The difficult airway: A practical guide : European Journal of Anaesthesiology | EJA

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Book review

The difficult airway

A practical guide

European Journal of Anaesthesiology 30(12):p 781, December 2013. | DOI: 10.1097/EJA.0000000000000008
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Carin A. Hagberg, Carlos A. Artime, William H. Daily. Oxford University Press 2013. Price £70 (∼€83), ISBN-13: 9780199794416

The difficulty that many airway management textbooks face is that while equipment and techniques are continually evolving, textbooks describing them become obsolete. The Difficult Airway: A Practical Guide offers the most up-to-date book currently available for those interested in difficult airway management and readers may recognise the authors from other books on the subject, Benumof and Hagberg's Airway Management being perhaps the most well known.

The first impression of this book was its spiral binding. This demonstrates the authors’ underlying brief: that it should be a practical guide, staying open on the correct page for easy reference. Unfortunately, this does mean the book is not robust and after a week being carried round it was beginning to look worn. The book is presented in 18 chapters that start with airway assessment, including chapters on all the relevant techniques and equipment you might expect (paediatrics, jet ventilation, cricothyroidotomy, retrograde intubation, etc.) and some that you might not (airway supplies, dissemination of information). The chapters stick to a logical format that begins with objectives and finishes with a list of suggested reading. Whenever a piece of equipment is encountered, the text is full of technical details (descriptions, sizes available, compatibilities, etc.) and the section will often conclude with a ‘tip’ box, which gives practical advice on use. An additional feature is the accompanying DVD that provides short video clips to illustrate the techniques described. Likewise, the book is well illustrated with colour photos throughout that are essential if the reader has no personal experience of the device.

The chapters on fibre-optic intubation are excellent. It is obvious that the authors write from years of experience and it truly is a practical guide. An example is the table comparing the outer diameters of nasal endotracheal tubes with the outer diameter of nasopharyngeal airways, which can be used to determine the tube size that will easily pass nasally. However, the book is not without its problems. Despite attempts at being exhaustive, there is no mention of the iGel laryngeal airway, now in common use in the UK. Likewise some techniques are not described. There is no mention of target-controlled infusions of remifentanil – a technique that some anaesthetists regard as essential. A pie chart describing the composition of air is superfluous to the target audience, but I would have liked more detail regarding airway disease (such as, swollen vocal cords, airway tumours, foreign body and epiglottitis) with advice about how these can be managed. Despite this, the book fulfils its aims – to be a practical guide to airway management, and does so well. I would recommend it to anaesthetists of all grades and think it would be a particularly good source of reference for any anaesthetic department.

David Evans

Airway Fellow

Queen's Medical Centre



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© 2013 European Society of Anaesthesiology