Terrorist Bomb Blasts: Emergency department management of multiple incidents

Abstract

Objective: To assess the preparedness of the hospital emergency system and medical personnel’s in dealing trauma victims of terrorist bomb blasts in Accident and Emergency. Patients and Methods: Four major terrorist bomb blasts incidents occurred in Karachi from December 2012 to May 2014. All patients of these 4 incidents were brought to Accident and emergency of Jinnah Postgraduate Medical Center. Place and type of bomb blast, their initial search and rescue, transfer and transportation noted. Data collected of these patients at Accident and emergency of Jinnah Post Graduate Medical Center, regarding triage, primary and secondary survey with adjuncts performed. Data was also collected from emergency operation theatres, Intensive care unit and admissions in wards. Time taken for early and effective management and disposal to different departments noted. Results: Total victims of these four bomb blast incidents were 179. Nineteen were brought dead, 8 more died within two hours, due to multiple system involvement which made total deaths 27 (15%). The patients were triaged with color coding, 44% of these patients were red and yellow, and 41% patients were of minor injuries and were labeled green. Total 67 (41.8%) underwent damage control surgery within two hours of arrival at accident and emergency. Most of the admissions were of Orthopedics and Chest surgery. Conclusion: Effective and early disposal of patients from Accident and Emergency needs collaborative efforts of hospital administration following comprehensive disaster plan & preparedness. Trained triage team with quick surgical response needs trauma training, disaster management courses and drill exercises for doctors and health workers. Keywords: Terrorist bombing, Preparedness, Triage, mass casualties, management.