Anesthetic Accidents: Case Studies By Torsten Gordg and Jacobus W. Monsert (review)

Anesthetic Accidents: Case Studies. By Torsten Gordh and Jacobus W. Mostert inInternationalAnesthesiology Clinics 16, no. 3 (1978): xviii+ 194. $35.00 per year (subscription tojournal). This volume describes with unusual insight and accuracy a group of anesthetic mishaps that occurred in Sweden. The location is of particular note because Swedish law requires reporting such incidents to the National Board of Health and Welfare, which publicizes all anesthetic deaths. Sections in this book deal with respiratory depression, airway obstruction, improper placement of catheters, inaccurate anesthetic dose, anaphylaxis, hyperkalemia, and autonomic inadequacy. There is also a section on neurological sequelae of anesthesia. Comments by the authors point out the means by which such misadventures might be prevented in the future, at the same time realizing that much more must be learned ifwe are to be able to avoid all such problems. For example, how could one know that an unconscious bleeding patient might have an allergy to a commonly used drug? or that he might develop malignant hyperthermia? The bulk of the reported problems could have been prevented by more caution and preparation, by keeping aware of current findings, or by better attention to patients' progress. Familiarity with these situations should help the anesthesiologist to avoid them in the future. As one example, three deaths which occurred at the time of electroschock therapy were probably due to vagal arrest. The authors suggest that atropine should have been used before the shock. Warnings are included about such complications as those arising from rapid administration of aminophyllin, complete dependence on the Sellick maneuver, prolonged (several days) epidural blocks, malignant hyperthermia, and simultaneous administration of halothane and epinephrine. The book is well put together and highly readable. It will be of value to and of interest for anyone who gives anesthetics. Robert W. Virtue 727 Birch Street Denver, Cobrado 80220 An Introduction to the History of Virology. By A. P. Waterson and Lise Wilkinson. New York: Cambridge University Press, 1978. Pp. 237+xiv. $27.50. At the end of the nineteenth century, physical and biological scientists were almost smug in their acceptance of the great strides made in their respective fields. They looked forward to a comfortable exploitation of neat and orderly concepts during the next century. Within the decade following the turn of the century, there were disarray and confusion in both the physical and biological sciences with the discovery of radioactivity and atomic particles, the genie theory of heredity, and a dawning knowledge of "life" beyond the reach of the light microscope in the viruses. In the relatively short span of 176 pages, A. P. Waterson and Lise Wilkinson have presented a remarkably lucid, comprehensive, and fascinating introduction to the history of virology. The authors structure each chapter from the point of view of the investigators, reconstructing their thoughts and those of their contemporaries and assessing Perspectives in Biology andMedicine · Winter 1980 | 317 ...