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Review Oxford Handbook of Expedition and Wilderness Medicine

Thrud

Richard Proenneke
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Review Oxford handbook of Expedition and Wilderness Medicine 2ndEd


This book weighs exactly 440g and has a nice plastic cover which means you will be able to wipe the blood off easily.

It is a pocket sized book and is billed as “Indispensable guide for all travellers to wild and remote places” That would certainly cover a trip to visit Bloffy in Albany.

The print is small and if you lost your reading glasses it wouldn’t be much good to you apart from a tinder source.

There are just over 800 pages and about 25 colour illustrations, it cost $65.

Written by experienced doctors, the chapters cover the following:

Expedition Medicine 15 pages of general data including the relative risk of dying (Everest 1:7 to 1:83, after surgery 1:250, Himalayan trekking 1:7000 and jogging 1:7700 (another excuse for me not to jog))

66 pages on Preparations. This includes everything from medical kits to insurance, immunizations, pre-existing conditions and is fairly comprehensive. The section on essential expedition medical skills is sensible

30 pages on caring for people in the field, including kitchen hygiene, latrines, drug admin, diet and a section on organising a healthy base camp. A lot of useful information for us bushcampers.

Obligatory chapter on Ethics and responsibilities including assessing your environmental footprint.

Chapter 5 is on Crisis management, emergency response plans, moving patients, missing people and death (probably only after eating some of Doc’s cooking)

Chapter 6 is tiny but very useful it includes history and examination for non-clinicians, clinical measurement and illness assessment forms.

Chapter 7 is getting into the meat of trauma along the lines of Airways breathing circulation, but also has bits on blast(sadly possible these days) and lightning(should have read that one….)

Chapter 8 really deals with non-traumatic emergencies; convulsions, chest pain, choking, hypothermia and is well illustrated and sensible.

Chapter 9 is skin; containing pieces on wounds/lacerations. (I know all that stuff!!!), burns , insect bites and some general stuff, which might save you a trip to a dermatologist (instant saving of $250)

Chapter 10 is head and neck, dealing with important topics such as head injury as well as eye problems, lacerations (I’m looking at you Uneekwahn), ear and nose issues

Chapter 11 is devoted to the tooth fairies and has info on pre-expedition dental care, fillings, missing crowns and other dental injuries with a diagnostic chart, which again might save you a trip to the dentist even if you’re not on an expedition!

Chapter 12 deals with chest issues; rib fractures, heart attack (when my missus finds out how much I’ve spent on knives) asthma and chest infection

Chapter 13, unlucky for some is abdo pain, well written and sensible. Including something very important; acute scrotal pain (again once the missus finds out…)

Chapter 14 is limbs and back; sprains, fractures of arms/legs pelvis. Tendon injuries, dislocations although the descriptions on how to reduce shoulder dislocations don’t have any drawings, which is an oversight; instead they use technical jargon which may limit it’s usefulness. How many of us know how to put an arm mid-prone and then externally rotate?

Chapter 15 is a big one on infectious disease. Of more use after the event, but still quite interesting with some useful links and info about tropical illness

Chapter 16 is an important chapter on psychological and psychiatric problems: including post traumatic stress disorder, psychological reactions, breaking bad news (that might help me with the missus) and a piece on surviving kidnapping

Chapter 17 is on risks from animals, this includes trauma from big things (elephants, crocs etc) a section on venomous creatures. Agin, I think there is a little too much emphasis placed on trying to identify the snake; although in fairness, they do state you should not attempt to catch or kill the snake.
Illustrated bit on bandaging suggesting 50-70mmHg pressure.
Marine animals; not much to say as the treatments are all supportive.

Chapter 18 is on plants and fungi; This is one of the odd chapters; they have a picture of an edible mushroom vs a Death cap. The implication is that it is simple. I think this is very wrong; don’t eat fungi. Period.

Chapter 19 is about anaesthesia in remote locations. There is a nice bit on local anaesthesia, which can easily be followed (assuming you had the happy juice), but most of this is specialized information. Sensibly at the beginning of the chapter it suggests you avoid anaesthesia if possible. (As a general principle I would try and avoid at all costs anyway, even if I wasn’t in the jungle….)

Chapter 20 On cold climates and injury. Worthwhile reading especially for our Eastern States chums, but hypothermia is an issue even in WA.

Chapter 21 is on high altitude medicine (anything over 2500m) so it can happen here.

Chapter 22 on inland and coastal waters; pages on environments,rescue, immersion and drowning, canoeing, white water rafting, medical problems in small craft, and kayaking

Chapter 23 Offshore has advice on medical kits and emergency stuff

Chapter 24 Underwater; decompression etc

Chapter 25 Hot, dry environments: surviving dust storm, heat illnesses, acclimatization and workload calculations. Fluid and electrolytes etc.

Chapter 26 Hot, humid environments: tropical forest: risk assessment, insects, staying healthy, navigation, campcraft, water and sanitation

Chapter 27 Caving: You have to be mad!

Chapter 28 Medical kits: This has sensible advice on personal (to my mind slightly small) and team kits, extra meds as well as extra materials for special skills


So, overall would I recommend this book? Yes, but it should be realised that reading it will not mean you should attempt to do some of the things in the book unless in extreme circumstance. It is a well thought out book and has been revised since it’s first edition. Some sections are easy to follow and others require a deeper understanding of the terms and language of medicine. For the price of a tank of petrol I think it is well priced. There are clear flow charts and diagrams which help with some of the diagnostic and management algorithmns. I won’t carry it with me, but I will reference it.
 

oncedisturbed

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Another good addition to consider is the latest addition of the SAS Survival handbook which covers very similar topics and also now includes the addition of Urban Survival and is released in standard size, pocket and app formats.
 

Aussie123

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Sounds like it has a chapter on everything !

although Ch 17 "Marine animals; not much to say as the treatments are all supportive." ... is not quite right?
I believe there are treatments for some stings including heat, vinegar and pressure immobilization - of course you need to know which are for which, but that's the point o a reference book
 

Thrud

Richard Proenneke
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Sorry Aussie, I was generalising a bit on this chapter. To be specific it covers sea snake bites; as you suggest, compression. Fish sting there is anti veneme for stonefish. Sea urchin, octopus, cone she'll, bristle worms are covered. Ingestion of toxins do have some specific treatments, but overall the treatments that can be administered in the field are really mostly supportive as you indicate to relieve symptoms and prevent progression.
 

Aussie123

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Sorry Aussie, I was generalising a bit on this chapter. To be specific it covers sea snake bites; as you suggest, compression. Fish sting there is anti veneme for stonefish. Sea urchin, octopus, cone she'll, bristle worms are covered. Ingestion of toxins do have some specific treatments, but overall the treatments that can be administered in the field are really mostly supportive as you indicate to relieve symptoms and prevent progression.

no probs. I was thinking the book didn't say much on those topics, but I was pretty sure there were treatments available for some stings.
We traveled across the North with a bottle of vinegar, a thermos of hot water, and a compression bandage ... just in case !

It sounds like a good read
Thanks for all the detail
 

swampy99

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Ill second this book. I have the latest edition and think new stuff is being written for a further update. This is also one of the prescribed text books for my Grad Cert in healthcare in remote and extreme environments by Tasmania university. Im half way through it at the moment, the grad cert I've read the book loads and reference it a lot at work.
 

Randall

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Sounds like it has a chapter on everything !

although Ch 17 "Marine animals; not much to say as the treatments are all supportive." ... is not quite right?
I believe there are treatments for some stings including heat, vinegar and pressure immobilization - of course you need to know which are for which, but that's the point o a reference book
I 2nd the stinger thing; vinegar is to prevent possible further venom injection for example:oops:. It sounds like the book is aimed at the world, as is the SAS book. I used to carry a small version of this when travelling pre internet days. I liked it because it made me consider safety and prevention - although I'd still always go for the roof of the bus:ROFLMAO:. Do you (swampy, thrud and anyone else who knows) think this is a good resource for just Australia? I do carry the little Australian first aid book - keep it in my travel bag.

Incidentally, I ride emtb. I often see other riders not carrying anything other than multi tool and tube taped to their frames. I stabbed myself in the shin with an aggressive pedal pin after a drop. I was wearing compression socks - there was blood spurting like a little water pistol out of my shin, no doubt in time with my heart beat. I had a roller bandage on it within a minute (sat down right there, bandaged over the sock) literally. I had easily lost a cup of blood in that minute - sock and shoe soaked, little pool on the ground. Once the bandage was on I felt pretty bullet proof and continued my ride. A little thing, but sort of shows how something like that can be a drama. It really needed pressure - it started spurting again at home after soaking the sock off and didn't stop till I got pressure on it again.

I don't go crazy carrying stuff; the roller bandage is the only medical thing in my outdoor kit (along with a few meds). I've had to use a bandage a few times now - very useful. I've also used gaffer tape (have some wrapped around a small pump) for injuries :ROFLMAO:

Got me thinking; I just found this as a free download if anyone is interested. Hard copy looks to be around $35 - $40; you can carry this one on your phone. This one actually looks better than the St John's emergency first aid - also a free download.

https://cdn.shopify.com/s/files/1/0269/7497/8132/files/Survival_eBook_JUNE_2019_compressed.pdf?410

and the St John's emergency first aid: https://www.stjohnvic.com.au/media/1932/pfa1d.pdf
 
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WanderOn

Malcolm Douglas
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Thanks Thrud. Awesome review.
Think I had better taking my safety in the bush a bit more seriously.
My Landcruiser has a pretty comprehensive first aid kit but not when I mountain bike. I’ve walked away from a few too many stacks too lightly. This includes knocking myself out whilst mountain biking alone.
I had better do some reading up as well.
 

swampy99

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I 2nd the stinger thing; vinegar is to prevent possible further venom injection for example:oops:. It sounds like the book is aimed at the world, as is the SAS book. I used to carry a small version of this when travelling pre internet days. I liked it because it made me consider safety and prevention - although I'd still always go for the roof of the bus:ROFLMAO:. Do you (swampy, thrud and anyone else who knows) think this is a good resource for just Australia? I do carry the little Australian first aid book - keep it in my travel bag.
I think it is a good book for Australia as it covers most hings in a general way. The chance of acute mountain sickness happening is rare seeing as we have no mountains over 2500m (if it does happen just go down 300m+ to a level you improve) but Hypothermia is always a risk in the alpine areas and also here in Queensland. Its all about exposure, time and clothing. A good plan is to research the area you are going on what is unique to that area and have this book as a support to your knowledge. Hope that helps.

Swampy.
 
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