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Pre-hospital Medicine: The Principles and Practice of Immediate Care.
  1. Timothy J Coats
  1. Senior Lecturer in Accident, Emergency and Pre-Hospital Care, London

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    Edited by I Greaves and K Porter. (Pp 806; £145.00.) Arnold, 1999. ISBN 0-340-67656-6.

    This book aims to fill a gap in the current range of pre-hospital texts. There is not a current reference work for pre-hospital management as previous books have mainly been aimed at pocket sized “How to Do It” guides.

    This book boasts an impressive list of authors with the index reading like a “Who's Who” of UK pre-hospital and emergency care and is comprehensive in its coverage of the subject. The format is very readable, there are enough illustrations to add interest to the text and there are line diagrams where appropriate. Key clinical tips are emphasised by shaded boxes within the text.

    The editors have achieved the correct balance between background information and practical advice, with each chapter starting with the theoretical, yet ending with the practical. The amount of referencing is about right, with enough further reading for anyone interested to delve deeper into the subject.

    I particularly liked the vigorous de-bunking given to some medical myths in the hypothermia section and the clarity of both text and illustrations in the “Understanding the electrocardiogram” section. As always there is a tendency to move away from a strictly pre-hospital information. (I doubt whether Symmond's test will be utilised by many pre-hospital care practitioners). However, blurring the boundaries between pre-hospital and inhospital treatment to provide a continuum of care is probably a very good idea.

    I was surprised to see that the section on “Immobilisation and extrication” had no information about the theory or practice of extrication. It is vital that medical staff speak the same language as the fire service and know both the advantage and limitations of different methods of extrication so that an appropriate synthesis of medical and physical rescue can be made. However, there are already good books on this subject.

    The clinical content is right up to date and I am sure that, if this is maintained by frequent editions, this book will become the standard reference work for pre-hospital medicine.

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