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Chapter 14 - Terrorism and Mass Casualty Incidents

Published online by Cambridge University Press:  20 July 2023

By
Gregory R. Ciottone  and
Derrick Tin
Edited by
Mark Curato ,
Kaushal Shah  and
Christopher Reisig
Mark Curato
Affiliation:
Weill Cornell Medicine, New York
Kaushal Shah
Affiliation:
Weill Cornell Medicine, New York
Christopher Reisig
Affiliation:
Weill Cornell Medicine, New York
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Summary

Terrorism and mass casualty incidents are considered low-frequency, high-impact events and while medical professionals have always responded and cared for victims of such events, there is an increasing need for healthcare systems to be proactive in preparing, mitigating, and responding to these increasingly complex and devastating incidents. Counter-terrorism medicine is a subspecialist disaster medicine field that aims to address the healthcare impacts of intentional, man-made attacks and the unique challenges medical professionals and healthcare systems face before, during and after a terrorist event. Mass casualty incidents are challenging, terrorist attacks are complex, and the day-to-day demands on healthcare systems around the world have never been higher. Although rare, a terrorism event has the potential to exploit all these vulnerabilities to create a black swan event and healthcare professionals need to collaborate with their intelligence, security, law enforcement and other emergency services counterparts to mitigate the risks of a potential devastating man-made disaster.

Keywords

TerrorismCounter-Terrorism MedicineMass Casualty IncidentEmergency PreparednessDisaster Medicine
Type
Chapter
Information
Urban Emergency Medicine , pp. 173 - 183
Publisher: Cambridge University Press
Print publication year: 2023

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References

United Nations Office on Drugs and Crime. Defining Terrorism. Available at: www.unodc.org/e4j/en/terrorism/module-4/key-issues/defining-terrorism.html. Accessed April 6, 2022.Google Scholar
Schmid, AP. The Routledge Handbook of Terrorism Research. Routledge, 2011; 50–60, 86–87.Google Scholar
Court, M, Edwards, B, Issa, F, Voskanyan, A, Ciottone, G. Counter-Terrorism Medicine: creating a medical initiative mandated by escalating asymmetric attacks. Prehosp Disaster Med. 2020;35(6):595–598. doi: 10.1017/S1049023X2000103X. PMID: 32792026.Google Scholar
Tin, D, Margus, C, Ciottone, GR. Half-a-century of terrorist attacks: weapons selection, casualty outcomes, and implications for counter-terrorism medicine. Prehosp Disaster Med. 2021;36(5):526–530. doi: 10.1017/S1049023X21000868. PMID: 34392864.Google Scholar
Ritchie, H, Hasell, J, Appel, C, Roser, M. Terrorism. Our World in Data. 2019 Available at: https://ourworldindata.org/terrorism. Accessed April 6, 2022.Google Scholar
National Strategy for Countering Domestic Terrorism. 2021. Available at: www.whitehouse.gov/wp-content/uploads/2021/06/National-Strategy-for-Countering-Domestic-Terrorism.pdf. Accessed May 19, 2022.Google Scholar
Cavaliere, GA, Alfalasi, R, Jasani, GN, Ciottone, GR, Lawner, BJ. Terrorist attacks against healthcare facilities: a review. Health Secur. 2021;19(5):546–550. doi: 10.1089/hs.2021.0004. PMID: 34319798.Google Scholar
Lozada, MJ, Cai, S, Li, M, Davidson, SL, Nix, J, Ramsey, G. The Las Vegas mass shooting: an analysis of blood component administration and blood bank donations. J Trauma Acute Care Surg. 2019;86(1):128–133. doi: 10.1097/TA.0000000000002089. PMID: 30371625.Google Scholar
Marcozzi, DE, Pietrobon, R, Lawler, JV, French, MT, Mecher, C, Peffer, J, Baehr, NE, Browne, BJ. Development of a Hospital Medical Surge Preparedness Index using a national hospital survey. Health Serv Outcomes Res Method. 2020;20:60–83. https://doi.org/10.1007/s10742-020-00208-6.Google Scholar
Kosashvili, Y, Aharonson-Daniel, L, Peleg, K, Horowitz, A, Laor, D, Blumenfeld, A. Israeli hospital preparedness for terrorism-related multiple casualty incidents: can the surge capacity and injury severity distribution be better predicted? Injury. 2009;40(7):727–731. doi: 10.1016/j.injury.2008.11.010. Erratum in: Injury. 2010;41(7):1076. PMID: 19394934.Google Scholar
Pollaris, G, Sabbe, M. Reverse triage: more than just another method. Eur J Emerg Med. 2016;23(4):240–247. doi: 10.1097/MEJ.0000000000000339. PMID: 26479736.CrossRefGoogle ScholarPubMed
Brooks, J, Erickson, TB, Kayden, S, Ruiz, R, Wilkinson, S, Burkle, FM Jr. Responding to chemical weapons violations in Syria: legal, health, and humanitarian recommendations. Confl Health. 2018;12:12. doi: 10.1186/s13031-018-0143-3. PMID: 29479374; PMCID: PMC5817898.Google Scholar
Kim Jong-nam killing: ‘VX nerve agent’ found on his face. BBC. 2017. Available at: www.bbc.com/news/world-asia-39073389. Accessed April 6, 2022.Google Scholar
Vale, JA, Marrs, TC, Maynard, RL. Novichok: a murderous nerve agent attack in the UK. Clin Toxicol (Phila). 2018;56(11):1093–1097. doi: 10.1080/15563650.2018.1469759. PMID: 29757015.CrossRefGoogle ScholarPubMed
Greathouse, B, Zahra, F, Brady, MF. Acetylcholinesterase inhibitors toxicity. In: StatPearls [Internet]. StatPearls Publishing, 2022. PMID: 30571049.Google Scholar
Negri, A, Townshend, H, McSweeney, T, Angelopoulou, O, Banayoti, H, Prilutskaya, M, Bowden-Jones, O, Corazza, O. Carfentanil on the darknet: potential scam or alarming public health threat? Int J Drug Policy. 2021;91:103118. doi: 10.1016/j.drugpo.2021.103118. PMID: 33482605.Google Scholar
Razak, S, Hignett, S, Barnes, J. Emergency department response to chemical, biological, radiological, nuclear, and explosive events: a systematic review. Prehosp Disaster Med. 2018;33(5):543–549. doi: 10.1017/S1049023X18000900. PMID: 30379127.Google Scholar
Ciottone, GR. Toxidrome recognition in chemical-weapons attacks. N Engl J Med. 2018;378(17):1611–1620. doi: 10.1056/NEJMra1705224. PMID: 29694809.Google Scholar
Wax, PM, Becker, CE, Curry, SC. Unexpected “gas” casualties in Moscow: a medical toxicology perspective. Ann Emerg Med. 2003;41(5):700–5. doi: 10.1067/mem.2003.148.Google Scholar
United Nations Office of Counter-Terrorism. Chemical, biological, radiological and nuclear terrorism. Available at: www.un.org/counterterrorism/cct/chemical-biological-radiological-and-nuclear-terrorism. Accessed April 6, 2022.Google Scholar
Bonte, FJ. Chernobyl retrospective. Semin Nucl Med. 1988;18(1):16–24. doi:10.1016/s0001-2998(88)80016-3. PMID: 3278382.Google Scholar
United States Nuclear Regulatory Commission, January 7, 2021. Available at: www.nrc.gov/reading-rm/doc-collections/fact-sheets/smoke-detectors.html. Accessed April 6, 2022.Google Scholar
Radiation Emergency Medical Management, US Department of Health and Human Services. February 17, 2022. Available at: https://remm.hhs.gov/ars.htm. Accessed April 6, 2022.Google Scholar
Tin, D, Sabeti, P, Ciottone, GR. Bioterrorism: an analysis of biological agents used in terrorist events. Am J Emerg Med. 2022;54:117–121. doi: 10.1016/j.ajem.2022.01.056. PMID: 35152120; PMCID: PMC8818129.Google Scholar
Bush, LM, Perez, MT. The anthrax attacks 10 years later. Ann Intern Med. 2012;156(1 Pt 1):41–44. doi: 10.7326/0003-4819-155-12-201112200-00373. PMID: 21969275.Google Scholar
9/11 Commission Report. 2004. Available at: www.govinfo.gov/content/pkg/GPO-911REPORT/pdf/GPO-911REPORT-24.pdf. Accessed April 29, 2022.Google Scholar
Cole, LA. Raising awareness about terror medicine. Clin Dermatol. 2011;29(1):100–102. doi: 10.1016/j.clindermatol.2010.07.015. PMID: 21146738.Google Scholar
Psychiatrists and terrorism. Can Med Assoc J. 1976;115(8):797. PMID: 987843; PMCID: PMC1878835.Google Scholar
Rignault, DP. Recent progress in surgery for the victims of disaster, terrorism, and war – introduction. World J Surg. 1992;16(5):885–887. doi: 10.1007/BF02066986. PMID: 1462624.Google Scholar
Tin, D, Hertelendy, AJ, Hart, A, Ciottone, GR. 50 Years of mass-fatality terrorist attacks: a retrospective study of target demographics, modalities, and injury patterns to better inform future counter-terrorism medicine preparedness and response. Prehosp Disaster Med. 2021;36(5):531–535. doi: 10.1017/S1049023X21000819. PMID: 34369349.Google Scholar
Tin, D, Hart, A, Ciottone, G. Rethinking disaster vulnerabilities. Am J Emerg Med. 2020:S0735-6757(20)30973–6. doi: 10.1016/j.ajem.2020.10.073.Google Scholar
Pollaris, G, Sabbe, M. Reverse triage: more than just another method. Eur J Emerg Med. 2016;23(4):240–247. doi: 10.1097/MEJ.0000000000000339. PMID: 26479736.CrossRefGoogle ScholarPubMed
Tin, D, Hart, A, Ciottone, GR. Hardening hospital defences as a counter-terrorism medicine measure. Am J Emerg Med. 2021;45:667–668. doi: 10.1016/j.ajem.2020.10.051. PMID: 33153832.CrossRefGoogle ScholarPubMed

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