Internet resources for the anaesthesiologist.

There is considerable useful information about anaesthesia available on the World Wide Web. However, at present, it is very incomplete and scattered around many sites. Many anaesthetists find it difficult to get the right information they need because of the sheer volume of information available on the internet. This article starts with the basics of the Internet, how to utilize the search engine at the maximum and presents a comprehensive list of important websites. These important websites, which are felt to offer high educational value for the anaesthesiologists, have been selected from an extensive search on the Internet. Top-rated anaesthesia websites, web blogs, forums, societies, e-books, e-journals and educational resources are elaborately discussed with relevant URLs.

INTRODUCTION

The Internet is a global network of computers that has enormous potential for disseminating information and promoting communication.[1] Anaesthetists are well represented on the Internet, which they use for communicating among individuals, for corresponding with organizations or discussion groups and for publishing information on the World Wide Web (WWW). There is considerable useful information about anaesthesia available on the World Wide Web. However, at present, it is incomplete and scattered around many sites. Even the literature regarding Internet resources on anaesthesia is inadequate.[2] Let us begin with some basics of Internet search.

Basic internet terminologies

The world wide web

The World Wide Web is a system of interlinked hypertext documents accessed via the Internet. With a web browser, one can view web pages that may contain text, images, videos and other multimedia, and navigate between them via hyperlinks.

You have probably heard of URLs … A URL is a “Universal Resource Locator”. This URL tells a browser where to find the files on the World Wide Web.

The words “.htm” or “.html” at the end of the file merely mean that it is written in a form of computer code called HTML – Hyper Text Markup Language.

And, you have probably seen “http://”, which stands for “Hyper Text Transfer Protocol”.

To clarify between HTML and HTTP, HTML is for humans to tell computers how to display and format a file so that it looks pretty, whereas HTTP is for computers to tell other computers how to transfer information.[3]

Search engines used

Search engines are of two types, namely Crawler-based search engines and human-powered directories. Crawler-based search engines, such as Google and Yahoo, compile their listings automatically. They “crawl” or “spider” the web and the people search through their listings. But, directories such as Open Directory depend on human editors to compile their listings.

Search engine helps you to find whatever you are looking for.

Most popular search engines are Google, Yahoo and Bing.

The other top 20 search engines are:

Ask, AltaVista, AllTheWeb, AOL, HotBot Excite, Lycos, WebCrawler, Dogpile, My Web Search, Metacrawler, Snap, Search.com, Netscape, mamma.com, Gigablast, Blog Search Engine.

Types of search

There are several ways to search in the World Wide Web. The search engines basically provide three types of searches. If you know the differences, it can help you get better results.

Keyword Search: Many search engines by default offer a keyword search. This kind of search will find all pages that contain any of the words you have specified.

Phrase Search: Many search engines allow you to perform an exact phrase search, such that pages with only the words you type in, in that exact order and with no words in between them, will be found.

Boolean Operators: Named after the mathematician George Boole, Boolean logic involves the operators AND, OR and NOT. These operators are available in some search engines to expand or contract your search results.

If you want to search for obstetric anaesthesia but you do not need labour analgesia, you have to enter the text in the following way.

Find web pages that have. (Google advanced search)

All these words: Obstetrics About 8,830,000 results

This exact wording or phrase: Obstetric anaesthesia About 295,000 results

But do not show pages that have… any of these unwanted words: “Obstetric anaesthesia (without) labour-analgesia About 289,000 results (As on 10-03-2012)

If you need more tools, you can add the following filters to narrow down your search results:

Language: any language

File type: any format Adobe Acrobat PDF (.pdf) Adobe, Microsoft Powerpoint (.ppt), Microsoft Word (.doc)

Search within a site or domain.

Torrent search engine

Torrent is a type of file downloading software that can download very large files in piece-meals from other computers. It is a peer-to-peer file sharing protocol used for distributing large amounts of data.

Rather than downloading a file from a single source server, the Torrent protocol allows users to join a “swarm” of hosts to download and upload from each other simultaneously.

Here, you can download movies, journals, e-books, software, videos and music.

http://torrentscan.com/

In this article, the important websites that are felt to offer high educational value for the anaesthesiologists have been selected from an extensive search on the Internet.

Scholar search from database-based educational resources

Cochrane library

The Cochrane Library is a collection of databases in medicine and other healthcare specialties provided by the Cochrane Collaboration and other organisations. At its core is the collection of Cochrane Reviews, a database of systematic reviews and meta-analyses that summarize and interpret the results of medical research. The Cochrane Library aims to make the results of well-conducted controlled trials readily available, and is a key resource in evidence-based medicine.

The Cochrane Library is a subscription-based database, originally published by Update Software and now part of the Wiley Online system. All residents of India can access the full contents of The Cochrane Library for free, thanks to sponsorship provided by the Indian Council of Medical Research (ICMR).

http://www.cochrane.org/

U.S. National Library of Medicine

The United States National Library of Medicine (NLM), operated by the United States federal government, is the world's largest medical library.[4] The NLM is a division of the National Institutes of Health. Its collections include more than seven million books, journals, technical reports, manuscripts, microfilms, photographs and images on medicine and related sciences, including some of the world's oldest and rarest works.

It contains databases from PubMed, Index Medicus and NCBI.

http://www.nlm.nih.gov/

Medline (PubMed)

Medline is an index of medical journal articles. Perhaps this is the best medical article database. It has more than nine million citations.

Indexing and abstracting services of the literature are important tools that help researchers, scientists, academicians, evidence-based data seekers, practitioners and others in their search for needed documents with full information about authors, time and place of these publications.

Indexing services list journal articles, books, reports and other materials for a specific subject field thus increasing its exposure to the public and simplifying the search for peer-reviewed, evidence-based data.

PubMed does not include full text journal articles.

Here are some tips for obtaining full text articles

Many articles are available for free.

If you are a physician, researcher or health professional, utilize your affiliation with a medical library or institution.

If you need articles on a routine basis, consider using the “Send to Order” option.

First, you must register with a delivery service. The default article order service is the NLM-sponsored Loansome Doc service. This service is recommended for health professionals associated with a medical library, and provides the full text of an article from participating medical libraries. Local fees and delivery methods will vary.

During the registration process, you will have the opportunity to search for a Loansome Doc provider in your area (U.S. and International).[5]

If you are a member of the general public or not affiliated with a medical library or institution, try finding free copies, check with your local library or go directly to the publisher. Journal publishers or related organizations may provide access to articles for a fee or may be free after registering as an individual or guest.

To access it, go to:

http://www.ncbi.nlm.nih.gov/PubMed

Top anaesthesia blogs (E-mail discussion groups)

A blog (a blend of the term web log)[6] is a type of website or part of a website. Blogs are usually maintained by an individual with regular entries of commentary, descriptions of events or other material such as graphics or video. Most blogs are interactive, allowing visitors to leave comments and even message each other via widgets on the blogs, and it is this interactivity that distinguishes them from other static websites.[7] The top-rated anaesthesia blogs on the Internet are given in Table 1.

Table 1

Top anaesthesia blogs and forums

News groups and forums

An Internet forum, or message board, is an online discussion site where people can hold conversations in the form of posted messages.[8] They differ from chat rooms, in that messages are at least temporarily archived. Also, depending on the access level of a user and/or the forum set-up, a posted message might need to be approved by a moderator before it becomes visible.

A forum is hierarchical or tree-like in structure, and can contain a number of sub-forums, each of which may have several topics. Within a forum's topic, each new discussion started is called a Thread, and can be replied by many people.

The top-rated anaesthesia forums on the Internet are given in Table 1.

Societies and journals

Every country has its own Societies for anaesthesia and its subspecialty. Each society has its own journal published online or as a hard copy. The following are few top-rated online journals that can be accessed through their publication websites, like Wiley Online Library, Lippincott Williams and Wilkins academic journals, Springer Link and Elsevier Health, or through their Society websites.

University of Virgina (www.hsl.virginia.edu) has listed 72 titles in E-Journals under the category of Anesthesiology as top-rated journals. Here, you can access full text articles, view ISI impact factors and subscribe to journals' Table of Contents.

The top-rated anaesthesia journals and their URLs are given in Table 2.

Table 2

Top-rated anaesthesia journals and their URLs

Journal access

Abstracts of all indexed journal articles are freely available. For the full text, you have to access through their publication websites after paying the subscription fee or through their Society websites after registering as a member.

But, some of the full text articles are freely available through an Open Access (OA) system.

Open access

OA journals are scholarly journals that are available online to the reader without financial, legal or technical barriers other than those inseparable from gaining access to the Internet itself.[9]

OA journals are of various types. Some journals may be entirely OA or only some research articles may be OA. Some other journals may be delayed OA or may be permitting self-archiving of articles.[10]

There are a lot of controversies over OA projects, as to whether these are constructive and not destructive.

There are several major directories of OA journals, most notably: Directory of Open Access Journals (DOAJ) and Open J-Gate.

If you are a registered member of a Journal Web, you can receive e-mail alerts for the Ahead of Print articles. These citations may not be available to your library until the print version of the journal is published.

The journals can be accessed as HTML format or mobile format. The smart phones with Android OS introduced in the year 2008 are a great boon to the anaesthetists who are working long hours with monotonous cases inside the four walls of the operation theatres. Thanks to the 3G network and the iPad (tablet computer), now our anaesthetists can browse the Internet for journals and e-books even in their working hours.

The journal articles can be downloaded from the Internet as an HTML file, Web archive (single file), text file or portable document format (PDF) file by clicking the Save option or Download option on the web page or Copy/Paste option.

Some of the journals and books are available as electronic publication (ePUB), which can be accessed from Android smart phones as e-book.

Rating of journals by impact factor

The top-rating journals can be judged by their Impact Factor.

The Impact Factor for a journal is calculated based on a 3-year period, and can be considered to be the average number of times published papers are cited up to 2 years after publication.

For example, the Impact Factor 2011 for a journal would be calculated as follows: A = the number of times articles published in 2009–2010 were cited in indexed journals during 2011 B = the number of articles, reviews, proceedings or notes published in 2009–2010. Impact Factor 2011 = A/B.

Impact factor for anaesthesia journals

According to the 2010 Impact Factor, the top five journals of anaesthesia are Pain, Anaesthesiology, British Journal of Anaesthesiology, European Journal of Pain and Anesthesia and Analgesia.[11] The rating of journals by “Impact Factor” is enumerated in the current edition (2010) of the ISI Journal Citation Reports available in the JCR web.[12]

The best anaesthesia sites on the web

Top 10 anaesthesia sites

The websites are rated depending upon the number of views of the website. Anaesthesia sites that are listed as Top Anaesthesia Sites in http://www.topsite.com are given in Table 3.

Table 3

Top ten anaesthesia sites on web

It is difficult to remember all important URLs. The web and the web browsers evolve extremely quickly, but if there is one web browsing feature that has stood the test of time, it is the browser bookmarks. These websites can be accessed quickly by bookmarking websites in your default browser by using the default bookmarking tool.

RSS Feed “Really Simple Syndication” is a web feed format that helps you by notifying the frequent update in the websites of your interest without browsing through it. The RSS reader checks the user's subscribed feeds regularly for new work, downloads any updates that it finds and provides a user interface to monitor and read the feeds.

URLs for anaesthesia subspecialities and allied specialities

Here is the collection of popular websites related to anaesthesia subspecialities and allied specialities.

Critical care medicine

Critical Care Medicine

http://journals.lww.com/ccmjournal

Current Opinion in Critical Care http://journals.lww.com/co-criticalcare

Paediatric Critical Care Medicine http://journals.lww.com/pccmjournal

Annals of Intensive Care http://www.springerlink.com/content/2110-5820/

Anaesthesia and Intensive Care Medicine

Anaesthetists and Intensivists in training will find Anaesthesia and Intensive Care Medicine an invaluable source of up-to-date information, with the curriculum of both the primary and the final FRCA examinations covered over a 3-year cycle.

http://anaesthesiajournal.co.uk/

Indian Journal of Critical Care Medicine

http://www.ijccm.org/

The Journal of Critical Care

This is the official journal of the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM) and Society for Complexity in Acute Illness (SCAI).

http://www.jccjournal.org/

Critical Care Medicine Tutorials http://www.ccmtutorials.com

Pain

The Clinical Journal of Pain http://journals.lww.com/clinicalpain

Regional Anesthesia and Pain Medicine http://journals.lww.com/rapm

The Journal of Pain and Symptom Management

This is the official journal of the American Academy of Hospice and Palliative Medicine.

http://jpsmjournal.com/

European Journal of Pain

The Journal of the European Federation of the International Association for the Study of Pain chapters (EFIC).

http://www.europeanjournalpain.com/

Paediatric anaesthesia

Pediatric Anesthesia http://onlinelibrary.wiley.com/journal/10.1111/%28ISSN%291460-9592

Obstetric anaesthesia

Obstetric Anesthesia Digest http://journals.lww.com/obstetricanesthesia

Neuro anaesthesia

Journal of Neurosurgical Anesthesiology http://journals.lww.com/jnsa

Regional anaesthesia

Nysora - the New York School of Regional Anesthesia

This journal features an overview of techniques and principles practised in the field of regional anaesthesia.

http://www.nysora.com

Ultrasound for Regional Anesthesia – USRA http://www.usra.ca

Techniques in Regional Anesthesia and Pain Management http://www.techreganesth.org/

The American Society of Regional Anesthesia and Pain Medicine (ASRA) www.asra.com

Ultrasound Guided Regional Nerve Blocks http://www.neuraxiom.com/

Peripheral Regional Anaesthesia http://www.nerveblocks.net/

Regional Anaesthesia – A Spanish language website (Google translation is available)

http://www.arydol.es

Ultrasound Guided Nerve Blocks – Videos

Emergency medicine

Emergency Medicine Australasia

Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

http://onlinelibrary.wiley.com/journal/10.1111/%28ISSN%291742-6723

Academic Emergency Medicine

Academic Emergency Medicine (AEM) is the official monthly publication of the Society for Academic Emergency Medicine (SAEM).

http://onlinelibrary.wiley.com/journal/10.1111/%28ISSN%291553-2712

Others

Current Opinion in Anesthesiology http://journals.lww.com/co-anesthesiology

Simulation in Healthcare http://journals.lww.com/simulationinhealthcare

Survey of Anesthesiology http://journals.lww.com/surveyanesthesiology

BMC Anesthesiology http://www.springerlink.com/content/1471-2253/

Journal of Anesthesia http://www.springerlink.com/content/0913-8668/

Journal of Clinical Anesthesia http://journals.elsevierhealth.com/periodicals/jca

The Clinics of North America - Anesthesiology Clinics http://anesthesiology.theclinics.com/home

Anaesthesia and anaesthesiology resources

This website elaborates the historical background of anaesthesia and its mentors and also has a collection of useful anaesthesia hotlinks.

http://www.general-anaesthesia.com

http://www.general-anaesthesia.com/resource

Anaesthesia wiki

The goal of this page is to collect and distribute evidence-based information regarding all aspects of anaesthesia. It provides this information in the form of a wiki (i.e., anyone can edit, add or subtract to it).

http://openanesthesia.org

Anaesthesia E-Books

Virtual anaesthesia textbook

This site is sponsored by GE Healthcare's Clinical Window information service.

http://www.virtual-anaesthesia-textbook.com/

Free anaesthesia books

http://www.freebookcentre.net/medical_text_books_journals/anesthesia_ebooks_journals_text_books_download.html

Capnography

This website provides dynamic, animated, interactive and up-to-date information on capnography.

http://www.capnography.com/

Videos

Difficult airway videos

This is a good website for Difficult Airway Management, Airway Devices, Intubation Techniques and Tutorials launched by the University of Florida and sponsored by AirTraq.

http://vam.anest.ufl.edu/airwaydevice

YouTube videos

YouTube is a video-sharing website on which users can upload, share and view videos.

http://www.youtube.com/

Slide world

Slide World is a Medical PPT search engine that searches for Health and Medical PowerPoint (PPT).

http://www.slideworld.org/browsecategory.aspx

Medscape

Medscape is a web resource of medical news, medical journal articles and drug information for physicians and other health professionals.

Medscape's free application is now available for Android mobiles.

http://www.medscape.com/anesthesiology

Anaesthesiology patient simulators

Centers for medical simulation

University of Rochester Medical Center

The Anesthesiology Department of the University of Rochester Medical Center was a pioneer in the field of medical simulation, owning and operating one of the first anaesthesia simulators in the United States.

The patient simulator uses computer-driven models of human physiology, pathophysiology and pharmacokinetics, combined with lifelike hardware, to approximate a living patient. It not only “breathes” (consumes oxygen and produces carbon dioxide) and “circulates” (has a measurable pulse, blood pressure and cardiac output) but is also capable of responding to a variety of drugs and other interventions in a very realistic manner.

http://web.anes.rochester.edu/index.php/center-for-medical-simulation

Stanford School of Medicine http://cisl.stanford.edu/

Bristol Medical Simulation Centre http://www.bmsc.co.uk/

The CAE Patient Simulator http://www.cae.com/en/healthcare/simulation.solutions.asp

METI: Medical Education Technologies Inc. http://www.meti.com/

Anesoft simulators http://www.anesoft.com/

Internet security

Everyone must be aware of the security threat while browsing the Internet and how to tackle this.

The Internet represents an insecure channel for exchanging information, leading to a high risk of intrusion or fraud, such as phishing.[13]

All websites are not safe. When you click on a link to a page known to host spyware or other malicious programs, a computer user can be tricked or forced into downloading software on to a computer that is of malicious intent. This malicious software is of many types.[14]

Computer viruses, worms and Trojan Horses are all malicious programs that can cause damage to your computer, but there are differences among the three.[15]

What can I do?

First and foremost, make sure the operating system and any program you use are up-to-date with patches/updates

Always be wary of any strange e-mails, especially ones with attachments. When in doubt of the e-mail, you can always contact the sender and ask if their message was legitimate

When browsing the Internet, always watch what you click and install. Do not simply click OK to dismiss pop-up windows. Also, make sure to read through the End User License Agreement (EULA) before installing software

Install anti-virus software; scan and update regularly. It can, in most cases, remove and prevent viruses, worms, Trojans and some spyware

Install anti-spyware/anti-adware; scan and update regularly. It can screen network traffic and is able to block traffic that is dangerous

For Internet transactions, be sure the website offers secure data encryption and other services to protect your personal information.

How to know which website is trust worthy? Web of Trust (WOT) is a community-based website reputation rating tool. WOT allows users to add their input on the categories of trustworthiness. This WOT tool can be downloaded as a free add-on in your existing browser from the following link http://www.mywot.com/

Copyright in cyberspace

A webpage is not much different than a book, a magazine or a multimedia CD-Rom, and will be eligible for copyright protection as it contains text graphics and even audio and videos.[16]

Copyright law grants the owner exclusive right to authorize reproduction of the copyrighted works, preparation of derivative works, distribution, etc.

Copyright is the most complicated area of cyber law and faces the greatest challenge.

Traditionally, copyright infringement has been a “strict liability” offense - a copier may be liable for an infringement even if he neither knew nor had reason to know that he was acting unlawfully.[17]

If I write an article for a journal that is actually an unauthorized copy of someone else's work, and the journal publishes it, with my permission but not the original author's, the journal has no way of knowing that it is infringing the original author's work, but if that author sues, the journal will still have to pay. The journal may be innocent, but so is the real author: as between them the law prefers that the author be compensated at the journal's expense.

CONCLUSION

There are 255 million websites as of December 2010. Therefore, searching for an anaesthesia article is like fishing out a grain from the bed of the ocean. If we fully understand the basics of Internet search techniques, we can half way reach our target and, by following the links from each site, we can easily reach our goal.

This article has briefly listed some of the important websites that provide educational information to the anaesthesiologists. Although every effort has been made to provide accurate web addresses of various sites, the dynamic nature of the Internet ensures that some of these addresses may change over time.