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Handbook of spinal cord medicine
86
by technical jargon or by the debased English that so often becomes associated with them. This makes the book easy to read as well as easy to understand and at the currently remarkable price one may hope that it will have many readers among the intelligent and enquiring public. P.S. LONDON
Handbook of Spinal Cord Medicine. By D. C. Bourke and D. D. Murray. 18.5 x 12.5 cm. Pp. x+90. Illustrated. 1975. Basingstoke, Macmillan. The book is offered as an introductory text for medical and paramedical staff working with the victims of spinal paralysis, and as such it succeeds so well that it is probably the best of its kind. While there is reference to surgical treatment, the main emphasis is on medical management, which is what all patients require and is much the more important consideration. There might, however, have been a little more written about the management of skull calipers. The fact that there are differences of opinion about certain aspects of treatment is indicated in several places, but in a book of this size it is perhaps reasonable that there is little discussion of which is preferred, and why. The principal virtue of this book is the amount of information that it contains, which is simply stated and covers the wide range of subjects related to spinal paralysis. The sections are short and so titled that the lack of an index puts little burden on one seeking a particular piece of information. As an introduction, it is rightly concluded by a list of books and papers for further reading. If one is to be critical, one may say that the diagrams are not very accurate, that the English is slovenly (but will be clearly understood) and that the use of abbreviations such as L.M.N. and U.M.N. saves little space or time. Even those with little Latin and less Greek will be distressed by diverticulae, nervus erigentes and visci and disappointed by the preference for quadriplegia over tetraplegia; however, English words are also misspelt. P.S. LONDON
Developments in Disaster Management. Edited by J. Howard. 30 x 21 cm. Pp. 95. 1976. Glasgow, Action for Disaster. f3.50. This is the second publication by theGlasgow organization Action for Disaster and it contains the proceedings of a meeting held in April, 1976. Like its predecessor, it contains a great deal of useful information, the best of which is understandably based on carefully analysed experience. Outstanding among the contributions was that by the Chief Officer of the London Fire Brigade, who offered reassuring observations about the Moorgate crash, such as that chaos was at first inevitable but that, nevertheless, a heartening common sense among the rescuers enabled them
Injury:
the British Journal
of Accident
Surgery
Vol. g/No.
1
remarkably often to do the right thing in very difficult conditions. Volunteers who are already at work may be reluctant and even resentful at being dismissed, not recognizing that this is as much in their own interests as in those of the victims. Difficulties included interpretation of medical messages passed back by word of mouth instead of directly by radio to the control centre, lack of interchangeability of some electrical fittings and the fact that the most efficacious cutting gear was not always the safest, with the result that rescue was often painfully slow. Because the last bodies to be removed were badly decomposed it was necessary to take precautions against contamination and infection and to have necropsies carried out on the spot and without delay. Other very important considerations in the case of continuing operations are the strict but considerate control of reporters and important visitors and the need to provide conveniently accessible lavatories for rescuers. Medical experience at Moorgate showed that in cramped working space Entonox was too clumsy and awkward and that sedative drugs were necessary. The difficulties of resuscitating more or less exsanguinated persons were such that many more intravenous cannulae were used than would normally be the case. It was alarming to read that in spite of the long drawn-out nature of the operation, some patients taken to hospital had then to wait for half an hour before being treated. The importance of documentation and communication and the role of the police in these tasks was brought out time and again, particularly the recording of all messages by a computer. But one speaker asked pertinently what happened if the post office system was badly damaged, and also, whether there was, in some respects, too much communication. The role of the amateur radio operator was also considered, including the occasional need to break regulations in the cause of humanity. A Canadian speaker outlined his country’s contribution in the form of a national medical stockpile from which anything from first aid kits for 500 persons to a 200-bed emergency hospital could be swiftly extracted, assembled and carried by air. The aged and infirm as well as others may have to be removed from the path of dangerous fumes or other substances that can be spread by fireman’s hose water, and the special disadvantages and needs of the deaf should be remembered. as should the fact that a person in a wheelchair may be more mobile than a person with arthritis or the effects of a stroke. With regard to the organization of medical rescue service, the British reader can only marvel at the money that the West German government provides for this purpose. This is one of the most interesting and useful of the growing number of publications dealing with disasters and it is to be hoped that anybody who needs to know these things will not be deterred by having to pay E3.50 for this duplicated (but clear) and paperbound publication. P.S. LONDON
by technical jargon or by the debased English that so often becomes associated with them. This makes the book easy to read as well as easy to understand and at the currently remarkable price one may hope that it will have many readers among the intelligent and enquiring public. P.S. LONDON
Handbook of Spinal Cord Medicine. By D. C. Bourke and D. D. Murray. 18.5 x 12.5 cm. Pp. x+90. Illustrated. 1975. Basingstoke, Macmillan. The book is offered as an introductory text for medical and paramedical staff working with the victims of spinal paralysis, and as such it succeeds so well that it is probably the best of its kind. While there is reference to surgical treatment, the main emphasis is on medical management, which is what all patients require and is much the more important consideration. There might, however, have been a little more written about the management of skull calipers. The fact that there are differences of opinion about certain aspects of treatment is indicated in several places, but in a book of this size it is perhaps reasonable that there is little discussion of which is preferred, and why. The principal virtue of this book is the amount of information that it contains, which is simply stated and covers the wide range of subjects related to spinal paralysis. The sections are short and so titled that the lack of an index puts little burden on one seeking a particular piece of information. As an introduction, it is rightly concluded by a list of books and papers for further reading. If one is to be critical, one may say that the diagrams are not very accurate, that the English is slovenly (but will be clearly understood) and that the use of abbreviations such as L.M.N. and U.M.N. saves little space or time. Even those with little Latin and less Greek will be distressed by diverticulae, nervus erigentes and visci and disappointed by the preference for quadriplegia over tetraplegia; however, English words are also misspelt. P.S. LONDON
Developments in Disaster Management. Edited by J. Howard. 30 x 21 cm. Pp. 95. 1976. Glasgow, Action for Disaster. f3.50. This is the second publication by theGlasgow organization Action for Disaster and it contains the proceedings of a meeting held in April, 1976. Like its predecessor, it contains a great deal of useful information, the best of which is understandably based on carefully analysed experience. Outstanding among the contributions was that by the Chief Officer of the London Fire Brigade, who offered reassuring observations about the Moorgate crash, such as that chaos was at first inevitable but that, nevertheless, a heartening common sense among the rescuers enabled them
Injury:
the British Journal
of Accident
Surgery
Vol. g/No.
1
remarkably often to do the right thing in very difficult conditions. Volunteers who are already at work may be reluctant and even resentful at being dismissed, not recognizing that this is as much in their own interests as in those of the victims. Difficulties included interpretation of medical messages passed back by word of mouth instead of directly by radio to the control centre, lack of interchangeability of some electrical fittings and the fact that the most efficacious cutting gear was not always the safest, with the result that rescue was often painfully slow. Because the last bodies to be removed were badly decomposed it was necessary to take precautions against contamination and infection and to have necropsies carried out on the spot and without delay. Other very important considerations in the case of continuing operations are the strict but considerate control of reporters and important visitors and the need to provide conveniently accessible lavatories for rescuers. Medical experience at Moorgate showed that in cramped working space Entonox was too clumsy and awkward and that sedative drugs were necessary. The difficulties of resuscitating more or less exsanguinated persons were such that many more intravenous cannulae were used than would normally be the case. It was alarming to read that in spite of the long drawn-out nature of the operation, some patients taken to hospital had then to wait for half an hour before being treated. The importance of documentation and communication and the role of the police in these tasks was brought out time and again, particularly the recording of all messages by a computer. But one speaker asked pertinently what happened if the post office system was badly damaged, and also, whether there was, in some respects, too much communication. The role of the amateur radio operator was also considered, including the occasional need to break regulations in the cause of humanity. A Canadian speaker outlined his country’s contribution in the form of a national medical stockpile from which anything from first aid kits for 500 persons to a 200-bed emergency hospital could be swiftly extracted, assembled and carried by air. The aged and infirm as well as others may have to be removed from the path of dangerous fumes or other substances that can be spread by fireman’s hose water, and the special disadvantages and needs of the deaf should be remembered. as should the fact that a person in a wheelchair may be more mobile than a person with arthritis or the effects of a stroke. With regard to the organization of medical rescue service, the British reader can only marvel at the money that the West German government provides for this purpose. This is one of the most interesting and useful of the growing number of publications dealing with disasters and it is to be hoped that anybody who needs to know these things will not be deterred by having to pay E3.50 for this duplicated (but clear) and paperbound publication. P.S. LONDON