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Review: Thoracic-Anesthesia.com

2007; Elsevier BV; Volume: 22; Issue: 4 Linguagem: Inglês

10.1053/j.jvca.2007.09.005

1532-8422

Chris Duffy, Paul S. Myles,

Airway Management and Intubation Techniques

For many anesthesiology residents and, let's be honest, anesthesiologists, knowledge of bronchial anatomy begins at the trachea and ends at the mainstem bronchi! A new Web site developed by an experienced thoracic anesthesiologist looks set to change this. The Web site, www.thoracic-anesthesia.com, is a superb resource for information and publications pertaining to thoracic anesthesia. The jewel in the crown is a fiberoptic bronchoscopy simulator. When visiting the Web site for the first time, a brief registration process is required to grant access to the advanced features of the site. A bronchial anatomy quiz and simulator can then be launched. The quiz takes about 5 to 10 minutes to complete and includes a mixture of still images and video files of bronchial anatomy and placement/positioning of double-lumen tubes and bronchial blockers. After completing the quiz, the bronchoscopy simulator is permanently unlocked for use. It is the simulator that makes this Web site most useful. The simulator, which requires Adobe Flash Player (available free; Adobe, San Jose, CA), allows the user to direct the bronchoscope in any direction throughout the tracheobronchial tree. A "roadmap" to the left of the camera view allows the user to see at all times where the bronchoscope is positioned. For each significant division in the airway, the video pauses and detailed descriptions of key features are described. The image quality is good and has a legend superimposed to allow identification of the major anatomic features being displayed. The simulator can be revisited, which enhances its educational value. Each of these is an excellent feature for novice bronchoscopists. The Web site also has links to reviews, lecture notes, and relevant journal articles on key topics in thoracic anesthesia, including preoperative assessment, lung isolation techniques, one-lung ventilation, complications, and postoperative analgesia. In future versions of this Web site, it would be great to see enhancements in the quality of the picture and video files in the quiz section as well as improvements in the resolution of the display in the simulator section. But, on second thought, perhaps this adds to the authenticity of the simulator; how often do we have to manage a difficult tube placement with suboptimal views in a patient with altered anatomy because of positioning, obesity, or thoracic pathology? This new Web site has a lot to offer both the trainee and specialist anesthesiologist, practicing not only in thoracic anesthesia but also in other fields of anesthesia in which one-lung ventilation may occasionally be required. We give full credit to Dr Slinger for his efforts in creating this novel, easy-to-navigate, and highly valued resource.