The Wilderness First Aid Handbook

      This new medical pocket book emphasizes 3 important tenets of wilderness medicine:
      • 1)
        One patient is enough; take no unnecessary risks that may cause additional casualties.
      • 2)
        Providing care in austere environments is important, but recognizing who needs to get to a hospital is critical.
      • 3)
        The book does not equal the knowledge.
      The book is arranged alphabetically by chief complaint with some informational general comments, which add little to the otherwise succinct symptoms and treatment. The icons for “red flag” symptoms are comfortingly clear. Anyone in a jam will appreciate the evacuation indications (a helicopter icon), and the freedom they may provide from analysis paralysis.
      The material assumes a basic understanding of first aid and a reasonable medical kit but provides enough details and illustrations that a layperson could provide stabilization while waiting for the cavalry. The trauma and wound care sections are especially well done, as is a curiously lengthy treatment on blisters (8 pages, compared to 2 pages on chest trauma).
      Navigation of the book’s content is not completely intuitive. A more detailed index or organization by body system, with a colored or tabbed layout, would accelerate quick reference. The illustrations are inconsistent; cardiopulmonary resuscitation and log roll illustrations are very clear, an illustration of someone injecting epinephrine seems intentionally comical, and the drawing of a 3-sided dressing for chest wounds shows air coming from a hole in the middle of the patch, not the open side.
      Appendix B, evacuation information, demonstrates only a daisy chain litter—which requires “at least 50 feet” of rope—and an unnecessary 3 pages on helicopter landing zones. This section needs more discussion on evacuation principles and land techniques.
      The book is waterproof, which seems at first to be a brilliant idea. While a clever innovation, the design also eliminates several additional potential uses for a backcountry field guide. You cannot burn it, tear out pages, or write in it. You can, however, take it on the most rugged, soggiest, abuse-laden excursion imaginable and not worry about a speck of degradation.
      This book is a reasonable collection of clearly explained wilderness pathology that belongs in the backpack of a weekend warrior or an occasional guide. An experienced provider facing a difficult emergency situation should look elsewhere for more emphasis on improvisation and a layout more consistent with the traditional primary and secondary survey.