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BOOK REVIEWS

concerning intensive care respiratory monitoring. Each chapter is followed by an excellent bibliography. It should be part of ones reference library in critical care medicine. Richard A. Orr, MD
Assistant Professor of AnesthrsiologylCCM Childrens Hospital of Pittsburgh Pittsburgh, PA 15213

Recovery Room Care

Elizabeth Frost and Cary I. Andrews, eds. International Anesthesiology Clinics, Vol. 21, No. 1. Boston: Little, Brown, and Company, 1983, 209 pp, $48.00 yr subscription This issue of IAC is devoted to a review of the normal and abnormal postanesthetic course in the recovery room. The text is divided into two sections. The first section deals with general considerations that may be applied to all patients in the recovery room. Admission Assessment and General Monitoring superficially and briefly cover the criteria to be met by the recovery room nurse. Including the Aldrete scoring chart at this point would have been useful; it is found seven chapters later in the discharge criteria. The remaining chapters in this section contain brief reviews of the normal physiology and pharmacology of particular organ systems. The relationship of coma, pain, fluid management, cardiac instability, respiratory depression, and drug interactions after a general anesthetic are then discussed. The final chapter gives guidelines for discharge criteria. The second part of the text addresses itself to the problems of particular special groups-pediatric, renal, thoracic, postregional anesthesia, neurosurgical, and burn patients. For the experienced anesthesiologist, these topics are covered very superficially; there is nothing new. Even the references do not offer a good overview. Notably lacking in the pediatric chapter is any reference to Smiths Anesthesia for Infants and Children, even though the text makes use of material from that source. The information in general is accurate and concisely stated even if frequently superficial. It is not stated for whom this text was written. Attending anesthesiologists will find little new here. However new residents and recovery room nurses in particular will find this book well worth their while. Helen R. Westman, MD
Assistant Professor of Anesthesiology Childrens Hospital of Pittsburgh 125 DeSoto Street Pittsburgh, PA 15261

Problems with Anesthetic and Respiratory Therapy Equipment

Leslie Rendall-Baker. Boston: Little, Brown and Company, 1982, 258 pp, $40.00 Progress in equipment technology is to the anesthesiologist a two-edged sword. Few doubt that modern gas machines,

ventilators, and plastic tubes and catheters have vastly improved patient care, making routine what was previously complicated and exceptional. However, new devices always bring with them their own inherent set of potential complications, not to mention the irritation of having to learn how to use them. This volume in the International Anesthesiology Clinics series attempts to help the practitioner avoid pitfalls while taking advantage of presently available equipment. Individual chapters cover a wide variety of devices: anesthesia gas machines, ventilators, humidifiers, tracheal tubes, oxygen therapy equipment, and oxygen concentrators, plus a pertinent chapter on infection problems. The chapter on gas machines contains a large collection of fascinating tidbits. There are descriptions of many specific episodes involving equipment failure that give one the feeling of there but for some good luck, or the grace of some newly replaced equipment, go I. This information should be widely disseminated, both to the users of older machines who will then be more aware of possible problems, and the users of the latest generation of machines who will better understand some of their new features. On the other hand, the chapters on mechanical ventilators and on humidifers and nebulizers consist largely of generalities and repetition of the percentages of each type of reported malfunction. The chapter on tracheal tubes deals.more with the problems of chronic intubation, but is nonetheless interesting. I found the chapter on infection problems particularly useful, with its specific recommendations for sterilization of contaminated equipment and review of the literature on disposable tubes and filters. Many of the authors review the literature concerning a particular type of equipment from a historical perspective, tracing the identification and eventual solution of some unique and interesting problems that all users of the devices concerned should be aware of. Some of these problems are not reported in the regular anesthesia literature, but are only available from problem-reporting agencies in the government. There is a heavy emphasis on development of standards. Indeed, at times the authors seem to be writing less to inform than to encourage adherence to published national standards throughout the specialty, its journals, and the industry that supplies it with equipment. However, this emphasis at least serves to familiarize the reader with those standards and the reasons behind them, preventing some of us from having to reinvent the wheel. I believe that this volume should be required reading for all with a personal interest in, or responsibility for, buying, updating, or maintaining equipment, but even those without such a primary interest will find it useful to own this volume as a sourcebook, listing the studies that form the basis for many present practices in the field of equipment.

Raymond Leanza, M D
Assistant Professor of Anesthesiology University of Pittsburgh Pittsburgh, PA 15261