Disaster and Mass Casualty Bibliography Blast Frykberg ER, Tepas JJ. Terrorist bombings: Lessons learned from Belfast to Beirut. Ann Surg 1988; 208: 569-576 A now classic paper that establishes a pattern of injury exists subsequent to blast events. Established the concept of critical mortality rate (CMR) and defines the case for appropriate triage by linking increased CMR with overtriage. DePalma RG, Burris DG, Champion HR, et al: Blast injuries. New Engl J Med 352:1335-1342, 2005. A useful overview of the physics and pathophysiology of blast injury, and how this relates to the proper evaluation and care of blast casualties. Born CT: Blast trauma: The fourth weapon of mass destruction. Scand J Surg 94:279285. A comprehensive review of the history of major explosive disasters, the physics and biodynamics of blasts, and how this relates to the injuries that should be anticipated for effective disaster planning and management. Sheffy N, Mintz Y, Rivkind AI, Shapira SC. Terror-related injuries: A comparison of gunshot wounds versus secondary-fragments-induced injuries from explosives. J Am Coll Surg 203:297303, 2006. A retrospective review of mass casualty victims from terrorist events in Israel showing a significantly increased rate of complications and mortality among those critically injured from bomb blast fragments compared with those from gunshot wounds, indicating that the complexity of wounds and decision-making from terrorist bombings is a surgical challenge requiring education and preparation for their proper handling. Burn Mass Casualty Events Mahoney EJ, Harrington DT, Biffl WL, Metzger J, Oka T, Cioffi WG. Lessons learned from a nightclub fire: Institutional disaster preparedness. J Trauma 2005;58:487-491. An organized account of the distribution and care of over 200 victims of a major fire in Rhode Island, documenting the contribution of a statewide disaster system based on its trauma center network, and active planning efforts, to the successful outcome of the medical response. Barriers to the disaster response were also identified and solutions proposed for the future. Tekin A, Namias N, O’Keefe T, et al. A burn mass casualty event due to boiler room explosion on a cruise ship: preparedness and outcomes. Am Surg 2005;71:210-215. An account of 15 burned patients presenting to a major Level I trauma center in Miami following a boiler room explosion and fire in 2003, with 45% critically burned, of whom 86% died. Injury patterns, prognostic factors, and the importance of disaster preparedness to handle such a casualty load are nicely reviewed. Rosenberg B, Sternberg N, Zagher V, et al. Burns due to terroristic attacks on civilian populations from 1975-1979. Burns 1982;9:21-23. A landmark account of burn injury patterns in a mass casualty setting from Israel. General/Epidemiology/History Arnold JL. Disaster medicine in the 21st century: Future hazards, vulnerabilities and risk. Prehosp Disast Med 2002; 17: 3-11 Reviews the conditions, both natural and man-made, which predispose to an increased likelihood of disasters and mass casualty events. Discusses common myths of disaster medicine. Ciraulo DL, Barie PS, Briggs SM, et al: An update on the surgeons scope and depth of practice to all hazards emergency response. J Trauma 60:1267-1274, 2006. A position paper of the Eastern Association for the Surgery of Trauma that reviews the major mass casualty disasters likely to confront medical providers, and the importance of surgeon leadership in disaster planning and management. Gutierrez de Ceballos JP, Turegano FF, Perez DD, et al: Casualties treated at the closest hospital in the Madrid, March 11, terrorist bombings. Crit Care Med 33:S107-112, 2005. This report describes how a large university hospital coped with a large-scale urban mass casualty incident in Madrid, 2005. It emphasizes the concept that only a small fraction of the casualty load consists of critically injured patients, and very few require immediate surgery. Klein JS, Weigelt JA. Disaster management: lessons learned. SCNA 1991; 71: 257- 266 A critical review of the experience of Parkland Hospital (Dallas TX) in the response to major airline crashes. Identifies common and repeated obstacles to performance such as planning and communications. Makes a strong case for the value of incident command. Mahoney LE, Reutershan TP. Catastrophic disasters and the design of disaster medical care systems. Ann Emerg Med 1987; 16:1085-1091. A landmark article that reviews the elements of medical systems that are essential for a successful medical response to mass casualty disasters. O’Neill PA: The ABC’s of disaster response. Scand J Surg 94:259-266, 2005. An excellent review of the basic principles and issues of disaster response at the prehospital and hospital levels, with a description of the structure, role and importance of the Incident Command System. Waeckerle JF: Disaster planning and response. NEJM 324:815-821, 1991. A concise review of basic principles of disaster planning and response that serves as a useful guide for all who wish to become acquainted with this field. Natural Disasters Norcross ED, Elliott BM, Adams DB, Crawford FA. Impact of a major hurricane on surgical services in a university hospital. Am Surg 1993;59:28-33. An informative account of the medical management of victims of Hurricane Hugo in Charleston, South Carolina in 1989, and what problems and resources should be anticipated in the wake of these disasters. Noji EK. The medical consequences of earthquakes: coordinating the medical and rescue response. Disaster Management 1991;4:32-40. An excellent review of general patterns of destruction and injury found after major earthquakes, and the implications for the medical and rescue response, by one of the world’s leading authorities in this field. Cocanour CS, Allen SJ, Mazabob J, et al. Lessons learned from the evacuation of an urban teaching hospital. Arch Surg 2002; 137:1141-1145. An account of the impact of Hurricane Alison and subsequent flooding in Houston, Texas on the delivery of medical services, providing important lessons for future similar events. Planning /Incident Command Auf der Heide E. The importance of evidence-based disaster planning. Ann Emerg Med 2006;47:34-49. A review of seven common flawed assumptions of occurrences and behaviors in disaster responses, with a review of current research from actual events that dispels many of these myths. The need for continued research into disaster principles and management is emphasized to develop realistic plans that can optimize disaster response. Burnett DJ, Balicer RD, Blodgett D et al. The application of the Haddon Matrix to public health readiness and response planning. Environ Health perspect 2005; 113: 561-6 A novel application of an established injury prevention tool to emergency preparedness. Hirshberg A, Holcomb JB, Mattox KL: Hospital trauma care in multiple-casualty incidents: A critical view. Ann Emerg Med 2001, 37:647-52 This review is a first attempt to address the especific implications of disaster preparedness on trauma care for severely injured patients. It addresses planning and training issues, triage and quality of trauma care in disasters. Psychsocial/Stress/Aftermath Hammond JS, Brooks J. Helping the helpers: The role of critical incident stress management. Crit Care 2001; 5:315-317. An introduction to the rationale and methodology of critical incident stress management as an effective tool to assure the welfare of disaster responders. Terrorism: General Arnold J, Halpern P, Tsai M, Smithline H. Mass casualty terrorist bombing: A comparison of outcomes by bombing type. Ann Emerg Med 2004; 43:263-273 A review of 29 bombings over past 30 years which resulted in >30 casualties. Describes patterns of injury and health system use. Slater MS, Trunkey DD. Terrorism in America: An evolving threat. Arch Surg 1997; 132:1059-66 A comprehensive review of the emerging threat of terrorism in the US. Issues a call to action by surgeons. Training Lennquist S. Education and training in disaster medicine. Scand J Surg 2005;94:300310. An excellent review of the rationale and methodology for effective training in disaster preparedness and management, including a list of some major training programs in the world. Hirshberg A, Stein M, Walden R: Surgical resource utilization in urban terrorist bombing: A computer simulation. J Trauma 47:545-550, 1999. A unique study of proper preparedness for disaster response using a computer simulation of a disaster based on data from actual events. Illustrates the typical problems with conventional disaster planning and how this information may be used to more realistically anticipate hospital resource needs Triage/Surge Capacity Ashkenazi I, Kessel B, Khashan T, Haspel J, Oren M, Olsha O, Alfici R. Precision of inhospital triage in mass-casualty incidents after terror attacks. Prehosp Disas Med 2006;21:20-23. A retrospective study of the accuracy of triage decisions rendered to mass casualties from two large incidents in Israel, showing high levels of inaccuracy even from the most experienced trauma surgeons, as compared to objective measures of injury severity. This emphasizes the need for backup mechanisms of continual reassessment. Frykberg ER. Triage: principles and practice. Scand J Surg 2005;94:272-278. A review of the essential principles of triage, and the unique applications of this concept that must be applied in mass casualty events, including the importance of triage accuracy, error-tolerant systems of response, the role of the triage officer, and decision-making. Hirshberg A, Scoot B, Granchi T et al. How does casualty load affect trauma carein urban bombing incidents: A quantitative analysis. J Trauma 2005; 58: 686-695 This paper presents an objective review of terror bombings, and employs a computer model of trauma center response. Identifies factors that will contribute to the degradation of quality of care as patient volume increases. WMD: Chemical/Radiological Chambers JA, Purdue GF. Radiation injuries and the surgeon. J Am Coll Surg. 2007;204:128-139. A thorough review of acute care and surgical/critical care issues after radiological injury and acute radiation syndrome. 73 references. Fry DE, Schecter WP, Parker JS, et al: The surgeon and acts of civilian terrorism: biologic agents. J Am Coll Surg 200:291-302, 2005. A comprehensive and useful review of principles and agents of bioterrorism, and the role of surgeons in mass casualty events involving this mechanism. This is the first of three articles on unconventional civilian disasters contributed by the Board of Governors of the American College of Surgeons. Eachempati SR, Flomenbaum N, Barie PS: Biological warfare: current concerns for the health care provider. J Trauma 52:179-186, 2002. A collective review of the relevant aspects of bioterrorism that all healthcare providers should know to optimize casualty outcomes from mass casualty biological events. Kiem ME. Terrorism involving cyanide: The prospect of improving preparedness in the prehospital setting. PreHosp Dis Med 2006;21: s56-s60. A good review of the pathophysiology and management of cyanide toxicity. Schecter, WP, Fry DE: The surgeon and acts of civilian terrorism: chemical agents. J Am Coll Surg 200:128-135, 2005. The second in the American College of Surgeons series on terrorist disasters, that addresses the pathophysiology and the principles of evaluation and management of mass casualty events from chemical agents.