Bomb Explosions in Acts of Terrorism: Evil Creativity Challenges Our Trauma Systems

An unprecedented wave of terror has captivated world attention, highlighted by events of increasing magnitude. 1-8 Terror represents extremists’ persistent efforts to invoke fear to force their philosophies on the world population. Not unlike disease outbreaks in world history, the current terror epidemic knows no borders and strikes innocent civilians during their most productive years of life. The objective of terrorists is to kill and maim as many citizens as possible and to incite fear and chaos, so dense population centers and locations where the public congregates are prime targets. Traditionally, key factors emphasized in epidemiologicstudieshaveincludedthemagnitudeoftheproblem, populations affected, and patterns of injury. Based on such reviews, interventional efforts have been tailored for specific injury prevention. Although politicians worldwide debate negotiated solutions, the medical community must respond to the immediate needs of the population, dealing with the devastating effects after such mass casualty events. The management of mass casualty events demands strict adherence to established protocols and coordinated mobilization of available manpower and medical resources, which are stressed to the maximum. Lessons learned from regions of the world that have encountered terrorist attacks reinforce the concept that the sheer volume of injured patients encountered in such events may challenge even the most mature trauma system and the most experienced individual institution. 9-13 Accordingly, as greater experience