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The Complete Recovery Room Book, Third Edition

Anthea Hatfield, Michael Tronson. Oxford University Press, 2001. 586 pages. $86.50 (CAN). ISBN 0 19 263218 3 (Pbk)

Calgary, Alberta

Started as a manual to help recovery room staff of isolated hospitals, this third edition of "The Complete Recovery Room Book" attempts to be a comprehensive compendium about patients’ conditions and complications in the immediate postoperative period. Chapters include setting-up/running a recovery room, monitoring, day surgery, operations, major complications, special problems and crisis management. There are eight appendices, some ‘international’ (e.g., arrhythmias), others less so (e.g., common abbreviations).

Although the authors suggest using the book like an encyclopedia, this requires comprehensive indexing, which this is not. For example, "saturation" is only included under "oxygen", and then linked with "extubation".

The book is clearly written, with good use of point form. Some information is sensibly repeated, with cross-referencing in the text. Helpful aphorisms are scattered throughout the book:

"The confused, restless, agitated patient is hypoxic until proven otherwise".

"Treat the patient, not the monitor".

While certain statements may seem simplistic, they address problems that continue to lead to catastrophes, both in recovery and on the ward. However, another aphorism - the devil is in the details - best indicates where we had difficulties.

First, we disagreed with some details. In this hospital’s recovery room, few anesthesiologists and probably none of the nurses would manage laryngospasm by routinely inspecting the patient’s airway with a laryngoscope before giving 100% oxygen. A similar step is included with how to extubate a patient’s trachea in the recovery room.

Second, in some parts the book was too detailed and in others, not enough. Statements are given about universal precautions, including glove disposal after a single use and how to deal with body fluid "spillage". Yet, these instructions are not related to the recovery room, nor is there mention of waterless hand sanitizing agents.

Some of our concerns reflect our inability to determine the book’s intended audience. Is it the solo nurse in an isolated hospital or one of many nurses in the 30-bed unit of a university hospital? If the former, then the book might provide necessary detail; if the latter, then the book will be less useful. Some parts might be helpful for recovery room nursing students and nurses on surgical wards. In addition, medical students and junior anesthetic and surgical residents might benefit from other sections as an introduction to recovery at the start of their rotations.

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