Knowledge and skills requested for accurate response to major incidents and disasters
A major incident or disaster can hit us any time, at any place and without warning, as has been very well illustrated by the development of the global terrorism. When we suddenly are faced with the demand to cope with a large number of injured or critically ill, we may not have:

• Access to, or time to use, the advanced techniques we are used to have at our disposal
• Access to specialists to deal with things that normally are handled by specialists
• Possibility to treat all patients with the quality and security that we are used to
• Access to theatres or ventilators “in reserve”, since every resource is already optimally utilized
• Supplies for heavy loads of casualties, since many supplies are refilled on day-to-day basis
• The computer support on which all our daily routines are based
• Functioning telecommunication, since modern systems are  vulnerable for over-loading and technical disturbances

This requires knowledge and skills to:

• Use simplified methods for diagnosis and treatment
• Primarily treat emergencies outside our own specialty, at least those commonly occurring in these situations
• Perform triage, i.e make rapid and accurate decisions with regard to priority between patients and between diagnostic and therapeutic measures
• Work as an integrated part of an organization where resources rapidly must be  redistributed depending on needs, which requires knowledge about this organization
• Work with limited supplies, and know how to get additional supplies
• Use  reserve systems if computer-or telecommunication systems, or other advanced technical systems , fail

In addition, specific types of incidents require special knowledge: Management of patients contaminated by hazardous material, biological agents or irradiation, or with specific injuries more rarely occurring in our daily care like high-energy missile of fragment injuries, blast injuries, severely contaminated injuries.
To work under austere conditions in areas with highly limited resources or in “chronic” disaster zones with severe public health problems, requires specific knowledge in fields as nutrition, infectious diseases, and management of refugees and displaced population. All this requires specific education and training for those deployed to serve in such areas.