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Emergency and acute care
242
is necessary because the next attack will be more serious. The immediate treatment is by subcutaneous injection of epinephrine-this can be followed by intramuscular antihistamines and repeated injections of epinephrine (every 20 minutes if indicated). Every patient who has had serious allergy to an insect bite should carry a medical warning tag and a kit
Injury: the British Journal of Accident
Surgery Vol. ~/NO. 3
containing a loaded syringe of epinephrine, a tourniquet to slow down the absorption of the toxin and some antihistamine tablets. The syringe should be checked regularly and renewed if the epinephrine turns brown. Frazier C. A. (1976) Insect stings-a medical emergency. JAMA 235,241O.
Book Reviews Pseudoarthrosis: Pathophysiology, Biomechanics, Therapy, Results. By B. G. Weber and 0. Cech. Trans. by Peter Konstam. 9$x 11%in. Pp. 323. 1976. Berne, Huber. This book is a masterpiece. It begins with a review of the physiopathology of fracture healing, carefully examining the experimental work that has led to the better understanding of the processes involved. It is followed by a section on the mechanical requirements necessary to secure bone union, and from experimental and histological evidence it is shown how failure to meet these requirements results in disturbed healing or non-union. The brilliant microphotographs of Professor Schenk are reproduced in colour in this admirably prepared volume. There follows a review of the literature on the various types of pseudarthrosis and their treatment, which is supported by a very exhaustive bibliography at the end of the book. The biological factors involved in the healing of pseudarthrosis have been studied by scintoscans, and the value of cancellous bone graft in stimulating the biological response is clarified. There is a survey of all the methods available for treating first aseptic pseudarthroses and then infected cases. The authors give advice about the appropriate technique for a wide range of individual problems. There is a valuable chapter about the use of all the current models of external fixation devices, giving the indications for the use of each. Detailed descriptions are given of the techniques of cancellous bone grafting, irrigation drainage, tension wiring, medullary fixation and the occasional indications for the use of bone cement. A very large number of cases are described and the illustrations, whether line drawings or radiographs, are models of clarity. It would be difficult to find a clinical case which could not be treated by reference to this book. The German idiom breaks through with disconcerting frequency, but the translator has done a fine job in interpreting the exacting terminology of this advanced work, dealing as it does with so many new
concepts and techniques. The elaborate technology of the A0 system is not easily understood by the uninitiated. The list of references is very comprehensive, including 174 items from papers and books, but it sadly omits reference to the papers by Hicks and the contribution of J. E. M. Smith. R. L. BATTEN
Emergency and Acute Care. By A. J. Harding Rains, K. W. Reynolds and V. Hunt. 22 x 14 cm. Pp. iv+172 with 58 illustrations and index. 1976. London, Hodder & Stoughton. E1.95. The objective of this book is admirable but it is doubtful whether it will generally be felt to have achieved it. There is a great deal of information but some of it is out of date, and one gets the impression that much of it has been written from a store of existing knowledge with additions of new ideas and facts, but often without up-to-date personal experience. There are, however, passages that indicate such experience. It is alarming to see vasoconstrictor drugs mentioned in the treatment of oligaemia, antigas gangrene serum still recommended but without mention of the use of hyperbaric oxygen, and 5 per cent CO, in 95 per cent 0, as part of the treatment of carbon monoxide poisoning. There is no mention of the currently popular drugs, such as marijuana and lysergic acid; sections on childbirth and emergencies of environment omit too much tobeof practical use. One is pleased to see acknowledged the importance of first aid and of talking to relatives, but sorry that there is no recognition of the value of medical social workers in emergency work nor any reference to mass disasters. It is also regrettable that the English is slipshod, so that there are numerous spelling mistakes, particularly of neurapraxia and myasthenia. P. S. L.0~00~
is necessary because the next attack will be more serious. The immediate treatment is by subcutaneous injection of epinephrine-this can be followed by intramuscular antihistamines and repeated injections of epinephrine (every 20 minutes if indicated). Every patient who has had serious allergy to an insect bite should carry a medical warning tag and a kit
Injury: the British Journal of Accident
Surgery Vol. ~/NO. 3
containing a loaded syringe of epinephrine, a tourniquet to slow down the absorption of the toxin and some antihistamine tablets. The syringe should be checked regularly and renewed if the epinephrine turns brown. Frazier C. A. (1976) Insect stings-a medical emergency. JAMA 235,241O.
Book Reviews Pseudoarthrosis: Pathophysiology, Biomechanics, Therapy, Results. By B. G. Weber and 0. Cech. Trans. by Peter Konstam. 9$x 11%in. Pp. 323. 1976. Berne, Huber. This book is a masterpiece. It begins with a review of the physiopathology of fracture healing, carefully examining the experimental work that has led to the better understanding of the processes involved. It is followed by a section on the mechanical requirements necessary to secure bone union, and from experimental and histological evidence it is shown how failure to meet these requirements results in disturbed healing or non-union. The brilliant microphotographs of Professor Schenk are reproduced in colour in this admirably prepared volume. There follows a review of the literature on the various types of pseudarthrosis and their treatment, which is supported by a very exhaustive bibliography at the end of the book. The biological factors involved in the healing of pseudarthrosis have been studied by scintoscans, and the value of cancellous bone graft in stimulating the biological response is clarified. There is a survey of all the methods available for treating first aseptic pseudarthroses and then infected cases. The authors give advice about the appropriate technique for a wide range of individual problems. There is a valuable chapter about the use of all the current models of external fixation devices, giving the indications for the use of each. Detailed descriptions are given of the techniques of cancellous bone grafting, irrigation drainage, tension wiring, medullary fixation and the occasional indications for the use of bone cement. A very large number of cases are described and the illustrations, whether line drawings or radiographs, are models of clarity. It would be difficult to find a clinical case which could not be treated by reference to this book. The German idiom breaks through with disconcerting frequency, but the translator has done a fine job in interpreting the exacting terminology of this advanced work, dealing as it does with so many new
concepts and techniques. The elaborate technology of the A0 system is not easily understood by the uninitiated. The list of references is very comprehensive, including 174 items from papers and books, but it sadly omits reference to the papers by Hicks and the contribution of J. E. M. Smith. R. L. BATTEN
Emergency and Acute Care. By A. J. Harding Rains, K. W. Reynolds and V. Hunt. 22 x 14 cm. Pp. iv+172 with 58 illustrations and index. 1976. London, Hodder & Stoughton. E1.95. The objective of this book is admirable but it is doubtful whether it will generally be felt to have achieved it. There is a great deal of information but some of it is out of date, and one gets the impression that much of it has been written from a store of existing knowledge with additions of new ideas and facts, but often without up-to-date personal experience. There are, however, passages that indicate such experience. It is alarming to see vasoconstrictor drugs mentioned in the treatment of oligaemia, antigas gangrene serum still recommended but without mention of the use of hyperbaric oxygen, and 5 per cent CO, in 95 per cent 0, as part of the treatment of carbon monoxide poisoning. There is no mention of the currently popular drugs, such as marijuana and lysergic acid; sections on childbirth and emergencies of environment omit too much tobeof practical use. One is pleased to see acknowledged the importance of first aid and of talking to relatives, but sorry that there is no recognition of the value of medical social workers in emergency work nor any reference to mass disasters. It is also regrettable that the English is slipshod, so that there are numerous spelling mistakes, particularly of neurapraxia and myasthenia. P. S. L.0~00~