International study finds ways to maximize effective responses after terrorism incidents

An important part of Scene Security is ensuring that people are who they say they are and are not a threat to the responders or bystanders. A hospital that received the bulk of patients from a bombed housing complex in Riyadh, Saudi Arabia, found this was very difficult, since members of the staff were showing up at the hospital without their identification badges leaving security guards to make difficult decisions about who to let in.

Support requires additional trained human resources for all incidents, but they are needed in a controlled manner. Many speakers stated that it took time to recall staff and that they needed to consider how to maintain medical systems for hours and days after the initial incident, not just to meet the initial demand. For example, as the trauma hospital in Darwin, Australia, prepared to receive patients from the Bali, Indonesia, night club explosion, they used the media to ask people not come to the emergency department unless they had a true emergency. However, this request did not significantly decrease the number of patients that came to the emergency department for care.

In considering evacuation, it was important to consider that many terrorist bombings occur in remote tourist communities in developing countries such as Turkey and Indonesia. This complicates the response since hospitals in tourist communities do not typically have the resources to attend to many severely injured casualties. Therefore, patients need to be stabilized and moved to larger hospitals that are some distance away. Another complication is that incidents in resort towns typically involve foreign nationals. This creates a situation where governmental agencies need to be involved in the response and arrangements need to be made to move patients back to their home countries. This may require specialty transport services depending on the nature of the injuries and the care required during transport.

An important component of recovery is informing the general public of the extent of the event, where they can receive assistance if needed, whether there are continued risks and how to mitigate them. Further, community awareness and notifying authorities if something seemed out of the norm was found to be important, particularly by the Israelis who feel that their population is always alert and reports anything that seems suspicious.

"This project provides an initial framework for learning lessons for preparing for terrorist events. However, the next steps are to identify best practices in response to a blast-incident and to develop a research agenda that will guide research priorities," Dr. Lerner says.