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Anesthesiology:
doi: 10.1097/ALN.0b013e318280a715
Reviews of Educational Material

The Anaesthetic Crisis Manual

Glassenberg, Raymond M.D.

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The Anaesthetic Crisis Manual is an excellent companion to Anaesthetic and Perioperative Complications. The latter gives advice on how to prevent complications, whereas the former is dedicated to getting out of bad situations. Management of common disasters is limited to two pages, with a different 10- step protocol that should be followed for each scenario. The appropriate care of severe intraoperative hemorrhage includes early arterial line placement for close monitoring of blood pressure. This monitor also allows for frequent blood draws to check hemoglobin, electrolytes, and coagulation factors. Arterial line placement is also advocated for managing postpartum hemorrhage and anaphylaxis.
How low should the hemoglobin fall before starting O negative or group-specific uncrossmatched blood? Dr.Borshoff states that a critical hemoglobin of five warrants transfusion. This key point is not referenced, but then the entire manual has no references. The purpose of a spiral-bound book such as this is for quick reference. It allows the user to find the appropriate dose of dantrolene to treat malignant hyperthermia or to find how many milliliters of 20% Intralipid one needs to treat local anesthetic toxicity. The Anaesthetic Crisis Manual has all drug doses conveniently available. In addition, it lists important blood specimens that should be drawn, for example, mast cell tryptase for suspected anaphylaxis. I would encourage the authors to create a smartphone application of their manual. This would eliminate the need to store this tome in the top drawer of anesthetic trolleys or carts.

© 2013 American Society of Anesthesiologists, Inc.

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