James C. Eisenach, M.D., Editor.
By Brendan T. Finucane and Albert H. Santora. St. Louis, Mosby-Year Book, Inc., 1996. Pages: 343 Price: $32.00.
I like to read. I liked the book. Finucane and Santora have produced a solid, clear, and concise dual-authored second edition of their 1988 book, Principles of Airway Management. The book stimulated hours of reading, obtaining references, and the purchase of another heavy and expensive 1,000-page textbook on airway management. This 6 x 9-inch pocket-sized book covers a great deal of information in the 12 chapters presented.
Chapters 1 and 2 are a good review of basic anatomy, basic airway management, and cardiopulmonary resuscitation. It is important material but, as always, dry. The presentation of anatomy would have been enhanced with more examples of correlative anatomy and better references. Most will not be patient enough to read through it.
Chapter 3 covers equipment for airway management. The numerous photographs are simple and not aimed for the practicing anesthesiologist, but for individuals being exposed to this equipment for the first time. The 41 references saved the chapter for me.
Chapter 4 is where the text begins to shine. Fiberoptic intubation is presented in a clear and logical sequence. I enjoyed their use of summary boxes to highlight important concepts and information. I thought the photographs were more suited to the anesthesia technician than the anesthesiologist.
Chapter 5, "Evaluating the Airway," is great. It puts much information in 20 pages. Good diagrams, photographs, and useful advice make this very clinically relevant. Reading this chapter a couple of times will give new insight and motivation to change our practice and stimulate us to document and perform more thorough preoperative examinations and communicate and document our findings on the anesthesia record or chart.
Chapters 6-9 cover preparation, techniques, and complications of intubation in four solid chapters that are well referenced. I enjoyed the handling of the American Society of Anesthesiologists algorithm for difficult intubation. The subchapter on difficult intubation in the emergency room setting tackles the problem of the patient with cervical spine injury. Challenging this topic and making it so worthwhile in 1.5 pages was an accomplishment. Their take home message is, "The most important consideration is that the anesthesiologist secure the airway using the most familiar technique." The references will help lead you to that conclusion. I have one bone to pick; The label of Figure 8-21 should be changed from EGTA to PtL(R) airway.
Chapter 10 presents a well cautioned, excellent review of surgical approaches to airway management. Retrograde intubation, cricothyroidotomy, and tracheotomy are covered. The diagrams and photographs are excellent, the advice is good, and they describe the commercially available kits. In the "cannot intubate, cannot ventilate" scenario, this chapter could be life-saving.
Chapter 11 covers the pediatric airway. Included are basic cardiopulmonary resuscitation in infants and children and a well written section on neonatal resuscitation. The algorithms and summary boxes are useful. Croup and epiglottitis are reviewed. The book ends with a short chapter (12) on the basics of mechanical ventilation.
If you like a well written portable manual, you'll like this book. I will continue to use it to teach medical students (the first edition's intention), anesthesia technicians, and prehospital students. Any physician requiring expertise in airway management will find it useful. I congratulate the authors on a job well done. I would like to thank the Wood-Library Museum for the loan of the first edition of this text; they continue to be an excellent resource to our society.
Jonathan C. Berman, M.D., Director of Obstetric Anesthesia, St. Anthony's Hospital Central, 4231 West 16th Avenue, Denver, Colorado 80204.
