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Disaster medicine
  1. J M Ryan

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    D E Horgan, and J L Burstein, editors. Philadelphia: Lippincott Williams and Wilkins, 2002, $79.95 (hardback), pp 435. ISBN 0-78172-625-5

    ‘The world is a dangerous place to live in’, say David Hogan and Jonathan Burstein. Today, it seems that this statement was never as true. The solitude of one’s office seems worlds apart from the frenetic troubled Middle East yet never has there been a time when preparedness was so important.

    I turned to this book as a timely opportunity to learn from other’s experiences and expertise and to cross check my own department’s state of readiness to deal with the unexpected. It contains many reports of previous disasters; maritime, terrorist, aviation, radiation and mass gathering disasters for example. However, it is the section on conflict related disasters that seems most appropriate at present. Time has already, perhaps, overtaken the authors and the concern about bioterrorism in particular has become highly pertinent. Transient as they might be, references to the helpful CDC and WHO web sites in this regard would have been a helpful addition as would reference to a number of other pertinent web sites.

    The sections are far from comprehensive but are sufficiently stimulating to make the reader search elsewhere for further information. The authors of the various chapters are exclusively American but have successfully resisted the temptation to be parochial in their choice of disasters to illustrate their chapters. Nevertheless the recommended response has a distinctive North American influence centred around an efficient EMS but at the same time a prehospital care system that differs in many ways from the UK and European models.

    The chapter authors have evidently been given considerable licence in writing their chapters. This makes for challenging reading. A more uniform approach might facilitate the reader in their quest for information.

    The editors propose a clinical approach although the depth of the clinical approach could be greater. For instance drug doses and therapeutics in general are understated. This is apparent for example in the chapter on mass gatherings where a list of the doses and volumes of medications required might be helpful to a reader planning a service for a major gathering.

    It seems to me that this is a book more suitable to the practising emergency health care ‘planner’ rather than the ‘provider’ as suggested by the editors. For those of us actively engaged in reviewing preparedness for disasters it is a worthwhile text that stimulated me to consider many aspects of my own department’s plans. However this is not a text for the provider to turn to on disaster day.