P.S. Auerbach H.J. Donner E. Weiss Field Guide to Wilderness Medicine, 3rd Edition 2008 Mosby 944 pages, $42.95 ISBN: 978-1-4160-4698-1

Abstract

Nearly every emergency physician has heard of or studied Paul Auerbach's Wilderness Medicine, the un-refuted “bible” of wilderness and outdoor emergency medicine. Many of us have wished we could compress and carry this comprehensive behemoth of a textbook, perhaps while on a medical mission to Haiti, or on a ski vacation in Utah, or on a diving trip to the Great Barrier Reef. For us, the Field Guide to Wilderness Medicine is just what the doctor ordered. Written to accompany the 5th edition of Wilderness Medicine, the third edition of the Field Guide is a lean, packable 1.6 lb soft cover book that covers essentials of the most commonly encountered medical and traumatic conditions a physician may encounter in the wilderness, backcountry or while traveling in remote areas. Unlike other wilderness medicine field guides published by groups such as the National Outdoor Leadership School, this guide is written by physicians for physicians and other advanced health care providers practicing medicine in the wilderness.Chapter topics range from high altitude medicine to diving and aquatic emergencies, traumatic injuries, plants, bites, stings, and travel-acquired illnesses. Specific topics within chapters are presented in an easy-to-read outline format and include signs and symptoms followed by treatment and, where appropriate, prevention. Additional chapters are focused on practical information including improvised procedural skills, techniques such as useful knots or carries, survival skills, and preventative health information for traveling such as recommended immunizations and methods for field water disinfection. There's even a chapter on emergency veterinary medicine--essential when traveling with pets or pack animals and veterinarians are unavailable.Each chapter is chock-full of clear illustrations or black and white photos, and supplemented by 20 pages of color photos. Physicians new to the specialty of wilderness medicine will be fascinated by improvised field procedures, such as using dental floss or hair tying to close scalp lacerations, safety-pinning the tongue to keep the airway open, use of honey on cutaneous wounds to prevent infection, irrigation of wounds using a baggie, or use of an inverted life jacket and kayak paddle to create a traction splint. An expanded collection of appendices provides recommendations for various survival kits, medications for parasitic infections, antibiotic prophylaxis following animal bites, medicines specific to women's health, and critical information on drug storage and stability.While incredibly useful with its comprehensive content and portable size, the book is not without criticism. Although meant to accompany the Wilderness Medicine textbook and purported to allow readers to “quickly and easily locate the information you need,” chapters in the guide are not presented in the exact same order as in the textbook, and are not broken down into sections (such as plants or mountain medicine) in the table of contents. This makes it a bit daunting to find a specific topic and I find it easier to look in the index. Color coding of chapters would be a great enhancement. The book is also inconsistent in describing the distribution of certain infections or insect/animal populations (such as sea snakes). Finally, while many rashes and cutaneous conditions are described throughout the book, there is no mention of contact dermatitis from poison ivy, oak, sumac or manchineel trees, all of which are commonly encountered. Although there is a chapter on aquatic dermatitis, a stand-alone chapter on wilderness dermatology would be a welcome addition.Who should buy this book? If you are a search and rescue or expedition team physician, this book is a “must have” in your backpack. But every physician - emergency medicine trained or not - will want to take along this invaluable book when on extended wilderness, sporting or overseas trips. The planned PDA/iPod version will be an excellent accompaniment to the paperback. Nearly every emergency physician has heard of or studied Paul Auerbach's Wilderness Medicine, the un-refuted “bible” of wilderness and outdoor emergency medicine. Many of us have wished we could compress and carry this comprehensive behemoth of a textbook, perhaps while on a medical mission to Haiti, or on a ski vacation in Utah, or on a diving trip to the Great Barrier Reef. For us, the Field Guide to Wilderness Medicine is just what the doctor ordered. Written to accompany the 5th edition of Wilderness Medicine, the third edition of the Field Guide is a lean, packable 1.6 lb soft cover book that covers essentials of the most commonly encountered medical and traumatic conditions a physician may encounter in the wilderness, backcountry or while traveling in remote areas. Unlike other wilderness medicine field guides published by groups such as the National Outdoor Leadership School, this guide is written by physicians for physicians and other advanced health care providers practicing medicine in the wilderness. Chapter topics range from high altitude medicine to diving and aquatic emergencies, traumatic injuries, plants, bites, stings, and travel-acquired illnesses. Specific topics within chapters are presented in an easy-to-read outline format and include signs and symptoms followed by treatment and, where appropriate, prevention. Additional chapters are focused on practical information including improvised procedural skills, techniques such as useful knots or carries, survival skills, and preventative health information for traveling such as recommended immunizations and methods for field water disinfection. There's even a chapter on emergency veterinary medicine--essential when traveling with pets or pack animals and veterinarians are unavailable. Each chapter is chock-full of clear illustrations or black and white photos, and supplemented by 20 pages of color photos. Physicians new to the specialty of wilderness medicine will be fascinated by improvised field procedures, such as using dental floss or hair tying to close scalp lacerations, safety-pinning the tongue to keep the airway open, use of honey on cutaneous wounds to prevent infection, irrigation of wounds using a baggie, or use of an inverted life jacket and kayak paddle to create a traction splint. An expanded collection of appendices provides recommendations for various survival kits, medications for parasitic infections, antibiotic prophylaxis following animal bites, medicines specific to women's health, and critical information on drug storage and stability. While incredibly useful with its comprehensive content and portable size, the book is not without criticism. Although meant to accompany the Wilderness Medicine textbook and purported to allow readers to “quickly and easily locate the information you need,” chapters in the guide are not presented in the exact same order as in the textbook, and are not broken down into sections (such as plants or mountain medicine) in the table of contents. This makes it a bit daunting to find a specific topic and I find it easier to look in the index. Color coding of chapters would be a great enhancement. The book is also inconsistent in describing the distribution of certain infections or insect/animal populations (such as sea snakes). Finally, while many rashes and cutaneous conditions are described throughout the book, there is no mention of contact dermatitis from poison ivy, oak, sumac or manchineel trees, all of which are commonly encountered. Although there is a chapter on aquatic dermatitis, a stand-alone chapter on wilderness dermatology would be a welcome addition. Who should buy this book? If you are a search and rescue or expedition team physician, this book is a “must have” in your backpack. But every physician - emergency medicine trained or not - will want to take along this invaluable book when on extended wilderness, sporting or overseas trips. The planned PDA/iPod version will be an excellent accompaniment to the paperback.