Lecture Notes Clinical Anaesthesia perfect for medical students, junior doctors, anaesthetic nurses and allied health professionals
It is now over 15 years since I embarked upon the first edition of this book, and with each subsequent edition I have tried to respond to the demands of the readers and the changes within the specialty of anaesthesia itself. In recent years the anaesthetist’s role has expanded dramatically from simply ‘providing the conditions under which surgery can be performed safely’ and now involves contact with the majority of patients admitted to hospital. This includes playing a major role in preoperative assessment and postoperative care, acute and chronic pain management, as well as the recognition, resuscitation and management of the critically ill. This edition sees many changes to reflect this.
The first major change to this edition is the loss of the chapter giving an overview of critical care. During my career in anaesthesia I have been privileged to see this specialty grow from the efforts of groups of enthusiasts to its recent formal recognition and the formation of the Faculty of Intensive Care Medicine within the Royal College of Anaesthestists. Consequently, I would encourage students to turn to the many excellent texts available on this fascinating and evolving specialty.
The next change in this edition is a reorganization of the way anaesthesia is presented. Firstly, information on equipment, monitoring and the drugs and fluids you will see anaesthetists use in their everyday practice. This is followed by an overview of ‘giving an anaesthetic’, which describes the processes and procedures used to ensure the patient’s safety. Also included is a small chapter covering some of the specialist branches of anaesthesia that students may encounter; it has not been possible to cover every one and I hope those whose specialties are not included will understand.
Trainees from many specialties now work as part of the ‘Hospital at Night’ team, and one of their roles is to respond to requests for help with acutely ill patients that they may not be familiar with. Following on from the success of the chapter in the previous edition on the recognition and management of the acutely ill patient on the ward, this has now been expanded into two sections; the first on recognition and assessment of these challenging patients, followed by advice on how initially to manage commonly encountered problems.
But perhaps the greatest change for this edition is that I now welcome my son, as he embarks on a career in anaesthesia, as co-author. He has provided a fresh insight into the specialty as seen by an anaesthetist in training, and is more aware of what medical students need to know, rather than what I think they ought to know. He has worked tirelessly on the manuscript and provided new photographic illustrations; for that I owe him enormously – thank you!
I close by reiterating what I said at the end of the preface of the previous edition, but this time the message comes from both of us; we hope you enjoy this book, but even more we hope it helps you care for your patients. If it has, tell your friends; if it hasn’t, tell us why and we’ll try to ensure that the next edition is even better!