The Pre-Hospital Emergency Management Master

Tim Hodgetts, Iain McNeil, Matthew Cooke. 72 pp. Illust. BMJ Publishing Group, London. 1995. Distributed in Canada by the Canadian Medical Association, Ottawa. $86.40 ($72 CMA members). Prices include shipping and handling. ISBN 0-7279-0905-3



This manual is aimed at emergency medical personnel who work at accident scenes, as well as being a basic reference for junior hospital staff. It has been compiled for use in the British emergency medical system; some of the information is not applicable to the Canadian system.

A "management master" is an interesting concept. This manual provides a quick reference for treatment of life-threatening emergency conditions, information on normal values for vital signs, drug doses for resuscitation according to approximate weight of the patient, check lists for management, a burns-fluid-resuscitation wheel as well as a management guideline for multiple casualty incidents (MCIs). It is fairly easy to use, contains a good numbering system and has an excellent index. The approach can be tailored to each incident without compromising the overall thrust of the book. The book is printed on waterproof paper for field use. In typically British military style, the book includes pictures of the insignia worn by senior officers in the British Emergency Services, presumably so that one knows whom to address as "Sir" at the scene of an accident!

Much of the information contained in this manual, particularly the section on treatment of life-threatening emergency conditions, is extremely basic but would be a useful review for personnel en route to an accident.

The large size of the manual (10 inches by 14 inches) makes it inconvenient to carry in the field. Several of the recommended regimens are different from those used in Canada.

The section on hazardous scenes would be useful as an introduction for personnel who had never been at the scene of an accident and as a review for those who normally work at such scenes. The section on triage and MCIs is concise and would be extremely helpful to those with no previous experience in conducting triage. Likewise, the section on radio communications would be useful to those unfamiliar with this skill.

This is an interesting manual to read in the comfort of one's armchair but in the heat of the moment I believe it would be left in the vehicle. It would be more useful if it were split into separate sections: the management and drug section could be produced in a format that would fit in a pocket, whereas the sections on MCI could remain in their present format for use at scene command.

This manual is of interest to those involved in emergency rescue and care. Although its relevance to Canadian emergency medical services is limited, it provides a good starting point for the production of a similar manual customized to Canadian needs.

Carolyn S. Neal, MB, ChB
Emergency physician
University of Alberta Hospitals
Edmonton, Alta.


CMAJ October 15, 1995 (vol 153, no 8) / JAMC le 15 octobre 1995 (vol 153, no 8)