Major Incident Medical Management and Support: the Practical Approach

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The format makes use of shaded bold type to emphasize chapter objectives, key learning points and summaries. Mnemonic devices, algorithms, models, boxes and tables are well done. The lists are informative and useful.

The book was written in the United Kingdom, with input from military sources. Therefore, the terms used to describe positions may not be familiar to Canadian providers. However, the concept, structure and process can be generalized to Canada. The chapters pertaining to the emergency department and hospital management are basic and brief, which is understandable since the focus is on prehospital care.

In most major incidents, many victims are rescued by themselves or by bystanders, overloading hospitals and minimizing use of prehospital care providers. One chapter mentions this inevitable situation; however, it should have been elaborated upon. A disaster rarely involves prolonged extrication and delayed transport to hospital of enough casualties to warrant a staged scene, as the book describes. However, should this prolonged disaster be the case, the model and process outlined in this book are easy to follow, credible and reflect current disaster-management principles.

A bibliography or reference list would have been a useful addition to this book. The training appendix provided could be expanded. Disaster planning and preparedness require extensive and current exercises to maintain providers' skills.

This is an interesting book that is easy to read and informative. It is a good resource for prehospital and emergency department personnel.

Laurie J. Morrison, BA, MD
Division of Emergency Medicine (FRCP-EM Residency)
Department of Medicine
University of Toronto
Toronto, Ont.