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Harvard Electronic Anesthesia Library

2003; Lippincott Williams & Wilkins; Linguagem: Inglês

10.1097/00000539-200306000-00080

1526-7598

Keith J. Ruskin,

Medical History and Innovations

Michael Bailin, ed.[LINE SEPARATOR] Philadelphia: Lippincott Williams & Wilkins, 2002. ISBN/ISSN: 0-7817-1408-7 (CD-ROM). $345.00. Electronic publications offer many advantages over printed text. Advanced search capabilities make it easy to find information on a specific item and large, high-resolution color images help to illustrate important points. Electronic publications also require a much shorter lead-time than printed media, making rapid updates possible. All of the major publishers use this technology, offering CD-ROMs with information on many topics pertinent to anesthesia practice. Most of the major textbooks and journals are now available online or on a CD-ROM, but few new publications have been developed specifically for electronic publication. The Harvard Electronic Anesthesia Library (HEAL), edited by Michael Bailin and developed by faculty at the four teaching hospitals of the Harvard Medical School, was developed exclusively for electronic publication. HEAL is an electronic textbook that covers the entire field of anesthesiology and can be used by anyone from medical students and residents through physicians in practice. It works with Windows or Macintosh operating systems, and its modest requirements (Table 1) enable it to run on almost any computer. For this review, HEAL was tested on a Dell workstation (512 megabytes, a 1.7 GHz Intel processor, and the Windows 2000 operating system) and an Apple iBook (512 megabytes, PowerPC G3 processor, and System 10.2.4).Table 1: Hardware requirements. The program also requires a Web client (Internet Explorer or Netscape 4.72 or later).Installing the program is very easy and takes only a few minutes. The installation instructions are well written and easy to follow. The user inserts the HEAL CD and then double-clicks on the Setup icon. The setup program copies navigation and image files to the computer, adds Heal to the Start button and places an icon on the desktop, and installs a server that runs in the background when the program is started. Setup also offers to install Netscape version 4.72 and make it the default Web client. If the program is run on a Macintosh running OS X, the Classic environment is started, and the program appears to require an older Web client. Attempts to use Safari or other Web clients running under OS X were unsuccessful. Double-clicking on the HEAL icon or selecting it from the Start menu launches the program. The user interface is well designed, making it easy to use by anyone who has read a textbook and used the Web. The first menu allows the user to choose from the Table of Contents, a list of authors, a Media Library, and a self-test. The Table of Contents is similar to that of other anesthesia textbooks, covering “General Considerations” (e.g., pharmacokinetics and gas laws), Airway Management, and subspecialty topics such as neurosurgical anesthesia and pediatric anesthesia (Fig. 1). The program is designed to let the user browse for topics of interest in the Table of Contents or search for a specific series of keywords. The product includes a search engine that allows the user to look for keywords, contributors, or specific subjects. Navigating the book is easy; a sidebar shows the reader’s location within the chapter, along with other subheadings within the same chapter. There were, however, no hyperlinks between chapters (e.g., the section on airway management in trauma surgery could have contained references back to the first airway management chapter).Figure 1: Table of Contents for the Harvard Anesthesia Library.All of the chapters are well written, with concise, clear explanations of the topic being covered. For example, the section on trauma anesthesia starts with airway management, then explains fluid resuscitation, and goes on to describe anesthetic management of specific injuries. In addition to its role as a textbook, this book could be used at the point of care to rapidly review a topic. Each chapter is well referenced, and most references are linked back to the National Library of Medicine’s PubMed Web site, making it easy to review the abstract or read an electronic version of the article if available. Figures are large, clear, and of very high quality. HEAL offers a multiple-choice test at the end of each section that allows the user to assess his or her understanding of the subject. A multiple-choice test that takes questions from each section of the book can be used to find areas to concentrate on, or as preparation for the written board examination. Despite its excellent organization and content, HEAL does have a few flaws. The program sometimes takes ten or more seconds to draw a page; this seems to occur more commonly on the Macintosh. The bottleneck appears to be the server program that is started in the background. The Web client, which is used to display the book, must communicate with the server before displaying any page. HEAL also occasionally became unresponsive on both test computers, and occasionally displayed only blank pages on the Windows computer. Stopping the program and restarting it fixed both of these problems. Moreover, closing the Web client did not automatically stop the server; it was necessary to stop it manually, either from the System Tray in Windows or from the Application Bar on the Macintosh. Despite these shortcomings, HEAL is a good example of how computers can make it easy to find and use clinical information. The product is worth serious consideration by anesthesiology residents and physicians in practice.