11. Special Incidents Rules

  1. Lieutenant Colonel Rob Russell MB, BS, MRCP(UK), FCEM, DipIMCRCSEd, RAMC Clinical Lead (Emergency and Critical Care) Consultant Senior Lecturer1,2,3,
  2. Colonel Timothy J Hodgetts CBE, QHP, MMEd, MBA, CMgr, FRCP, FRCSEd, FCEM, FIMCRCSEd, FIHM, FCMI, FRGS, L/RAMC Professor Consultant3,4,5,
  3. Colonel Peter F Mahoney OBE, TD, MSc, FRCA, L/RAMC Defence Professor Consultant5,6 and
  4. Nicholas Castle MSc, DipIMCRCSEd, RGN, SRPara Nurse Consultant Honorary Research Fellow7,8

Published Online: 18 NOV 2010

DOI: 10.1002/9781444329681.ch11

Disaster Rules

Disaster Rules

How to Cite

Russell, L. C. R., Hodgetts, C. T. J., Mahoney, C. P. F. and Castle, N. (2010) Special Incidents Rules, in Disaster Rules, Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444329681.ch11

Author Information

  1. 1

    Emergency Medicine, Peterborough, and Stamford Hospitals NHS Foundation Trust, UK

  2. 2

    Military Emergency Medicine, Royal Centre for Defence Medicine, UK

  3. 3

    Emergency Medicine, University of Birmingham, UK

  4. 4

    College of Emergency Medicine, UK

  5. 5

    University Hospitals Birmingham NHS Foundation Trust, UK

  6. 6

    Royal College of Anaesthetists, UK

  7. 7

    Frimley Park Hospital NHS Foundation Trust, UK

  8. 8

    Durban University of Technology, Republic of South Africa

Publication History

  1. Published Online: 18 NOV 2010
  2. Published Print: 24 NOV 2010

ISBN Information

Print ISBN: 9781405193788

Online ISBN: 9781444329681



  • Special Incident Rules;
  • Casualty decontamination is a healthcare priority;
  • chemical, biological, radiation or nuclear (CBRN);
  • Chemical Personal Protective Equipment (CPPE);
  • Think once, think twice, think HAZMAT;
  • Detection, Identification and Monitoring (DIM);
  • Toxidrome recognition is all in the eyes;
  • The Centre for Disease Prevention and Control (CDC);
  • Systemic Inflammatory Response Syndrome (SIRS)


This chapter contains sections titled:

  • Rule 63: Casualty decontamination is a healthcare priority

  • Rule 64: Consider your local utilities when planning for mass unconventional casualties

  • Rule 65: Unconventional incidents require unconventional assistance

  • Rule 66: With hazardous materials, presume the worst and respond accordingly

  • Rule 67: Think once, think twice, think HAZMAT

  • Rule 68: The 4 I's of CBRN exposure

  • Rule 69: Triage is expanded for CBRN casualties

  • Rule 70: A simple change in position can save lives

  • Rule 71: The solution to pollution is dilution

  • Rule 72: When decontaminating, prevent recontamination

  • Rule 73: A requirement for dexterity is a recipe for difficulty

  • Rule 74: When in doubt, wash it out – still in doubt, chop it out

  • Rule 75: Toxidrome recognition is all in the eyes

  • Rule 76: Patients present with biological syndromes, not laboratory diagnoses

  • Rule 77: Sepsis is the final fatal biological syndrome

  • Rule 78: Time–distance–shielding: the three principles of radiation protection

  • Rule 79: The radiation may kill in years, but the trauma kills in minutes

  • References