Improvised Medicine: Providing Care in Extreme Environments

Improvised Medicine: Providing Care in Extreme Environments by Kenneth Iserson

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Deliver quality healthcare in the most challenging field conditions

"Dr Iserson has given us a most remarkable book. Many readers may be familiar with David Werner's lay healthworker book, Where There Is No Doctor; this new volume could be titled Where There Is a Doctor–But No Stuff. Drawing from his experience providing care in international, wilderness, and disaster settings, he has compiled an impressive collection of bare-bones equipment and work-around strategies to provide the best possible care in resource-poor settings. While presenting many creative examples, the purpose of the book is not to offer an exhaustive list of solutions to missing resource challenges but to inspire creativity in readers who may find themselves needing to improvise." -- Family Medicine

Full of practical clinical pearls and proven strategies, this indispensible guide shows you how to operate outside your comfort zone and devise effective treatment solutions when the traditional tools (medications, equipment, and staff) are unavailable—or when you need to provide care outside of your specialty. Improvised Medicine is a must for anyone who plans to work in global, disaster, or other resource-poor settings.


Simple-to-follow directions, diagrams, and illustrations describe practical techniques and the improvised equipment necessary to provide quality care during crises.

Contains improvisations in anesthesia and airway management, dentistry, gynecology/obstetrics, infectious disease/laboratory diagnosis, internal medicine, otolaryngology, pediatrics and malnutrition, orthopedics, psychiatry, and surgery.

Also includes basic disaster communication techniques, post-disaster forensics, a model hospital disaster plan, and innovative patient-transport methods.


Make an endotracheal tube in seconds

Perform digital-oral and blind-nasotracheal intubations

Make plaster bandages for splints/casts

Give open-drop ether, ketamine drips, and halothane

Use subcutaneous/intraperitoneal rehydration/transfusion

Make ORS and standard nutrition formulas

Clean, disinfect, and sterilize equipment for reuse

Warm blood units in seconds inexpensively

Take/view stereoscopic x-rays with standard equipment

Quickly and easily stop postpartum hemorrhage

Fashion surgical equipment from common items

Evacuate patients easily for high-rise hospitals

Make esophageal and precordial stethoscopes

Quickly improvise a saline lock

Make ECG electrode/defibrillator pads and ultrasound gel
Publication Date:
06 / 12 / 2011

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