• crowding
• major trauma management

In their EMJ paper, James et al report the findings of a simple survey conducted among NHS emergency department leads to assess their level of preparedness for a major incident.1 Although the response rate was disappointing, the findings provide some valuable insights. Unsurprisingly, all respondents reported experiencing crowding in their departments, with more than half noting that their departments are crowded over 75% of the time. A more concerning result, however, was that less than 10% of respondents believed they would be able to clear their department in the event of a major incident. Furthermore, only less than 20% of the department leads felt their team was adequately prepared to respond to such an incident. Despite changes made in the major incident plan in …