The High Altitude Medicine Handbook, 3rd edi-tion, by Andrew J. Pollard and David R. Mur-doch, Radcliff Medical Press Ltd., Abingdon,Oxon, U.K., 2003, 193 pp., U.K. £23.50, ISBN 185775 849 8

Almost 25 years ago John Dickinson, myhigh altitude mentor of the time, told me toread Peter Hackett’s Mountain Sickness: Preven-tion, Recognition and Treatment, but, unfortu-nately, since 1980 when I used this book at theHimalayan Rescue aid post at Pheriche, I haveseen no new editions of this field classic. Al-though there are other useful pocket books forthe lay population dealing with altitude medi-cine, such as Bezruchka’s Altitude Illness Pre-vention and Treatment and Duff and Gromly’sFirst Aid and Wilderness Medicine, insofar as ahandbook geared toward educating health care professionals on altitude medicine is con-cerned, The High Altitude Medicine Handbook byAndrew J. Pollard and David R. Murdoch in itsthird edition is peerless.

The first edition of this book by Pollard andMurdoch was published in 1997. The most at-tractive feature of this new edition, besides be-ing well written, is that it is indeed very up todate, and the section on altitude sickness is es-pecially well done. For example, the relativelyrecently acquired knowledge of the potentialusefulness of a long-acting b-agonist inhaler in the prevention of high altitude pulmonaryedema is brought up. The elaborate patho-physiology of high altitude pulmonary edema(HAPE) and high altitude cerebral edema(HACE) is clearly discussed, with simple dia-grams and emphasis on new concepts. I also

liked their emphasis on early recognition ofHAPE and the fact that often HAPE may notfollow acute mountain sickness (AMS). Indeed,many high altitude doctors now think that the persistent, severe headache equivalent inHAPE may be shortness of breath at rest. Manytrekkers and guides seem to think that if youdo not have headache and nausea you are freefrom altitude sickness, but as clearly pointedout in this book this is a fallacy.

The section on hypothermia and frostbite issuccinct but well covered, and the new algorithmon the management of avalanche victims is awelcome addition. The section on the medi-colegal considerations for treks and expeditionsthat many health professionals may be unawareof is also clearly discussed, especially in matterspertaining to the British judicial system. Finally,the useful references, the fact sheets, and the Websites in the appendix and clear discussions onpregnancy, contraception, and no-altitude sick-ness medical problems at altitude are other out-standing features in this handbook.

More emphasis on porters and their medicalproblems at altitude in the Himalayas andother areas (e.g., Mount Kilimanjaro) wouldhave been desirable so that Western trekkersare made more aware of the well-being of thehard-working porters. The authors did how-ever include a Web site, www.ippg.net. In addition, the chapter on altitude sickness inchildren could be shortened as this area lacksevidence-based advice, and there is some rep-etition of information here from the adult sec-tion. Finally, azithromycin needs to be listed inthe travelers’ diarrhea section as an alternativeto ciprofloxacin, as resistance by the common

HIGH ALTITUDE MEDICINE & BIOLOGYVolume 5, Number 1, 2004© Mary Ann Liebert, Inc.

Book Review

BUDDHA BASNYAT

Nepal International Clinic and Himalayan Rescue Association and Department of Physiology, Institute of Medi-cine, Patan Hospital, Nepal

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88 BOOK REVIEW

campylobacter-induced diarrhea is increas-ingly encountered.

In conclusion, this book is highly recom-mended for all mountain medicine enthusiasts,especially health care professionals helpingtravelers at high altitude, and I agree with Dr.Schoene who, in the foreword, says this bookis seasoned to perfect taste.

Address reprint requests to:Buddha Basnyat, MD

Nepal International ClinicLal Durbar, GPO Box 3596

Kathmandu, Nepal

E-mail: Rishisbas@wlink.com.np