Diagnosis and Management of Diabetes Mellitus

All emergency physicians are confronted with common environment-related emergencies including heat and cold injuries, animal and insect bites, ingestion of or contact with toxic plant materials, and the like. Few of us, however, are called upon to deal with wilderness trauma emergencies such as wild animal attacks, search and rescue missions, natural disaster management, high altitude or diving injuries, and so on. It's good to know, then, that an excellent reference text entitled Management of Wilderness and Environmental Emergencies is available, a book that covers these and a multitude of other situations. The preface to the first edition of this outstanding compendium stated that its goal was to provide the "clinician with a body of knowledge concerned with the interactions between people and the natural environment." This goal was amply achieved in that edition and its success is further extended in this new second edition. There are 36 chapters covering all relevant areas of knowledge, including space medicine, search and rescue, emergency veterinary medicine, and even medical liability as related to wilderness emergencies. This book tells you when to expect high-altitude flatus expulsion (over 11,000 feet-not serious but disconcerting), how to build a snow cave, the duration of survival without water at rest and in the shade at 80 degrees (eight to nine days) the number of deaths per year attributed to ostrich attacks (two), the estimated biting force of great white sharks (18 tons per square inch), and describes three urinophilous catfish species in southern South America that are attracted to and enter the human urethra and require surgical removal. The chapters are expertly written and include clinical presentations, pathophysiology, and treatment modalities in sufficient detail to guide the emergency treatment of virtually any environmentally related illness or injury encountered anywhere in the world. This book should be included in the reference library of every emergency physician and all physicians practicing in rural and undeveloped areas. I don't advise back-packing, however, as the volume is 9 by 11 inches in size and contains more than a thousand pages-each a valuable resource.