Surgical Resource Utilization in Urban Terrorist Bombing: A Computer Simulation

Hirshberg, Asher; Stein, Michael D.; Walden, Raphael

doi:10.1097/00005373-199909000-00020

Cited by 92 publications

(36 citation statements)

References 12 publications

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“…Computer simulation and planning tools may be useful to help bridge this preparation and training gap. 20,21 Chemical and radiological preparedness in Canada Decontamination Decontamination of chemically or radiologically contaminated patients, ideally prior to entering the health care facility, is a critical step in the delivery of care. 8,12,15,16 In the review of decontamination capability, only 18 of 59 respondents (30%) stated that their ED had a decontamination area or a plan to establish one.…”

Section: General Disaster Preparedness In Canadamentioning

confidence: 99%

Canadian emergency department preparedness for a nuclear, biological or chemical event

Kollek

2003

CJEM

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Since the terror attacks of September 11th, emergency departments across North America have become more aware of the need to be prepared to deal with a mass casualty terror event, particularly one involving nuclear, biological or chemical contaminants. The effects of such an attack could also be mimicked by accidental release of toxic chemicals, radioactive substances or biological agents unrelated to terrorist activity.The purpose of this study was to review the risks and characteristics of these events and to assess the preparedness of Canadian emergency departments to respond. This was done by means of a survey, which showed a significant risk of a mass casualty event (most likely chemical) coupled with a deficiency in preparedness -most notably in the availability of appropriate equipment, antidotal therapy and decontamination capability. There were also significant deficiencies in the ability to respond to a major biologic or nuclear event. RÉSUMÉDepuis les attaques terroristes du 11 septembre, les départements d'urgence à travers l'Amérique du Nord ont été sensibilisés davantage à l'importance de se préparer en prévision d'une catastrophe à victimes multiples, en particulier lorsque des polluants nucléaires, biologiques ou chimiques sont en cause. Les effets d'une telle attaque pourraient aussi se manifester dans le contexte d'une libération accidentelle de produits chimiques toxiques, de substances radioactives ou d'agents biologiques non reliés à des activités terroristes.La présente étude avait comme objectif de passer en revue les risques et caractéristiques de ces événements et d'évaluer l'état de préparation des départements d'urgence canadiens en cas de désastre. L'étude prit la forme d'un sondage qui révéla un risque important de catastrophe à victimes multiples (très probablement d'origine chimique) associé à un état de préparation inadé-quat, plus particulièrement au niveau de la disponibilité de l'équipement approprié, des antidotes et des capacités de décontamination. On notait également des lacunes importantes dans la capacité à répondre à une catastrophe majeure d'origine biologique ou nucléaire.

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Section: General Disaster Preparedness In Canadamentioning

confidence: 99%

Canadian emergency department preparedness for a nuclear, biological or chemical event

Kollek

2003

CJEM

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“…Unfortunately, the extent of blast injury cannot be reliably assessed by the typical rapid triage examination. 48 This mandates an atypically high over-triage rate, 432 which may affect patient flow and use of hospital resources. 48 The emergency department care should be centered on stabilization measures in accordance with Advanced Trauma Life Support principles.…”

Section: Emergency Departmentmentioning

confidence: 99%

“…48 This mandates an atypically high over-triage rate, 432 which may affect patient flow and use of hospital resources. 48 The emergency department care should be centered on stabilization measures in accordance with Advanced Trauma Life Support principles. 49 A thorough evaluation for signs of primary blast injuries should also be conducted; especially when there is a history of a powerful explosion.…”

Section: Emergency Departmentmentioning

confidence: 99%

“…48 The major bottleneck to the flow of critically injured patients was the availability of shock rooms and CT scanners, not operating rooms. Imaging studies required for the critically injured stable patients typically included head, chest or abdominal CT scans, followed by plain radiographs to locate shrapnel and diagnose fractures.…”

Section: Hospitalmentioning

confidence: 99%

“…Those patients waiting for delayed radiographs can be treated with temporary splints and analgesics. 48 Psychological disturbances may affect up to 50% of bombing survivors, and include hysteria, guilt, PTSD, and behavioral alterations. 28,8 It is important to provide psychologic followup opportunities for all patients discharged from the hospital.…”

Section: Hospitalmentioning

confidence: 99%

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