James C. Eisenach, M.D., Editor

World Anaesthesia Online

URL:http://www.nda.ox.ac.uk/wfsa

Sponsors: World Anaesthesia and the World Federation of Societies of Anesthesiologists

Webmasters: Dr. Jason Sewell and Gerard Robinson

The mission of this web site is “Advancing Anaesthesia Throughout the Developing World.” The site is an interesting experiment in the use of the Internet as a way of providing high-quality medical information to developing countries without the expense of transporting physical books or journals. It consists of two parts, “Update in Anaesthesia” and “World Anaesthesia.”

This is the Web version of an annual educational journal “aimed at providing practical advice for those working in isolated or difficult environments,” edited by Dr. I. H. Wilson. Some articles are universally relevant (e.g., “Axillary Brachial Plexus Block”), whereas others, such as “What Do You Do When the Laryngoscope Bulb Fails during Intubation?” and “Make Your Own Endotracheal Tube Introducers,” would mainly interest those working in difficult circumstances. Authors are mainly from British community hospitals, with a few from developing countries. Most of the articles do not contain references. They are intended for an audience with minimal training in anesthesia and would be useful when teaching medical students or first-year residents the basics of anesthetic practice under these circumstances.

There is a “Search” function, which requires the use of a semicolon for the boolean function “AND,” and a comma for the boolean function “OR.” This is unusual and “user-hostile.” There are two indices, one by issue and one by section.

There are no links beyond the World Federation of Societies of Anaesthesiologists (WFSA) home page and the home page for the Nuffield Department of Anaesthesia, which hosts the site. A useful addition would be a collection of relevant links, such as that available at Anaesthesia International (http://www.oyston.com/anaes/international/). This site, written by Dr. Bekaert, includes information about how to contact organizations such as Medecins Sans Frontieres, sources of recycled equipment, courses on third world anesthesia, and other topics that would probably be of interest to readers of “World Anaesthesia Online.”

Each issue can be downloaded as a single file in Adobe's “page definition format.” These files are relatively small (e.g., 263 kbytes for the 32 pages of the 1997 issue) and produce a nicely formatted document with clear fonts and illustrations. This is intended to allow users to create local copies of the journal, which they may distribute freely for educational purposes. The journal is also distributed in print and on disk.

This is the annual newsletter of the WFSA. It includes articles such as “The Anaesthetic Situation in The Gambia” and “Anaesthesia for Palestinians in the Lebanon.” Anyone complaining about their current income should read a “Letter from St. Petersburg.” These articles make fascinating reading for the armchair adventurer, provide useful information for those considering working in these areas, and make the rest of us appreciate the comfort of a cozy and well-equipped operating room!

The web site evolved from the need to distribute the educational material in “Update in Anaesthesia” as widely as possible at minimum cost (personal communication, Dr. M. Dobson). As a result, both sections are presented in the same somewhat unusual format. Each article is divided into pages. Small navigational icons allow one to move from page to page, to skip to the next article, or to return to an index. Turning “pages” is rapid and satisfying. A typical page takes 7.5 s to download on a 14.4 kbps modem.

Because the site is intended for users in developing countries, in appropriately avoids using frames. Java, video, or animations. The images used are mainly clear black and white line drawings. Clicking on any image produces a twofold enlargement, but the “Back to Article” button only works if JavaScript is enabled. The site can be navigated in text-only mode.

In conclusion, this site represents an excellent source of information for all anesthesiologists and would probably be invaluable to those anesthetists in developing countries who could access the information in any of its formats.

John Oyston, M.B., B.S., F.F.A.R.C.S.

Department of Anaesthesia; Orillia Soldiers' Memorial Hospital; 170 Colborne Street West; Orillia, Ontario; Canada;oyston@oyston.com