A single, improvised "Kassam" rocket explosion can cause a mass casualty incident: a potential threat for future international terrorism?

Schwartz, Deena; Ostfeld, Ishay; Bar‐Dayan, Yaron

doi:10.1136/emj.2008.061143

Cited by 4 publications

(5 citation statements)

References 14 publications

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“…In open-air related terrorism blasts, injuries are usually found in the head, neck and periphery [18,39] and are often associated with secondary and tertiary blast injuries. Multiple areas of injury are usually described as a diffuse pattern, with the majority of injuries occurring in the extremities, especially the distal portion of the limbs [13,27,[40][41][42], as well as facial and skull fractures [44,45,47]. This aspect of open-air blast is consistent with observations in the sample as well as with other contexts such as enclosed blast.…”

Section: Discussion/conclusionsupporting

confidence: 68%

“…In the Oklahoma City bombing, 75% of the victims had extremity trauma [43]; whereas in the Madrid train bombings, the head and neck area was the most injured followed with the extremities [28,48,49]. The diffuse injury and fragmentation of the extremities in the Bosnian blast-injury cases were associated with a rocket-propelled grenade that had been launched into a closed environment; therefore the fracture patterns are expected to be more similar to an enclosed contexts rather than an open air context [45].…”

Section: Discussion/conclusionmentioning

confidence: 99%

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Evaluation of trauma patterns in blast injuries using multiple correspondence analysis

Dussault

Smith

Hanson

2016

Forensic Science International

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A B S T R A C TAnthropology features little in published literature about blast injuries. Contributions through case studies and experimental research are beginning to expand our understanding of the effect these injuries have on the human skeleton. This study examines blast injury and gunshot related fractures through multiple correspondence analysis (MCA) with the aim of establishing injury patterns between the two types of trauma. Using a sample of 491 individuals from Bosnia, MCA is employed to identify which body regions differentiate between blast or gunshot related fractures. Cranial fractures were more closely associated with gunshot related cases. Post-cranial fractures were associated with blast-related cases. A differentiation in post-cranial and cranial fractures between gunshot and blast related cases was revealed in the samples. The high prevalence of extremity trauma in blast is similar to previous work, but the smaller amount of cranial blast-related fractures differs from previous studies and from what is found in gunshot-related cases. Differentiation of blast and gunshot wound injuries can be made on the human skeleton and can be used to possibly interpret injury mechanism in large skeletal assemblages as well as single cases.

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Section: Discussion/conclusionsupporting

confidence: 68%

Section: Discussion/conclusionmentioning

confidence: 99%

Evaluation of trauma patterns in blast injuries using multiple correspondence analysis

Dussault

Smith

Hanson

2016

Forensic Science International

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“…Hamas launched approximately 4,000 missiles against Israeli civilian population centers . Civilians were injured by these rockets, which typically landed far from where direct military confrontations were taking place in Gaza and significantly damaged the surrounding infrastructure as well . Hamas also fired mortars at a shorter distance from the theater of war and injured civilians living closer to the Gaza border.…”

mentioning

confidence: 99%

“…Hamas also fired mortars at a shorter distance from the theater of war and injured civilians living closer to the Gaza border. The rush to sheltered areas while air‐raid sirens, warning of the approaching rockets, were sounding also contributed to acute and chronic stress reactions …”

mentioning

confidence: 99%

Lessons From Analyzing the Medical Costs of Civilian Terror Victims: Planning Resources Allocation for a New Era of Confrontations

et al. 2017

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We found 3 major sources of costs: hospital expenditures, mental health services dedicated to acute stress reactions, and ambulatory follow-up. During the first year, most of the costs were related to hospitalization and support for stress relief. During the second year, ambulatory and rehabilitation costs continued to grow. Public health specialists should consider these major components of costs and their evolution over time to properly advise the medical and social authorities on allocating resources for the medical and nonmedical support of civilian casualties resulting from war or terror.

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“…A systematic review compared different available protocols of standardized reporting [14] and we chose this protocol because it was developed to report real incidents, has a practical approach, is freely available, has been published [1,15,16] and has been used previously [10,17,18]. Other protocols are more extensive but less practical, such as the Utstein template [19], the DISAST-CIR, a protocol used by the Israeli Defense Force Home Front and Ministry of Health [20][21][22][23][24][25][26][27][28] and two unused protocols [29,30]. None of these protocols have been tested on Internal and external validity [14].…”

Section: Discussionmentioning

confidence: 99%

Indoor fire in a nursing home: evaluation of the medical response to a mass casualty incident based on a standardized protocol

Koning

Ellerbroek

Leenen

2014

Eur J Trauma Emerg Surg

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Purpose This retrospective study reports the outcome of a mass casualty incident (MCI) caused by a fire in a nursing home. Methods Data from the medical charts and registration system of the Major Incident Hospital (MIH) and ambulance service were analyzed. The evaluation reports from the MIH and an independent research institute were used. The protocol for reports from major accidents and disaster was used to standardize the reporting [Lennquist, in Int J Disaster Med 1(1): [79][80][81][82][83][84][85][86] 2003]. Results The emergency services were quickly at the scene. The different levels of pre-hospital management performed a tight coordination. However, miscommunication led to confusion in the registration and tracking of patients. In total, 49 persons needed medical treatment, 46 were treated in the MIH. Because of (possible) inhalation injury nine patients needed mechanical ventilation and nine patients were hospitalized to exclude delayed onset of pulmonary symptoms. No incident related deaths occurred. The intensive care unit of the MIH was initially understaffed despite the efforts of the automated calling system and switchboard operators. The handwritten registration of incoming staff was incomplete and should be performed digitally. Some staff members were unfamiliar with the MIH procedures. The medical chart appeared too extensive. Miscommunication between chain partners resulted in the delayed sharing of (semi) medical information. Conclusion The different levels of incident managers performed a tight coordination. The MIH demonstrated its potency to provide emergency care for 46 patients and 9 intubated patients. No deaths or persistent disabilities occurred. Areas of improvement were recognized both in the pre-hospital as the hospital phase.

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A single, improvised "Kassam" rocket explosion can cause a mass casualty incident: a potential threat for future international terrorism?

Cited by 4 publications

References 14 publications

Evaluation of trauma patterns in blast injuries using multiple correspondence analysis

Evaluation of trauma patterns in blast injuries using multiple correspondence analysis

Lessons From Analyzing the Medical Costs of Civilian Terror Victims: Planning Resources Allocation for a New Era of Confrontations

Indoor fire in a nursing home: evaluation of the medical response to a mass casualty incident based on a standardized protocol

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