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- Title
Mass casualty incidents after terrorist bombings.
- Authors
Parashkevov, Alexander; Mutafchiyski, Ventsislav; Popivanov, Georgi; Todorov, Paulin
- Abstract
Introduction: The frequent suicide terrorist attacks in the last years logically raise the question how prepared we are to cope with their consequences. In comparison to the other types of trauma, bomb explosions more frequently lead to mass casualty incidents (MCIs), generating a large number of casualties with multiple injuries within a short time frame. This number usually exceeds the capacity of the hospital, which tend to exhaust the hospital resources. Additionally, there are several important differences between combat and civilian MCIs. This reality, together with the unpredictability of these events, justifies their detailed analysis and discussion. Material and methods: In the present work two suicide terrorist attacks led to MCI were analyzed. The first one occurred in a combat setting in Kerbala, Iraq, on 27 December 2003. The second occurred in a civilian setting at the International Airport in Bourgas, Bulgaria on 18 July, 2012. The following variables were analyzed and compared - a total number of the casualties, number of dead on scene (DOS), hospitalized victims and those who needed major surgery (MS), hospital mortality and returned to duty (RD) for the military personal. The severity of trauma was assessed by Injury Severity Score (ISS). Results: Overall, there were an average 26 casualties per incident 52, 13.5% dead on scene and 62.5% hospitalized. The severely injured (ISS>16) were 12.5% (n=13), major surgery was performed in 12 of them (92.3%) or 11.5% of all (12/104). The overall mortality was 11.5%. It was higher after the bus explosion (17.9%) than those in Kerbala (7.7%). The bus explosion was also associated with a higher proportion of wounded - 78% vs. 50%, more immediate deaths - 15.4% vs. 6.2% and higher dead/wounded ratio - 1:5.6 vs 1:13. Conclusions The civilian terrorist attacks result in significantly more casualties and immediate fatalities, higher overall mortality and a higher dead/wounded ratio. Due to the unpredictability of these events, not only the largest trauma centers, but every hospital should have a contingency plan for MCIs. Every surgeon should be familiar with the art of triage and to develop ability for a judicious allocation of the precious hospital resources.
- Publication
Balkan Military Medical Review, 2014, Vol 17, Issue 3, p95
- ISSN
1107-6275
- Publication type
Article
- DOI
10.5455/bmmr.165480