Terrorism Disaster Medical Support Management
Written by Anam Hussain
Definition:
- United States Department of defence: terrorism is the is calculated sue of unlawful violence or threat of unlawful violence to inculcate fear. Intended to coerce or intimidate governments or societies in pursuit of goals that are generally political, religious or ideological
The main elements for terrorism are: violence, fear and intimidation. Each of these elements produces terror in its victims
Terrorism characteristics:
- Violence or threat of use of violence
- Clear and defined objective
- Target is the public opinion
- Modifying public opinion is the goal
Main damaging Factor in terrorism is: Psychological factor.
The main target for terrorists is not those dying or injured by their use of weapons but their goal is to intimidate the population. The fear of the population is their weapon for targeting the principal objective: the government, authorities and leaders of the country
AOD depends on weapons used by terrorists.
From a Disaster medicine point of view, required DMS is related to provision of medical aid to those are actual casualties, on the spot of the attack
Particularities of DMS in regards to terrorist attacks, are related to general situation and incident management
- Incident commander is from the Police force and not from fire safety or population protection
- Location of FMS or areas for medical teams is chosen by incident commander and decision is definitive
- In the actual AOD-
- due to security uncertainty; special police forces enter with main objective to locate and eradicate the terror hazard and to clean the area.
- Secondary tasks are to find casualties and survivors and organise their collection in previously cleared areas called nests
- Medical aid is only provided to those bleeding
- From nests, organised evacuation of casualties is conducted
- In FMS, triage is performed based only on urgency of medical support required
- Medical team task is to stabilise and evacuate all casualties in the most rapid and efficient manner
- Evacuation organisation is based only on: first stabilised and prepared is first evacuated. Triage evacuation principle is violated
- Medically equipped vehicles are not expected for evacuation
- Recommended to perform contamination screening in pre-hospital triage due to lack of triage in FMS
- Security concerns should be taken into consideration during prehospital triage
- Medical staff informed that all information regarding management of the situation should be given to the police and not the media, as the media could become an ally of the terrorist.