Book Reviews

Book Reviews: the Water of Life, a Jungian Journey Through Hawaiian Myth by Rita Knipe; Before the Horror: the Population of Hawai'i on the Eve of Western Contact by David E. Stannard; Observations and Interpretation of Hawaiian Volcanism and Seismicity 1779-1955. An Annotated Bibliography and Subject Index by Thomas L. Wright and Taeko Jane Takahashi; An Account of Two Voyages to the South Seas, to Australia, New Zealand, Oceania 1826-1829 in the Corvette Astrolabe; and to the Straits of Magellan, Chile, Oceania, Southeast Asia, Australia, Antarctica, New Zealand, and the Torres Strait 1837-1840 in the Corvettes Astrolabe and Zelee. by Jules S. C. Dumont d'Urville, Translated and edited by Helen Rosenman; Paths of Duty: American Missionary Wives in Nineteenth-Century Hawaii by Patricia Grimshaw; Journal of Stephen Reynolds Edited by Pauline King; Moramona: the Mormons in Hawaii by R. Lanier Britsch; the Peopling of Hawai'i by Eleanor C. Nordyk

Population, resources, and environment: Implications of human behavioral ecology for conservation

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43481/1/11111_2005_Article_BF02207996.pd

Detonation of aerial bombs

Introduction. Even today aerial bombs and unexploded ordnance from World War II are still common. For deactivation many relevant factors must be noted by emergency medical service personnel. The aim of the present review is to summarize resulting problems and to assess organizational challenges for deactivation procedures of aerial bombs. Materials and methods. Detonations were analyzed only for Germany and Austria for the years 1990-2010. For the review an extensive Internet search on explosions and unexpected detonations was performed independently from deactivation procedures. Results. In the last years a total of 5 detonations during deactivation procedures were identified for Germany and Austria (in each case 0-4 killed and 0-6 injured persons). Additionally, 20 unexpected detonations independent from deactivation procedures (in each case 0-3 killed and 0-17 injured persons) were found. Discussion. During intended or performed deactivation of aerial bombs the emergency medical strategy, organizational assessment and coordination of the medical mission are the responsibility of the chief emergency physician. These missions are rare and therefore the personnel usually have very limited experience. The number of injured and killed persons may be considerable and represents a significant organizational challenge for the emergency physicians at the scene

Severe airway distress following cervical spine operation. Retrospective breakdown of the chain of errors

A 71-year-old female patient received a prothesis due to a cervical disc prolapsed and bleeding into the collar soft tissues occurred postoperatively. Following a computed tomography examination severe peracute respiratory decompensation occurred while administering topical anesthesia to the pharynx in order to perform fiber optic intubation. Endotracheal intubation using conventional laryngoscopy was unsuccessful and the patient required immediate cricothyroidotomy. As an on-site cricothyrotomy set to establish a secure airway was not available the decision was taken to perform surgical cricothyroidotomy. As a conclusion to this life-threatening event in the case of symptoms, such as dyspnea, dysphonia and dysphagia after operations of the cervical spine the airway has to be secured early and according to the local algorithm

Anesthesiological management of Caesarean sections. Nationwide survey in Germany

Background. The rate of Caesarean sections in Germany continues to rise. The change in anesthetic technique of choice from general to spinal anesthesia began later than in other countries and at the last survey in 2002 was not widely established. The literature on the anesthetic management of Caesarean sections contains many controversies, for example fluid preload before performing spinal anesthesia and the vasopressor of choice. Other issues have received relatively little attention, such as the level of experience of anesthesiologists working autonomously on the labour ward or the timing of antibiotic prophylaxis. The aim of the current survey was to provide an updated overview of anesthetic management of Caesarean sections in Germany. Material and Methods. A questionnaire was sent out to 709 departments of anesthesiology serving obstetric units in Germany. The questionnaire concerned various aspects of anesthetic management of Caesarean sections. Results. A total of 360 questionnaires (50.8%) were returned of which 346 were complete and could be analyzed, accounting for 330,000 births and 90,000 Caesarean sections per year. The predominant anesthetic method used for Caesarean sections was spinal anesthesia (90.8%) using hyperbaric bupivacaine and in approximately one third of the hospitals surveyed without administering intrathecal opioids. Approximately 12% of the departments surveyed used traumatic Quincke needles. In 86.2% the vasopressor of choice was caffedrine/theodrenaline. Nitrous oxide was used in only 19.2% of departments surveyed when general anesthesia is performed. An antibiotic drug was administered in only 11% of hospitals before cord clamping. In 43.1% no neonatologist was available to treat unexpected critically ill newborns. In 32.1% of departments surveyed residents with less than 2 years experience worked autonomously on the labour ward. Conclusions. Currently the predominant anesthetic technique of choice in Germany is spinal anaesthesia and at a much higher rate than in 2002. In addition 12% of departments use traumatic Quincke needles which are associated with a higher incidence of postpuncture headache. Nitrous oxide is no longer frequently used in Germany. Finally, the administration of an antibiotic before cord clamping has been shown to lead to lower rates of endometritis and postoperative wound infection without detrimental effects on the newborn. This is practiced in only a small minority of departments across Germany