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Beyond A to E: addressing the unfamiliar issues arising in the acute and immediate phase post-catastrophe
  1. Adam Reckless,
  2. S McPhail,
  3. C Lillington and
  4. B Kingsley-Smith
  1. Institute of Naval Medicine, Royal Naval Medical Services, Gosport, Portsmouth, UK
  1. Correspondence to Dr Adam Reckless, Royal Naval Medical Services, Portsmouth, UK; adamdreckless{at}


During a time in which there is increased focus on level 5 and 6 prehospital emergency care provision and utilisation in the deployed military space, it is important to consider the range of care that more junior medical practitioners may be exposed to. The initial response to a catastrophe at a level pertaining to General Duties Medical Officers or similar forward-deployed tri-service personnel comprises acute care and triage skills, which are widely taught through prehospital courses and Foundation training. However, beyond that, the necessary workload becomes less clear. To provide comprehensive care in-theatre, there is the need to consider more nuanced and unfamiliar issues such as components in the immediate postcatastrophe landscape. These include aspects such as care of human remains, mental health, chronic conditions in the acute phase and the scope of military medical assistance within the wider relief effort. This is a paper commissioned as a part of the Humanitarian and Disaster Relief Operations special issue of BMJ Military Health.

  • accident & emergency medicine
  • international health services
  • preventive medicine
  • public health
  • trauma management
  • medical ethics

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study. Not applicable.

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Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study. Not applicable.

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  • Contributors AR is the primary contributing author having collated the article, actioned the revisions and written a substantial portion of the original work. All other listed authors made significant contributions and wrote key aspects of the original piece.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.