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3 of 3 people found the following review helpful
5.0 out of 5 stars In many ways essential for any doctor, 6 Aug. 2009
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This review is from: Wilderness Medicine, (Wilderness Medicine: Management of Wilderness and Environmental Emergencies) (Hardcover)
This is a fascinating book. Never mind the wilderness, this book helps you understand all the things every doctor feels they should know and understand but don't. You never know when you may need to improvise a splint, sling or stretcher, even in the back garden!

The book is quite exhaustive, and covers big topics like cold immersion, frostbite, heat stroke, burns, penetrating trauma, all about lightning strikes, snakebite, search and rescue and altitude sickness. It also covers important little topics like how to really manage blisters, bites, and travellers diarrhoea. I never knew duct tape had so many medical applications - a dressing, ankle support, replacement lens for you spectacles or even sunglasses. Did you know how to properly size shoes and boots? In short unlike most medical textbooks you also get good advice on avoiding a problem in the first place, and on the improvisations and practicalities of managing problems when you lack access to a hospital.

Criticisms are few, and fairly minor - the authors ignore the utility of of cold IV crystalloid solutions for cooling in the context of heatstroke - 3L of 4C Hartmans will drop the core temperature of a 70kg adult by 1-2C more or less instantaneously (the advent of therapeutic cooling following cardiac arrest has certainly enhanced my understandoing of how to cool patients). Conversely a slightly more instructive approach to the circumstances in which CPB should be used in hypothermia would be helpful - my experience is it is almost always used too late, although of course CPB may not be available in many wildernesses and it is a tough problem for an RCT! Finally I wouldn't have minded a bit of basic discussion on how acupuncture can be used to alleviate pain - endorphins are always available, needles are usually available, but wandering around with opioids is strangely frowned upon in our society! Conversely I suspect the last place I would want a Bier's block is in the middle of nowhere.

This is a big book - for the office not the trail, but it really is brilliant. No book is ever a substitute for clinical experience, but this comes close. What I love most is you gain a pretty full understanding of the pathophysiology and both theoretical basis and practicalities of treatment so you gain a much more rounded and memorable understanding than I am used to with most text books. If you have read even 10% of this book I suspect you would be well placed to make a start on most problems and would know what to worry about when someone gets into trouble.

Yes I recommend it... very strongly.
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1 of 2 people found the following review helpful
4.0 out of 5 stars just whai needed, 4 Aug. 2010
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Dr. N. P. Rushton (devon) - See all my reviews
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This review is from: Wilderness Medicine, (Wilderness Medicine: Management of Wilderness and Environmental Emergencies) (Hardcover)
i am doinganmsc in remote health care here in uk ,this book is the best
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Wilderness Medicine, (Wilderness Medicine: Management of Wilderness and Environmental Emergencies)
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