Clinical Anesthesia for PDA. By Paul G. Barash, Bruce F. Cullen, Robert K. Stoelting. LWW Mobile, Baltimore, 2002. ISBN: 0-7817-3852-0 (CD-ROM). 0-7817-3955-1 (Online Deliverable). Price: $59.95.

This personal digital assistant (PDA)–based resource is derived from Barash, Cullen, and Stoelting's respected textbook, Clinical Anesthesia . The software is loaded from a Windows or Macintosh system and is useable on either a Palm OS or Windows CE–based PDA. I tested the software using Windows XP and a Palm Vx PDA with Palm OS 3.5.

Installation was straightforward using the directions supplied. The product is installed on a computer, and then the PDA is “synched” with that system requiring 250 kilobytes of free memory on the PDA. Installation proceeded smoothly; however, some basic features were less than optimal. For example, the software will not install unless all fields of the registration form are filled out and submitted, and there was no place on the registration form to opt out of promotional mailings and e-mails. No printed manual comes with the product, except for installation instructions. Documentation is installed on the computer, limiting it to being read only at the workstation on which the software was installed. Curiously, some examples shown in the documentation do not appear to be from the actual product itself. Unfortunately, the documentation does not cover all of the icons and buttons used in the application, so some trial and error was necessary.

The intended audience for this product is unclear. The license states it is a “concise reference resource.” However, in my opinion this resource does not replace a textbook or handbook. The product is navigated by a main menu, via  a “Table of Contents,” allowing one to move through the body of the text. This is derived from the Clinical Anesthesia  text, consisting of six chapters and a collection of appendices. Chapter topics include an introduction to anesthesia practice, basic principles of anesthesiology, basic principles of pharmacology, preparing for anesthesia, management of anesthesia, and postanesthetic and consultant practice. Although the attempt to cover a wide range of topics is admirable, in many cases this is at the cost of providing only a superficial examination of these topics. For example, the text mentions various Practice Guidelines drafted by the American Society of Anesthesiologists, but it does not describe their content or how to access these guidelines. As another example, in the discussion of acid-base physiology there is little on the analysis of laboratory data to diagnose the etiology of the acid-base disorder in any detail, nor analysis of mixed acid-base disorders. There is a similar lack of depth and detail throughout the body of the text. References or sources for more information are listed infrequently, and there are few graphics to help understanding. Navigation could be improved by providing links between appropriate sections, which in most cases are lacking.

Although the lack of depth in the body of the text limited its usefulness to me as an experienced anesthesiologist, I found the appendices very useful. They provide details that one would typically need to look up on a fairly regular basis. The first appendix lists hemodynamic and respiratory formulas and normal values. The next section covers criteria for electrocardiographic diagnoses. There are two sections on anesthesia drugs and herbal medication in which, in addition to covering uses, include common doses, metabolism, interactions, and toxicity. American Heart Association protocols are included with both advanced cardia life support and pediatric advanced guidelines. Procedures for dealing with automatic implantable cardiovascular defibrillators, including manufacturers’ 24-hr help-line phone numbers, are included. To me, this represents the most valuable feature of the product. The application also includes a master medication index cross-referencing the text and the appendices, although incompletely. The application includes a “Personal Topics” feature allowing one to add one's own notes, although they are not linked to any of the topics listed in the table of contents or index.

In summary, this version of Clinical Anesthesia for PDA  may be useful for persons at the junior resident level, i.e. , those with a grasp of the basics who are trying to gain experience with a larger body of knowledge. Much good information is provided. Nevertheless, both beginners and experienced persons may find that several features produce frustration, especially the lack of detail in many areas. This may be a limitation inherent in this type of product, but one would hope that later versions could improve the user interface, provide extensive links within the text, and provide a consistent breadth and depth of information.