"This brilliantly assembled expert compendium provides a much-needed guide for the practical application of anesthesiology in medical practice in the most bereft underdeveloped and violence-afflicted regions of the globe." -Seymour Topping, Professor Emeritus of International Journalism, Columbia University This is a comprehensive guide to the role of anesthesiologists in medical missions. In their capacity as perioperative physicians, anesthesiologists improve the safety and efficacy of surgical interventions for underserved patients in low- and middle-income countries around the world. Contributions from international experts in global health provide essential historical context, practical medical and surgical considerations for planning missions, and scenarios of "on the ground" implementation of care. The final section considers anesthesiology education in the context of global health. This is an encompassing and eye-opening resource for trainees and physicians considering participating in a medical mission and students and faculty of global health.

A ground-breaking new volume and the first of its kind to concisely outline and explicate the emerging field of whole person care process, Whole Person Care: A New Paradigm for the 21st Century organizes the disparate strains of literature on the topic. It does so by clarifying the concept of 'whole person' and also by outlining the challenges and opportunities that death anxiety poses to the practice of whole person care. Whole person care seeks to study, understand and promote the role of health care in relieving suffering and promoting healing in acute and chronic illness as a complement to the disease focus of biomedicine. The focus is on the whole person -- physical, emotional, social, and spiritual. Using concise, easy-to-read language, the early chapters offer practitioners a thorough understanding of the concepts, skills and tools necessary for the practice of whole person care from a clinician-patient interaction standpoint, while the last two chapters review the myriad implications of whole person care for medical practice. An invaluable resource for all areas of medical practice and for practitioners at all stages of development, from medical students to physicians and allied health providers with many years of experience, Whole Person Care: A New Paradigm for the 21st Century will have a profound impact on western medical practice in North America and elsewhere.

Promotes ease of understanding through a unique problem-solving method and new clinical application scenarios! With a focus on chemistry and physics content that is directly relevant to the practice of anesthesia, this text-written in an engaging, conversational style- supplies all the scientific information required for the combined chemistry and physics course for nurse anesthesia students. Now in its third edition, the text is updated and reorganized to facilitate a greater ease and depth of understanding. The addition of a third author-a practicing nurse anesthetist-enhances the clinical relevance of the scientific information. Clinical scenarios now begin every chapter, and a concluding chapter, new to this edition, provides detailed, step-by-step solutions to the book's review questions. Also included is a comprehensive list of need-to-know equations.The third edition retains the many outstanding learning features from earlier editions, including a special focus on gases, the use of illustrations to demonstrate how scientific concepts relate directly to their clinical application in anesthesia, and end-of-chapter summaries and review questions to facilitate self-assessment. Fifteen online videos enhance teaching and learning, and abundant clinical application scenarios help reinforce scientific principles and relate them to day-to-day anesthesia procedures. This clear, easy-to-read text will help even the most chemistry- and physics-phobic students to master the foundations of these sciences and competently apply them in a variety of clinical situations. New to the Third Edition: Increased focus on clinical relevance Revised and updated chapters foster ease of understanding Clinical application scenarios open each chapter A new Chapter provides guidance about calculator use and a unique problem-solving method Detailed step-by-step solutions clarify answers to end-of-chapter problems Comprehensive list of all key equations with explanation of symbols New instructor materials, including PowerPoint slides Updated information on the gas laws Key Features: Written in an engaging, informal style for ease of understanding Focuses solely on chemistry and physics principles relevant to nurse anesthetists Provides end-of-chapter summaries and review questions Fifteen online videos enhance teaching and learning Includes abundant illustrations that apply theory to practice

Over the years, interventional radiology has developed many effective and less invasive procedures. As the number and types of interven tions increase, radiologists are becoming more and more involved in clinical patient care. This includes pre-interventional patient workup, sophisticated medical therapy and monitoring during interventions, regular inpatient rounds and complete follow-up management. Therefore interventional radiologists are faced with a broad spectrum of clinical and pharmacological questions. Adjunctive medical therapy should increase the patient's comfort, should improve the success rates, and should further reduce the risks of the procedures. In order to fulfill our responsibility to the patients, a profound knowledge of certain drugs is indispensable. This in cludes, for example, sedatives, analgesics, cardiovascular drugs and agents to prevent infections, thromboembolic complications or restenoses. Moreover, a good monitoring system during complex procedures will increase the safety of radiological interventions. These topics and several more have been presented and discussed during an international symposium in Basel, Switzerland, in January 1992. It is the benefit of the authors, that all these results could be published shortly after the event. Connected with our thanks to all the co-workers the editors hope to find this publication assisting an increasing number of safe interventions.

At the Fifth International Neuromuscular Meeting held in Tokyo in 1994, leading experts in the field came together to discuss the physiology and pharmacology of neuromuscular receptor sites and neuromuscular blocking agents (NBAs). The proceedings of the meeting present a review of the history of muscle relaxants and a comprehensive examination of recent research, with a primary focus on clinical considerations. Among the topics covered by specific chapters are aspects of the neuromuscular junction (NMJ), pharmacokinetics, metabolism and metabolites of neuromuscular blocking agents, and drug interaction. Presenting the most up-to-date knowledge of the physiology and pharmacology of the NMJ and NBAs, this volume will be highly valuable to clinicians and researchers in anesthesiology, physiology, and pharmacology.

Dysfunction of the gastrointestinal tract in critically ill patients has recently become a focus of intensive research. This book, the first one on this topic, is a comprehensive overview of what is currently known about the role of the gut in patients requiring intensive care. The definitions and pathogenesis of intestinal dysfunction are critically evaluated. Currently available and potential new ways to monitor intestinal function in the intensive care setting are presented. Emphasis has been placed on the evaluation of therapeutic strategies in the prevention and treatment of gut dysfunction. Options for monitoring and treating gut dysfunction in critically ill patients are rapidly evolving. This volume provides state-of-the-art information for both clinicians and clinical researchers.

The World Federation of Societies of Intensive and Critical Care Medicine (WFSIC- CM) has reached the age of maturity. Physicians, nurses, and many others associated with the field of Intensive and Critical Care Medicine will be coming from all corners of the world to Florence, Italy in August, 2009 to celebrate the 10th quadrennial congress. Every 4 years for the last 36 years, congresses in the magnificent venues of London (1973), Paris (1977), Washington (1981), Jerusalem (1985), Kyoto (1989), Madrid (1993), Ottawa (1997), Sydney (2001), and Buenos Aires (2005) have sig- fied an ever-developing process which has resulted in the four pillars of the field of Intensive and Critical Care Medicine, namely partnership, ethics, professionalism, and competence. The first pillar is based on a stronger interdisciplinary collaboration and a mul- professional partnership in the field of Intensive and Critical Care Medicine. In recent decades, professional activity in medicine has been regulated by well-defined, universal principles, such as the welfare of the patient, autonomy, social justice, and the patient-physician relationship. The second pillar, ethics, has offered welcomed assistance to all these principles in establishing an ethics curriculum.

Ability to learn from errors is an essential aspect of the quest to improve treatment quality and patient safety. This book consists of 33 cases in anesthesiology that is based on real life situations and illuminate avoidable complications and mishaps. The cases are presented in a novel manner in that they are embedded within narratives. The reader comes to each case "cold", without any clue as to the content, and each case comprises a narrative and a factual component that are interwoven. The narrative parts provide the reader with information and tips regarding the clinical problems and tasks that the protagonist must face and try to solve. The idea is to engage the reader emotionally while reading and to entertain him or her while learning. All cases conclude with short debriefing sections which include possible strategies to prevent similar errors or mishaps.

In susceptible individuals, malignant hyperthermia (MH) can be triggered by various anesthetics during surgery. First described in 1960, research since then has concentrated on reducing the very high mortality rate associated with MH. Although significant progress in treatment has been made with the introduction of dantrolene sodium in 1979, many questions remain unanswered. Following on the results of more than 30 years of investigative efforts, the Third International Symposium on MH was held in Hiroshima, Japan, in 1994, immediately before the Seventh International Workshop on MH. Specialists in the field discussed the most up-to-date findings from the point of view of clinical classification, history, and incidence based on the evidence of epidemiology, diagnostic muscle testing, genetics, and biochemistry. These proceedings of the symposium present important keys to understanding the mechanism of MH and related syndromes at the genetic level and include procedures for the monitoring and care of patients. This volume will be invaluable not only for surgeons and anesthesiologists but also for physiologists and researchers.

This is the premier evidence-based textbook in critical care medicine. The Third Edition features updated and revised chapters, numerous new references, streamlined content, and new chapters on key topics such as the new paradigm in critical care medicine, cardiac output monitoring, surgical optimization, vital signs, and arterial blood gas analysis. The book maintains the author's trademark humor and engaging writing style and is suitable for a broad and diverse audience of medical students, residents, fellows, physicians, nurses, and respiratory therapists who seek the latest and best evidence in critical care. From reviews of previous editions: "This is an excellent introduction to the concept of evidence-based medicine...The writing is clear, logical, and highly organized, which makes for fast and enjoyable reading. I believe this book will get daily use in most intensive care units, by a wide range of readers." -Respiratory Care "This is one of the most comprehensive handbooks on critical care medicine with a strong emphasis on evidence base...Overall, this book should be useful for junior doctors or intensive care trainees who are starting their term in an intensive care unit." -Anaesthesia and Intensive Care

This edition of the companion volumes Muscle Pain: Understanding the Mech- isms and Muscle Pain: Diagnosis and Treatment is essential reading for those interested in clinical approaches to acute and chronic pain conditions involving muscle tissues and in the mechanisms underlying these conditions. The volumes cover a very important topic in pain medicine, since muscle pain is very common and can often be dif?cult to diagnose and treat effectively. Furthermore, chronic pain involving muscle and other components of the musculoskeletal system increases with age, such that it is a common complaint of those of us who are middle-aged or older. Indeed, as changing population demographics in "west- nized" countries result in higher proportions of the population living longer and being middle-aged and elderly, chronic muscle pain will likely become even more of a health problem. In the case of acute muscle pain, this can often be very intense, and in the short term can limit or modify the use of components of the musculoskeletal system associated with the sensitive muscle. Chronic muscle pain can also be intense, as well as unpleasant and disabling, and it is in many cases the over-riding symptom of most musculoskeletal disorders that are associated with long-term deleterious changes in musculoskeletal function.

Patients with cardiac conditions routinely present for noncardiac surgeries, requiring special protocols for perioperative assessment and management by the anesthesiologist. Essentials of Cardiac Anesthesia for Noncardiac Surgery: A Companion to Kaplan's Cardiac Anesthesia provides current, easily accessible information in this complex area, ideal for general anesthesiologists and non-cardiac subspecialists. From preoperative assessment through postoperative care, this practical reference covers all perioperative approaches to today's patients with cardiac conditions. Provides guidance on the anesthetic diagnosis and management of the full range of cardiac lesions, helping minimize adverse outcomes and reduce complications for patients with common, complex, or uncommon cardiac conditions. Includes complete coverage of echocardiography and current monitoring techniques needed for thorough perioperative assessment - all from the anesthesiologist's perspective. Discusses safe and effective perioperative anesthetic management of patients presenting with advanced levels of cardiac care such as drug-eluting stents, multiple antiplatelet drugs, ventricular assist devices, multiple drugs for end-stage heart failure, and implanted electrical devices that produce cardiac resynchronization therapy, as well as patients with complicated obstetric problems or other significant cardiovascular issues. Features a concise, easy-to-navigate format and Key Points boxes in each chapter that help you find answers quickly. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

This book comprises structured questions and answers that closely simulate the structured oral examination (SOE) format of The Royal College of Anaesthetists' final FRCA examination. The style of exam questions has changed over the years and this book matches the most recent changes in this updated exam. It will consist of ten sets (chapters) of complete SOE papers. Each SOE set (chapter) includes one long case, three short cases and four different applied basic science topics (anatomy, physiology, pharmacology and clinical measurement). As this book will be presented in the format of complete examination papers, it will enable candidates to assess their knowledge and skills. It will also assist trainers in setting up mock exams. With thorough revision of this book, trainees can confidently sit their exams. The authors have been organising final FRCA viva courses for the past five years, running four exam preparation courses a year, attended by about 200 trainees each year. This book includes updated knowledge based on the syllabus and more recent questions asked in the FRCA examination. It is, therefore, essential study material for trainees and a great educational tool for trainers. This book will also help candidates all over the world to pass highly competitive postgraduate examinations in anaesthesia. It is an invaluable educational resource for all anaesthetists.

This book presents the development and experimental validation of the structural test strategy called Oscillation-Based Test - OBT in short. The results presented here assert, not only from a theoretical point of view, but also based on a wide experimental support, that OBT is an efficient defect-oriented test solution, complementing the existing functional test techniques for mixed-signal circuits.

Perioperative Addiction addresses an issue that every anesthesiologist will encounter many times during the course of his or her career: the patient who arrives for operative care under the influence of legal or illegal drugs. The editors and contributors provide expert guidance on how to identify and manage the addicted patient, approaching the subject from the vantage points of the specific drug and of special patient populations. Features: * Guidance for spotting and managing addicted patients * All common and important drugs of addiction, from opioids, cocaine, club drugs, and alcohol, to tobacco, marijuana, nitrous oxide, inhalants, and propofol * Special populations, including pregnant women, pain patients, adolescents, older patients, and healthcare professionals * Fascinating overview of the long history of addiction * Genetic basis of addiction, and the range of pharmacological treatments for addiction

Regional anaesthesia is used across specialties within anaesthesia, and is a rapidly growing sub-specialty. This new handbook covers both traditional and ultrasound guided techniques, concentrating on the differences between them. Offering readers a comprehensive overview for clinical practice, it includes paediatric and acute pain applications. Each topic covers anatomy, contraindications, landmark/US settings, technique, complications, and clinical notes. Discrete sections on pharmacology, principles, and training further the book's use for teaching purposes. It will appeal to both trainees and consultants in regional anaesthesia, as well as anaesthetic nurses and anaesthetic practitioners. Presented in the Oxford Specialist Handbook series, it offers practical advice as well as background information in a convenient pocket-sized title.

The prevalence of obesity, an important risk factor for various diseases, has increased markedly worldwide in recent years. The results of long-term dietary behavioural therapy, however, remain sadly inadequate, with a relapse rate of about 90%. Surgery is still the only effective treatment for these patients. The annual number of weight loss operations performed in the United States in the early 1990s totaled only about 16,000, but by 2005 the figure exceeded 200,000. The anesthetic care of severely obese patients entails particular issues, and difficulties are believed to escalate in the presence of co-morbidities. Despite this, outcome data in respect of anesthetic care and pain management are still scarce. Anesthetic Management of the Obese Patient considers a wide range of important practical issues and controversies. Key questions in preoperative, intraoperative, and postoperative management are carefully addressed, and different approaches are evaluated, casting light on their effectiveness and limitations. Written by world leaders in the field, this book will be an invaluable aid for anesthesiologists.

Many drugs used in current anesthetic practice are administered intravenously. An appreciation of their kinetics and dynamics is of great assistance in determining the most appropriate drug to use, and optimal dosage regimens for any given patient. This book is specially oriented to the requirements of anesthesiologists. It will enable the student of those subjects to gain enough knowledge to make these subjects usable in daily anesthetic practice. As such it is intermediate in difficulty between mathematically oriented texts, and those which only offer a very qualitative understanding of these subjects. Practical applications and examples of the uses to which kinetic and dynamic principles can be put in daily practice are emphasized and illustrated. Basic principles and techniques with which the reader can perform kinetic and dynamic calculations are explained simply and demonstrated in detail using examples derived from clinical practice. Two appendices provide kinetic and dynamic data on the most commonly used anesthetic drugs. The last chapters use the principles discussed in the first chapters to show how variations of normal physiology and disease affect drug kinetics and dynamics. This is especially valuable to the clinician as it enables clinically useful, albeit qualitative, predictions to be made of the direction of any change of kinetic and dynamic parameters of drugs due to these factors.

Written by residents and attendings at the world-renowned Massachusetts General Hospital Department of Anesthesia, Clinical Anesthesia Procedures of the Massachusetts General Hospital, Tenth Edition, offers current, comprehensive, and concise guidelines on all facets of anesthesia, perioperative care, critical care, and pain management. Emphasizing the clinical fundamentals necessary for patient safety and optimal outcomes, this trusted guide provides fast answers to the most frequent problems encountered in daily anesthetic practice, making it an invaluable resource for practicing anesthesiologists and residents as well as nurse anesthetist trainees and practitioners. Focuses on the clinical fundamentals needed for the safe delivery of anesthesia and perioperative care in day-to-day practice. Uses an easy-to-scan outline format that progresses intuitively from preoperative evaluation through administration of anesthesia to perioperative issues for each subject. Updated and reorganized table of contents in addition to chapters on evaluating the patient, anesthesia for pediatric surgery and care of the neonate, non-operating room anesthesia and pain management. Includes new chapters on the basics of echocardiography, anesthesia for orthopedic surgery, anesthesia for transplant surgery and vascular access. Features appendices covering drugs and intravenous antibiotics. Enrich Your eBook Reading Experience Read directly on your preferred device(s), such as computer, tablet, or smartphone. Easily convert to audiobook, powering your content with natural language text-to-speech.

Sleep and anesthesia resemble in many ways at a first glance. The most prominent common feature of course is the loss of consciousness, i.e. the loss of awareness of external stimuli. However a closer look at the loss of consciousness reveals already a difference between sleep and anesthesia: anesthesia is induced by an anesthetic drug whereas we may fall asleep without external cause. Other questions may arise about the difference of the two effects: do we dream during surgery under anesthesia, do we feel pain during sleep? Essentially, we may ask: what is common and what are the differences between sleep and anesthesia? To answer these questions, we may take a look at the neural origin of both effects and the involved physiological pathways. In which way do they resemble? Moreover, we ask what are the detailed features of normal sleep and general anesthesia as applied during surgery and which features exist in both phenomena? If yes in which way? To receive answers to these questions, it is necessary to consider several experimental techniques that reveal underlying neural mechanisms of sleep and anesthesia. Moreover, theoretical models of neural activity may model both phenomena and comes up with predictions or even theories on the underlying mechanisms. Such models may attack several different description levels, from the microscopic level of single neurons to the macroscopic level of neural populations. Such models may give deeper insight into the phenomena if their assumptions are based on experimental findings and their predictions can be compared to experimental results. This comparison step is essential for valuable theoretical models. The book is motivated by two successful workshops on anesthesia and sleep organized during the Computational Neuroscience Conferences in Toronto in 2007 and in Berlin 2009. It aims to cover all the previous aspects with a focus on the link to experimental findings. It elucidates important issues in theoretical models that at the same time reflect some current major research interests. Moreover it considers some diverse issues which are very important to get an overview of the fields. For instance, the book discusses not only neural activity in the brain but also the effects of general anesthesia on the cardio-vascular system and the spinal cord in the context of analgesia. In addition, it considers different experimental techniques on various spatial scales, such as fMRI and EEG-experiments on the macroscopic scale and single neuron and LFP-measurements on the microscopic scale. In total all book chapters reveal aspects of the neural correlates of sleep and anesthesia motivated by experimental data. This focus on the neural mechanism in the light of experimental data is the common feature of the topics and the chapters. In addition, the book aims to clarify the shared physiological mechanisms of both phenomena, but also reveal their physiological differences.

When I first proposed this book, one of the hopes was that it would be the stage upon which would be conducted a quiet, well reasoned discussion of the various techniques of stereotactic radio surgery. At that time, there was quite a bit of rancorous debate that tended to obscure the scientific and medical merits of each of the separate methods. At the present time, I am happy to report that the field of stereotactic radiosurgery is much less riven by such inappropriate posturing. The field has taken many steps towards maturity, both technically and medically. In the course of this mat uration process, there have been many grandiose plans and speeches made on behalf of stereotactic radiosurgery. Inevitably, the reality will not live up to the hype, but such is the natural course of devel opment in these sorts of matters. However, even though events may not match our hopes, we should keep in mind the words of Herbert Parker. Recognizing that new modalities for the treatment of cancer do not stand much chance of revolutionary success, nevertheless, he quite correctly pointed out that " . . . with any type of radiatiQn, the margin between success and failure is small. If the chance of success is a little greater . . . thi~ might well be classed as a great advance. " Mark H.

This book is the first of four books on the core principles of acute neurology. This book is a primer - and a great deal more - on how to clinically recognize acute brain injury and to treat its consequences. Acute brain injury often changes the dynamics of cerebral blood flow, cerebrospinal fluid mechanics and eventually intracranial pressure. And furthermore, acute brain and spine injury impacts on heart function, blood pressure control, breathing regulation and even gastric and bladder function. It is necessary to not only understand these fundamentals but also how certain measures could influence or correct these manifestations. Major concepts are illustrated to facilitate understanding. Each chapter concludes with a section that explains its relevance to clinical practice.The book truly combines basic neuroscience with practical know- how in an easy to read prose useful for both the novice and expert.

Authored by "a superb clinician and award-winning teacher,"* Near Misses in Pediatric Anesthesiology, Second Edition is a thorough updating and significant expansion of this popular case book in the newest anesthesiology subspecialty to be approved by the American Board of Medical Specialties. The book comprises 87 true-story clinical "near misses," including 40 cases that are brand new. Recommendations, references, and discussion accompany each case. The cases provide an ideal basis for problem-centered learning and also model how to learn from experience and to maintain professionalism during the lifelong development of clinical expertise. Dr. Brock-Utne's latest case book provides a pediatric complement to his bestselling Case Studies of Near Misses in Clinical Anesthesia (Springer, 2012) and Clinical Anesthesia: Near Misses and Lessons Learned (Springer, 2008) . * Jay B. Brodsky, MD, from the Foreword.

This book is the first of its kind - a comprehensive reference for anesthesia and perioperative clinicians involved in aortic surgery. With a primary focus on anesthesia for various aortic surgical procedures, including endovascular aortic surgery, the title also provides expanded coverage of CNS monitoring and protection, intraoperative transesophageal echocardiography, renal and spinal cord protection during surgery, management of aortic trauma, and postoperative care. Written by top cardiac anesthesiologists, surgeons, and intensivists, this indispensable reference provides everything you need to know about the burgeoning field of aortic surgery in one handy volume.

The International Hypoxia Symposium convenes biannually to bring together international experts from many fields to explore the state of the art in normal and pathophysiological responses to hypoxia. Representatives from five continents and 32 countries joined together in February 2003 for four days in the dramatic mountains of Banff, Alberta. As editors of the Proceedings of the International Hypoxia Symposia, we strive to maintain a 26 six year tradition of presenting a stimulating blend of clinical and basic science papers focused on hypoxia. Topics covered in 2003 include hibernation and hypoxia, hypoxia and fetal development and new advances in high altitude pathophysiology, oxidative stress and membrane damage, hypoxic regulation of blood flow, heat shock proteins in hypoxia, and future directions in hypoxia research. In 2003 we also had the privilege ofhonoring John W. Severinghaus as a friend, colleague, mentor and inspiration to many in the field. Tom Hornbein's personal tribute to John Severinghaus is the first chapter in this volume, followed by an entertaining update of the history of the discovery of oxygen written by John Severinghaus.