Practical response to disaster

Bushfires, bus and train crashes, and multiple shootings happen in Australia and this is why the Major Incident Medical Management and Support (MIMMS) course was started in about 1995. The course has flourished since then, and now, with terrorism and biological threats very real after September 11 and recent events in Bali, this concise and comprehensive second edition is timely. This volume aims to teach all doctors (from GPs to emergency care specialists) a practical approach to a situation where they are at the scene of a disaster where the number of injured exceed the available resources. It sets out a structured approach and outlines the roles of the various services involved.

The clinician will find that this approach is clearly explained. Aided by tables and diagrams, the reader is shown how to assess the scene, communicate appropriately with the services, use an accepted quick triage sieve (in the field using respiratory rate and capillary return), deal with the dead, and do practical procedures from airway management to femoral nerve blocks. Various topics, from media interaction to chemical and radiological incidents, are covered, although biological agents seem to have been forgotten.

The great strength of this work is that it is relevant and very practical. It is supplied in a loose-leaf folder so that it can be updated, and there are spaces to record specific local details. In spite of a respected Australian contributor it does have a British flavour, but the principles are universal.

In our fast-moving and troubled society, no doctor, whether a rural GP or a city doctor, can be sure he or she will escape being caught up in a major incident. Having medically responded to several of Australia’s major disasters I have done the MIMMS course, and I always take this excellent manual with me. Both are to be recommended most highly.

Gordian W O FuldeDirector, Emergency Medicine St Vincent’s Hospital, Sydney, NSW