By MD Jeffrey E. Isaac PA-C and David E. Jo Wilderness and Rescue Medicine: A Practical Guide for the Basic and Advanced Practitioner (Second) [Paperback]

by Jeffrey Isaac

A Guide to Practicing Medicine in Challenging Environments Wilderness and Rescue A Practical Guide for the Basic and Advanced Practitioner provides the critical insight and tools required to practice medicine in remote or challenging environments. There is no place in field medicine for unreasonable restrictions on the practical application of medical judgment that is the guiding philosophy of this user-friendly guide. Wilderness and Rescue A Practical Guide for the Basic and Advanced Practitioner teaches readers how to improvise, adapt and exercise reasonable judgment at any level of medical training and in any difficult environment, from the desert to the oceans, from the backwoods to cities stricken by disaster. Grounded in the collective wisdom of hundreds of instructors, rescue personnel and medical practitioners, this text explores medical problems in a broad wilderness context including cold injuries, altitude illness, diving and lightening injuries and toxins, among others and pairs that exploration with the realities of solving such problems in the field, well outside the confines and comforts of mainstream medicine. Wilderness and Rescue A Practical Guide for the Basic and Advanced Practitioner The most up-to-date guidance on practicing medicine in a wilderness context An introduction to critical body systems and the general principals of trauma Specific information on environmental and backcountry medicine An examination of the medical role in search and rescue missions

Unknown Binding

First published March 13, 2012

Reviews

[Eb0 · Rating 5 out of 5]

This is a textbook I read for a wilderness first aid class sponsored by Cascadia Wilderness Medicine. It's the Wilderness Medical Associates International standard curriculum textbook. I've done quite a bit of training over the years in regular urban/rural EMS to get and keep my EMT license, so I've been exposed to a ton of educational techniques. Regular EMS runs towards rote memorization of flow charts and algorithms, glued together by a ridiculous number of horrible mnemonic aids, all intended to replace human judgment in situations where the hospital is a few minutes away and the safest thing to do is be risk-averse and simply keep patients ticking over until they get to the hospital.

Where long transport times are an issue, as in wilderness settings (and my rural EMS district), it's actually necessary to make judgment calls rather than turn the care provider into a robot. More than any other curriculum I've seen, this one teaches not just knowledge but wisdom. It gives a grounding in the basics, but emphasizes in each chapter the factors to consider in making judgment calls about whether and when to attempt high-risk maneuvers to get someone to help -- and how to give the best possible care with minimal equipment when help is far away.

There are a few mnemonics in the course -- EMS standards like AVPU and SAMPLE -- but most of the evaluation and treatment process is described in a clever memory-palace style that is basically a linked series of triangles representing scene size-up, primary assessment, and secondary assessment stages. I'm sick and tired of new ways of memorizing EMS stuff and made an active effort NOT to memorize this system, but it's so darn easy to use that after reading this book and taking the five-day class, I learned it anyway completely against my will.

This book, and the WFR course, is some of the best first aid education I've gotten in all my time in EMS. (Its only rival is Mike Helbock's "Sick/Not Sick" training, an extraordinarily helpful curriculum that made me much better at the work but is more geared towards urban EMS.) Like any textbook, this book is not something I'd recommend reading in isolation (though I suppose it could be done) -- its best value is as an adjunct to a class taught by professionals. I recommend the curriculum to anyone who might have to treat illness or injury far from help.

[Eduardo Santiago · Rating 4 out of 5]

A comfortable old friend by now; this is probably my fourth time reading it. The tone and style totally work for me: the emphasis on remaining calm, on diagnosing only within the scope of what we can help with and learning how to do so with whatever materials are on hand, and on developing judgment for situations beyond field treatment. This is a helpful companion to WFR certification and a welcome reminder for picking up every year or two.

[Tinea · Rating 3 out of 5]

Re-reading and re-certifying in January 2013.
2nd only to my Permaculture course in life-saving skills: Wilderness First Responder.

A well-written supplement to my WFR course, this book goes into details, science, and theory that the course doesn't have time to teach. Sparse on technical medical details, though-- this is a supplement only, not a how-to guide.

I could not stop thinking about the climax of Catch-22 as we repeatedly went over head to toe assessments for every patient, regardless of what symptoms they're presenting.