the most junior anaesthetists, many anaesthetic departments might consider buying it as a teaching adjunct for surgical and nursing staff and operating department assistants. Furthermore, it should be helpful for training paramedic ambulancemen. The part on manual methods could easily be used for training first aiders. In conclusion, this video deserves to be widely seen by all people with an interest in airway care. It may seem rather expensive for training those who are only interested in basic airway care which occupies half the video but trainers may wish to borrow this video from others who have purchased it. Anne Sutcliffe FRCS
Vascular Surgery - Current Questions. Ed. A. A. B. Barros D’Sa, P. R. F. Bell, S. G. Darke, P. L. Harris. Butterworth-Heinemann, Ltd., 0 7506381 5, f49.50, 247 pp. The nineteen chapters of this British text cover a range of topics that are of primary concern to practising vascular surgeons. All twenty authors are authorities in their selected field and their writing reflects a combination of wide personal experience and an in-depth knowledge of the subject. The quality of production is uniformly excellent with clear photographs and line diagrams augmenting a readable text. The bibliography is exceptionally thorough in every case and individual chapters should serve as a valuable source of reference in their field for many years to come. The book will be indispensable to career vascular surgeons from registrar level upwards whereas clinicians in related fields and more junior surgeons may wish to dip into it selectively. Some of the chapters, such as that on carotid body tumours, will remain classics while those covering the more rapidly evolving areas of aortic, visceral, carotid and distal reconstructive surgery may need updating within a few years. The chapters on the vascular laboratory and on audit should be of particular value to newly appointed consultants. This book does not pretend to be a core textbook of vascular surgery and the growing field of interventional vascular radiology is not covered. However, it presents a comprehensive update of the surgical aspects of current vascular practice and makes an important contribution to a rapidly developing specialty. Malcolm
H. Simms FRCS
printed in Greaf Brifuin
Injury (1993) 24, (2) 140
Book Reviews
A Practical Guide to Head Injury Management. P .V. Marks and C.B.D. Levy. W.B. Saunders Co. London. f9.95, 1992, 145~~. This pocket-sized handbook is a useful guide to the management of head injury. Its particular virtue is that it covers the whole spectrum of head injury from pathophysiology through to rehabilitation and prognosis, in less than 150 pages, and it does this well. The book generally follows the norms of British practice as outlined by the Glasgow Group and the DHSS Harrogate Seminar No. 8 in 1984. The strengths of the book are its readable style, small size and the excellent appendices on anaesthesia, maxillofacial management, paediatrics and rehabilitation. The book would have been improved if the authors had included more didactic recommendations about drug dosages and usage. Particularly in the anaesthesia section, the recommendations for management are quite specific, and would have been enhanced by including a list of useful analgesic, anaesthetic and sedative drugs, their dosages and a few notes about their risks and indications. This could also be done for the section on epilepsy, and for antibiotics. It is done for Mannitol. The authors have not sufficiently emphasized hypoxic/ ischaemic brain damage and the dangers of hypotension, with high ICP and consequently jeopardized cerebral perfusion pressure, as the major mechanism for secondary brain damage. This aspect is a cornerstone of head injury management and some of the ten pages allocated to the techniques of making burr holes could have been better allocated to this. In general, however, this small book makes a useful contribution to knowledge for people involved in head injury care, right throughout the referral chain from ambulance personnel to nurses in the intensive care unit. Ross Bullock FRCS
Video - The Obstructed Airway. SSVC, f 59.95.1992. This video is produced by the Services Sound and Vision Corporation, one of whose functions is to provide Training Support for HM Armed Forces all over the world. The video lasts for approximately 30 minutes. It covers all aspects of airway care from recognition to treatment of obstruction. It starts with a demonstration of a normal airway and then actors are used to demonstrate the appearances of airway obstruction, See-saw respiration and tracheal tug are welI shown but the appearance of the use of the accessory muscles of respiration is not mentioned or shown. The video then goes on to show manual methods of airway control. Each technique is accompanied by diagrammatic representation of the effects of the manoeuvre and an illustration of the reasons why failure may occur and possible complications. The use of oropharyngeal and nasopharyngeal airways are then demonstrated followed by use of the laryngeal mask airway, oral endotracheal tube, nasotracheal 0 1993 Butterworth-Heineman 0020-1383/93/020140-02
Ltd
tube and cricothyroidotomy. Each technique is demonstrated on anaesthetized patients. In general the filming is excellent although sometimes the camera angle is suboptimal. Each technique is clearly demonstrated and is accompanied by a clear and concise commentary. The only technique which could have been shown more effectively is the use of the left lateral position. The importance of potential cervical spine injury is stressed several times and the use of manual in-line traction is well demonstrated. This video gives an excellent overall view of methods of managing the obstructed airway. Although it may be too simplistic for all but the most junior anaesthetists, many anaesthetic departments might consider buying it as a teaching adjunct for surgical and nursing staff and operating department assistants. Furthermore, it should be helpful for training paramedic ambulancemen. The part on manual methods could easily be used for training first aiders. In conclusion, this video deserves to be widely seen by all people with an interest in airway care. It may seem rather expensive for training those who are only interested in basic airway care which occupies half the video but trainers may wish to borrow this video from others who have purchased it. Anne Sutcliffe FRCS
Vascular Surgery - Current Questions. Ed. A. A. B. Barros D’Sa, P. R. F. Bell, S. G. Darke, P. L. Harris. Butterworth-Heinemann, Ltd., 0 7506381 5, f49.50, 247 pp. The nineteen chapters of this British text cover a range of topics that are of primary concern to practising vascular surgeons. All twenty authors are authorities in their selected field and their writing reflects a combination of wide personal experience and an in-depth knowledge of the subject. The quality of production is uniformly excellent with clear photographs and line diagrams augmenting a readable text. The bibliography is exceptionally thorough in every case and individual chapters should serve as a valuable source of reference in their field for many years to come. The book will be indispensable to career vascular surgeons from registrar level upwards whereas clinicians in related fields and more junior surgeons may wish to dip into it selectively. Some of the chapters, such as that on carotid body tumours, will remain classics while those covering the more rapidly evolving areas of aortic, visceral, carotid and distal reconstructive surgery may need updating within a few years. The chapters on the vascular laboratory and on audit should be of particular value to newly appointed consultants. This book does not pretend to be a core textbook of vascular surgery and the growing field of interventional vascular radiology is not covered. However, it presents a comprehensive update of the surgical aspects of current vascular practice and makes an important contribution to a rapidly developing specialty. Malcolm
H. Simms FRCS