Changes in monitoring and therapy during the preparation of 100 critically ill patients for interhospital transfer by a specialist team were documented prospectively with the aim of providing guidelines for nonspecialists. Severity of illness scores were recorded before and after preparation. Median duration of preparation for ambulance journeys was 50 min and for aeroplane journeys was 82 min. During preparation, a portable electrocardiogram and pulse oximeter were attached to 21 and 76 patients respectively and intra-arterial pressure monitoring was continued or instituted in 88 patients. Supplemental oxygen and intravenous fluids were the therapies most commonly increased or instituted by the transport team; mechanical ventilation, positive end-expiratory pressure and inotropic drugs were increased or instituted less frequently. Median therapeutic intervention scores before and after preparation were 21 and 23 respectively, highlighting the need to increase rather than withdraw support for transfer.
An important aspect of effectiveness of intensive care services is change in the quality of life of survivors after critical illness. A questionnaire was complied using established methods for assessment of quality of life and sent to all known survivors of a regional intensive care unit. Each patient's quality of life was then quantified using disability categories. The results show that patients with a good premorbid quality of life suffered a significant decline after critical illness. Similar important decreases in quality of life were found in younger patients and trauma victims. Quality of life may be a valuable consideration in determining the appropriateness of intensive care management.
On 1 October 1711, a contingent of the provincial marechaussee came from Strasbourg to Colmar to arrestJohann Jacob Sonntag. Sonntag was an apothecary, a Lutheran churchwarden, a civic councilor, and one of Colmar's richest men. He was also the self-proclaimed head of a civic reform movement. The lieutenant and his troop paraded Sonntag through the city's twisting streets with deliberate slowness to broadcast his defeat before the entire community. They then escorted Sonntag to Strasbourg where he received a tongue lashing from the intendant, Felix Le Pelletier de La Houssaye, and a six-month prison term. During the ensuing weeks, his supporters trickled into Strasbourg one by one to beg La Houssaye's pardon or to serve a brief sentence in prison.' Throughout the summer of 1711, Sonntag had drummed up support among the citizens for his petition against Colmar's municipal leadership, the Magistrate. He evidently expected official endorsement and brandished before his neighbors an arret of 1683, which had called for triennial elections of civic officeholders through-
Voracious Idols and Violent Hands: Iconoclasm in Reformation Zurich, Strasbourg, and Basel. By Lee Palmer Wandel. Cambridge and New York: Cambridge University Press. 1995. Pp. xii + 205. $39.95. ISBN 0-521-47222-9. - Volume 29 Issue 3
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