Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-22T11:22:44.351Z Has data issue: false hasContentIssue false
  • English
  • Français

Defining the Problem, Main Objective, and Strategies of Medical Management in Mass-Casualty Incidents Caused by Terrorist Events

Published online by Cambridge University Press:  28 June 2012

Itamar Ashkenazi ,
Boris Kessel ,
Oded Olsha ,
Tawfik Khashan ,
Meir Oren ,
Jacob Haspel  and
Ricardo Alfici
Itamar Ashkenazi*
Affiliation:
Hillel Yaffe Medical Center, Israel
Boris Kessel
Affiliation:
Hillel Yaffe Medical Center, Israel
Oded Olsha
Affiliation:
Shaare Zedek Medical Center, Israel
Tawfik Khashan
Affiliation:
Hillel Yaffe Medical Center, Israel
Meir Oren
Affiliation:
Hillel Yaffe Medical Center, Israel
Jacob Haspel
Affiliation:
Hillel Yaffe Medical Center, Israel
Ricardo Alfici
Affiliation:
Hillel Yaffe Medical Center, Israel
*
Surgery B Department, Trauma Unit Hillel Yaffe Medical Center Hadera, POB 169 Israel 38100 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Based on the experience of managing >20 such events during the last decade, the authors' understanding of a mass-casualty incident is that it is an event in which there may be many victims, but only a few that actually suffer from life-threatening injuries. To make an impact on survival, one must identify those who are severely wounded as quickly as possible and offer those patients opti-mal care. Experienced trauma physicians are the most important resource available to achieve this objective, and they should be allocated to the treat-ment of seriously injured victims instead of more traditional management roles such as triage and incident manager.

Keywords

blast injurybomb injuriesmass-casualty incidentterrorismtriage
Type
Research Article
Information
Prehospital and Disaster Medicine , Volume 23 , Issue 1 , February 2008 , pp. 82 - 89
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Committee on Trauma: American College of Surgeons Statement on disas-ter and mass casualty management. J Am Coll Surg 2003;197(5):855–856.10.1016/S1072-7515(03)00808-1CrossRefGoogle Scholar
2. Frykberg, ER: Medical management of disasters and mass casualties from terrorist bombings: How can we cope? J Trauma 2002;53:201–212.10.1097/00005373-200208000-00001CrossRefGoogle ScholarPubMed
3. Frykberg, ER: Principles of mass casualty management following terrorist disasters. Ann Surg 2004;319–321.Google Scholar
14. Michaelson, M, Olin, N, Hyams, G: Preparedness for mass casualty situa-tions—The key to success. In: J, Shemer, Shoenfeld, Y (eds): Terror and Medicine. Lengerich: PABST Science Publisher, 2003, pp 359–360.Google Scholar
5. Shapira, S: Blast Injuries. In: Trauma Letter. Israel Defense Forces Medical Corps, April 1993:1–15.Google Scholar
6. Peleg, K, Aharonson-Daniel, L, Stein, M, Michaelson, M, Kluger, Y, Simon, D, Israeli Trauma Group, Noji, E: Gunshot and explosion injuries: Characteristics, outcomes, and implications for care of terror-related injuries in Israel. Ann Surg 2004;239(3):311–318.10.1097/01.sla.0000114012.84732.beCrossRefGoogle ScholarPubMed
7. Frykberg, ER: Disaster and mass casualty management: A commentary on the American College of Surgeons position statement. J Am Coll of Surg 2003;197(5):857–859.10.1016/S1072-7515(03)00809-3CrossRefGoogle ScholarPubMed
8. Almogy, G, Belzberg, H, Minz, Y, Pikarsky, AK, Zamir, G, Rivkind, AI: Suicide bombing attacks: update and modification to the protocol. Ann Surg 2004;239(3):295–303.10.1097/01.sla.0000114014.63423.55CrossRefGoogle Scholar
9. Caro, D, Irving, M: The Old Bailey bomb explosion. Lancet 1973;1(7817): 1433–1435.10.1016/S0140-6736(73)91753-4CrossRefGoogle ScholarPubMed
10. Brismar, B, Bergenwald, L: The terrorist bomb explosion in Bologna, Italy, 1980: An analysis of the effects and injuries sustained. J Trauma 1982;22(3):216–220.CrossRefGoogle ScholarPubMed
11. Frykberg, EK, Tepas, JJ 3rd, Alexander, RH: The 1983 Beirut Airport terror-ist bombing. Injury patterns and implications for disaster management. Am Surg 1989:55(3):134–141.Google ScholarPubMed
12. Biancolini, CA, Del Bosco, CG, Jorge, MA: Argentine Jewish community institution bomb explosion. J Trauma 1999;47(4):728–732.10.1097/00005373-199910000-00019CrossRefGoogle ScholarPubMed
13. Mallonee, S, Shariat, S, Stennies, G, Waxweiller, R, Hogan, D, Jordan, F: Physical injuries and fatalities resulting from the Oklahoma City bombing. JAMA 1996;276(5):382–387.10.1001/jama.1996.03540050042021CrossRefGoogle ScholarPubMed
14. Hogan, DE, Waeckerle, JF, Dire, DJ, Lillibridge, SR: Emergency deparment impact of the Oklahoma City terrorist bombing. Ann Emerg Med 1999;34(2):160–167.10.1016/S0196-0644(99)70224-6CrossRefGoogle Scholar
15. Thompson, D, Brown, S, Mallonee, S, Sunshine, D: Fatal and non-fatal injuries among U.S. Air Force personnel resulting from the terrorist bomb-ing of the Khobar Towers. J Trauma 2004;57(2):208–215.CrossRefGoogle ScholarPubMed
16. Feliciano, DV, Anderson, GV Jr, Rozycki, GS, Ingram, WL, Ansley, JP, Namias, N, Salomone, JP, Cantwell, JD: Management of casualties from the bombing in the centennial Olympics. Am J Surg 1998;176(6):583–543.CrossRefGoogle ScholarPubMed
17. Driscoll, GS: Up from the ashes. Lessons learned from the bombing of the United States Embassy Nairobi, Kenya August 7, 1998. USAID/Kenya.Google Scholar
18. Cushman, JG, Pachter, HL, Beaton, HL: Two New York City hospital's sur-gical response to the September 11, 2001 terrorist attack in New York City. J Trauma 2003;54(1):147–154.10.1097/00005373-200301000-00018CrossRefGoogle Scholar
19. Kirschenbaum, L, Keene, A, O'Neill, P, Westfal, R, Astiz, ME: The experience at St. Vincent's Hospital, Manhattan, on September 11, 2001: Preparedness, response, and lessons learned. Crit Care Med 2005;33(1 Suppl):s48–s52.10.1097/01.CCM.0000151067.76074.21CrossRefGoogle ScholarPubMed
20. Southwick, GJ, Pethick, AJ, Thalayasingam, P, Vijayasekaran, VS, Hogg, JJ: Australian doctors in Bali: The initial medical response to the Bali bombing. MJA 2002;177:624–626.Google Scholar
21. Rodoplu, U, Arnold, JL, Tokyay, R, Ersoy, G, Cetiner, S, Yucel, T: Mass-casualty terrorist bombings in Istanbul, Turkey, November 2003: Report of the events and the prehospital emergency response. Prehospital Disast Med 2004;19(2):133–145.CrossRefGoogle ScholarPubMed
22. de Ceballos, JP, Turegano-Fuentes, F, Perez-Diaz, D, Sanz-Sanchez, M, Martin-Llorente, C, Guerrero-Sanz, JE: 11 March 2004: The terrorist bomb explosions in Madrid, Spain: An analysis of the logistics' injuries sustained and clinical man-agement of casualties treated at the closest hospital. Crit Care 2005;9(1):104–111.10.1186/cc2995CrossRefGoogle Scholar
23. Aylwin, CJ, Konig, TC, Brennan, NW, Shirley, P, Davies, G, Walsh, MS, Brohi, K: Reduction in critical mortality in urban mass casualty incidents: Analysis of triage, surge and resource use after the London bombings on July 7, 2005. Lancet 2006;368:2219–2225.CrossRefGoogle ScholarPubMed
24. Ryan, J, Montgomery, H: Terrorism and the medical response. N Engl J Med 2005;353(6):543–545.10.1056/NEJMp058177CrossRefGoogle ScholarPubMed
25. Hirshberg, A: Multiple casualty incidents: Lessons from the front line. Ann Surg 2004;239(3):322–324.CrossRefGoogle ScholarPubMed