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The high altitude medical handbook
  1. F Bellis
  1. Competing interests: A Pollard (book author) and F Bellis (reviewer) are both members of Medex, a medical mountaineering and expedition club

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    A J Pollard, D R Murdoch. Oxford: Third Edition, £23.50 (paperback), ISBN 1-85775-849-8.

    If imitation is the best form of flattery, then the authors of The High Altitude Medicine Handbook should consider themselves flattered indeed. The "mini micro" bootleg version of the first edition of the handbook, published in India, and widely available in bookshops in Kathmandu, has perhaps sold more copies to those departing on high altitude treks than the original. This illicit version was my first copy of the handbook and it lived in my back pocket when I was working as a medical officer on expedition in a remote corner of eastern Nepal. At high altitude, when cold, fatigue, and hypoxia muddled my brain, it was my constant reference text and bible.

    I was therefore delighted to be asked to review the third edition, which was published in 2003 to coincide with the 50th anniversary of the first ascent to the summit of Mount Everest and the 25th anniversary of the first ascent without oxygen.

    The handbook is not, nor does it set out to be, a definitive text on altitude medicine. There is therefore little on the physics of hypobaric hypoxia or the underlying pathophysiology of acute mountain sickness. Instead, it achieves exactly what it sets out to do: it is a clear, concise, commonsense guide to the management of all aspects of medical problems at high altitude. There are not only the expected chapters on high altitude illness, first aid and travel related illnesses, but also sections on children, ethics, culture, environmental and medicolegal concerns. All chapters are extensively referenced so readers can easily refer back to original literature. This third edition has been thoroughly revised to reflect the rapid increase in knowledge in the 5 years since the last edition.

    The foreword by Sir Edmund Hilary reflects that both Andrew Pollard and David Murdoch are experienced mountaineers, Andrew Pollard having reached 8600 metres on the south col of Mount Everest in 1994. They are both experts in high altitude and expedition medicine and have a breadth of experience in managing medical conditions in some of the world’s most challenging environments. David Murdoch worked for 2 years in the Everest Region, first at the Himalayan Rescue Organisation’s first aid post at Pheriche, then at Kunde hospital. This makes the handbook occasionally controversial, always authoritative, and full of practical advice on how to overcome the technical challenges of practising medicine in such difficult conditions.

    This is a valuable guide to have with you on expedition or any high altitude trek, but also includes valuable pre-departure planning information such as an appendix on what to include in a typical high altitude medicine kit list. Although the handbook is primarily aimed at medical practitioners, its straightforward text makes it accessible to lay travellers and can be highly recommended to anyone considering travelling to high altitude.

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