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Reviews of Educational Material  |   April 2012
Tracheostomies: The Complete Guide
Author Notes
  • John H. Stroger, Jr., Hospital of Cook County and Rush Medical College, Chicago, Illinois.
Article Information
Reviews of Educational Material / Airway Management
Reviews of Educational Material   |   April 2012
Tracheostomies: The Complete Guide
Anesthesiology 4 2012, Vol.116, 972-973. doi:10.1097/ALN.0b013e318244a136
Anesthesiology 4 2012, Vol.116, 972-973. doi:10.1097/ALN.0b013e318244a136
Edited by Linda L. Morris, Ph.D., and M. Sherif Afifi, M.D. New York, Springer Publishing Company, 2010. Pages: 384. Price: $85.00.
Tracheostomies are one of the more common, as well as the earliest recorded, surgical procedures. According to the editors of Tracheostomies: The Complete Guide  , Dr. Linda L. Morris and Dr. M. Sherif Afifi, the nature of compartmentalized health care in medicine does not allow for a clear overview of the continuum of care for patients with tracheostomies. Surgeons, anesthesiologists, intensivists, respiratory therapists, and nurses need to be aware of the “fine details of daily care of patients with tracheostomies, to help [themselves] make appropriate decisions and educate their patients.” Those fine details are just what this book provides.
This book is informative and concise; its focused chapters provide an extraordinary amount of relevant information. The chapters are very logically ordered, starting with the functional anatomy of the airway and ranging to various aspects of patient care. The book effectively balances basic science background and clinical information. The first few chapters provide a detailed review of the anatomy, physiology, and basic science of various surgical techniques. The later chapters delve into more clinical subjects, such as detailed explanations of numerous patient-related issues. Each chapter is designed to be short and succinct, providing key points that are often very clinically oriented. As a practicing academic anesthesiologist, I especially enjoyed the “Summary” and “Key Points” sections at the end of each chapter. These can be tremendously helpful to residents and fellows in quickly referencing the most important information discussed in each chapter.
The chapter titled “Complications and Emergency Procedures” is broken down into immediate (hemorrhage, pneumothorax, intraoperative fire, air embolism), early (infections, obstruction, subcutaneous emphysema, inadvertent decanulation, false passage, mucus plugs), and late (infections, tracheomalatia, fistulas, stenosis, tracheocele) complications. This breakdown is a perfect example of the phenomenal detail of the book, as each aspect of tracheostomies is thoroughly covered.
In addition to highlighting a variety of special considerations, such as pediatric tracheostomies, routine laryngectomies, and emergency procedures, the breadth of this text extends much further by including chapters on tube fitting, phonation, downsizing, and decanulation. The fifth chapter emphasizes special considerations, such as ventilation, retained secretions, cuff leaks, and cuff pressure changes, which are unique for tracheostomy patients and very important in everyday practice. Clinicians will also find that the book provides an excellent discussion of the rehabilitation and recovery process, mentioning that “it takes patience, methodical planning, continuous assessment, and encouraging support to guide these patients toward optimal function.”
Overall, this book should be owned by any healthcare provider who regularly cares for patients with tracheostomies. The book's easy-to-read chapters and efficiently indexed information make it a very useful tool for quick reference during preoperative discussions as well as in the operating room. The text is filled with comprehensive figures and tables, enhancing its usefulness in clinical practice. The editors have clearly achieved their goal of providing a complete guide for the care of patients with tracheostomies.