How I Made It


While the digital format is useful in terms of wider education, and personal reference I wouldn’t advocate using it in a crisis. Hence the need for a physical version. No unlocking the phone, tapping on your pdf app, scrolling and zooming required. The book should be in a known, consistent place in every Anaesthetic Location.


As part of producing the 2nd version of this manual I have investigated ways to speed production up. It still requires some arts and crafts.

– I have experimented with some colour laser printable, waterproof tear resistant plastic paper. Depending on where you buy the paper this can range from 70c to 150c/page. I would recommend using paper as heavy as you can find. >150gsm is ideal.

– Then print double sided colour on all pages except first 2 pages of both books. I relaxed the need for borderless printing and printed with a border (shrink to 96% of fullsize to account for the full page .pdf books)


– Cut the tabs out on these sheets with a guillotine. I tried to angle the cut to further protect the tabs. There is no need to laminate these pages now.


– Print the first 2 pages of each book on standard A4. Laminate these only. Make sure to leave a big clear border on the right hand side. This will protect the tabs when the book is closed


– Collate the book into its topsy turvy design


– Wire bind the book – then you’re done


The advantages of this method are that: quick to print on hospital colour laser printers, no need to cut the tabs then laminate then cut the tabs again, the book is thinner, the plastic paper prints really clearly and nicely. Most importantly it is much faster!


– I tied some fine bore plastic infusion tubing around the top three rings to allow the book to be hung. Another option is a zip tie

– Finally: I superglued hooks to each Anaesthetic cart, and printed some stickers to place under the hooks (to alert people to where the handbook is meant to be hung & thus missing if not hung there).


This involved less steps but unfortunately still time consuming:

– Firstly: On the Mac its pretty easy to convert .pages files into .pdfs by ‘printing’ pages files into pdfs
– Then: Collate all the individual pdfs into on document by dragging them into the thumbnails on Preview. Then ‘print’ them all into one pdf document
– Next to enhance the pdf:  I bought a MAC program called PDFpen9. Not cheap but it is quick to go through and add internal links to all pages.

This multi-step process isn’t entirely perfect unfortunately. It means every time i make a change on a pages file, i need to reprint the pdf, re-collate the individual pdfs into one book, then load it in pdfpen9  and re-add all the links again. Pretty painful unfortunately. In the last year apples pdf kit has also broken it’s relationship with clickable links in pdfs. I can find no work around except to not open the digitial file in preview/ibooks or anything apple. If you do, and click a link that link will be permanently broken. Instead i recommend using any other pdf viewer eg adobe, goodreader etc.

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