Medical and psychiatric casualties caused by conventional and radiological (dirty) bombs

Hall, Ryan; Chapman, Marcia J.

doi:10.1016/j.genhosppsych.2006.03.001

Cited by 11 publications

(10 citation statements)

References 63 publications

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“…The nearest medical center should be prepared to treat fully urgent patients, as well as a large number of self-evacuated patients. [211] On the other hand, aggregation of people in the scene causes several problems for primary resuscitation of patients and then transfer to the hospitals. In the present study, medical centers were near to the scene and EMS rapidly referred the patients, it may have an important role in patients’ survival.…”

Section: Discussionmentioning

confidence: 99%

“…Early diagnosis, long-term follow up, and early medical and psychological help to the victims are important. [213]…”

Section: Discussionmentioning

confidence: 99%

“…[2] Explosive materials cause injuries in four mechanisms; primary blast injury is caused by the rapid outward spread of the shock wave, the energy of which is inversely proportional to the distance from the explosion's epicenter. Gas-containing organs such as the lungs, tympanic membranes, and bowel are the most susceptible parts to injury.…”

Section: Introductionmentioning

confidence: 99%

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Explosive attack: Lessons learned in Seyed Al Shohada mosque attack, April 2008, Shiraz, Iran

Paydar

Sharifian

Parvaz

et al. 2012

J Emerg Trauma Shock

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Introduction:The threat of explosive attacks has become a worldwide problem. Bombing is the preferred method of attacks. These attacks result in specific physical and psychiatric trauma. In this paper, we present an epidemiologic description of the physical injuries of patients who survived the explosive attack in Seyed Al Shohada mosque April 2008 Shiraz, Iran.Materials and Methods:All medical records of the patients admitted at Shiraz Hospitals on April 2008 due to Seyed Al Shohada mosque bombing attacks, Shiraz, Iran, were reviewed.Results:A total of 202 patients were referred to the hospitals over 24 h following the terrorist attack. One hundred sixty-four patients were admitted for short periods of observation (<24 h). Thirty-eight patients needed more than 1 day of hospitalization. The mean age of the patients was 26.2 (range 2 to 51) years. One hundred thirty-five (66.8%) patients were males. Twenty-six (12.8%) were children. Burn was the most prevalent cause of admission. Five (13.5%) patients needed chest tube insertion and eight (21%) needed skin grafts due to burn. Overall, 12 patients expired (5%). Three (25%) of them were children (2 and 6, and 11 years old). Mortality rate was significantly higher among the children than adults (P value <0.05). The most important cause of death was head trauma which was seen in five (41.6%) of the expired patients followed by burn (including air way burn) in four (33%), and internal bleeding in three (25%). Patients with head trauma had significantly a higher rate of mortality than other patients (P value <0.05).Discussion:Following a bombing attack, numerous victims were brought to the emergency unit suffering from a combination of multi-organ injuries caused by the blast, penetrating injuries caused by shrapnel and other debris, and burns. It is important for a physician to be familiar with the clinical features and treatments of explosive attacks victims. Early management of patients at the scene and hospital may save their life.

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Section: Discussionmentioning

confidence: 99%

“…Early diagnosis, long-term follow up, and early medical and psychological help to the victims are important. [213]…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Explosive attack: Lessons learned in Seyed Al Shohada mosque attack, April 2008, Shiraz, Iran

Paydar

Sharifian

Parvaz

et al. 2012

J Emerg Trauma Shock

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show abstract

“…The radioactive material may be enough to cause radiation sickness in exposed people, complicate cleanup efforts, or just act as a psychological weapon to increase anxiety among the public. 20,21 Some authorities prefer to include deliberate additives to IEDs in a separate category of quinary blast effects. 22 …”

Section: Quaternary Blast Effectsmentioning

confidence: 99%

Blast Injury

Lesperance¹,

Nuñez²

2015

Critical Care Nursing Clinics of North America

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“…There are data that show that the risk of developing PTSD is related to the type of trauma experienced. For example, many studies suggest that the occurrence rate of PTSD in patients involved in motor vehicle accidents ranges from 9% to 39%; for sexual assault/rape, up to 80%; for combat, between 15% and 35%; and when related to a terrorist attack, between 10% and 35% (1,3,7,14–21). The widely varying rates of PTSD in these situations cloud the study and diagnosis of the disorder and make it difficult to apply findings from one study/population (e.g., combat vs. civilian, male vs. female) to others.…”

Section: Prevalence Of Ptsd and Malingeringmentioning

confidence: 99%

Detection of Malingered PTSD: An Overview of Clinical, Psychometric, and Physiological Assessment: Where Do We Stand?

Hall

2007

Journal of Forensic Sciences

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Posttraumatic stress disorder (PTSD) is a condition that can be easily malingered for secondary gain. For this reason, it is important for physicians to understand the phenomenology of true PTSD and indicators that suggest an individual is malingering. This paper reviews the prevalence of PTSD for both the general population and for specific events, such as rape and terrorism, to familiarize evaluators with the frequency of its occurrence. The diagnostic criteria for PTSD, as well as potential ambiguities in the criteria, such as what constitutes an exposure to a traumatic event, are reviewed. Identified risk factors are reviewed as a potential way to help differentiate true cases of PTSD from malingered cases. The question of symptom overreporting as a feature of the disease versus a sign of malingering is discussed. We then examine how the clinician can use the clinical interview (e.g., SIRS, CAPS), psychometric testing, and the patient's physiological responses to detect malingering. Particular attention is paid to research on the MMPI and the subscales of infrequency (F), infrequency-psychopathology (Fp), and infrequency-posttraumatic stress disorder (Fptsd). Research and questions regarding the accuracy of self-report questionnaires, specifically the Mississippi Scale (MSS) and the Personality Assessment Inventory (PAI), are examined. Validity, usability, and cutoff values for other psychometric tests, checklists, and physiological tests are discussed. The review includes a case, which shows how an individual used symptom checklist information to malinger PTSD and the inconsistencies in his story that the evaluator detected. We conclude with a discussion regarding future diagnostic criteria and suggestions for research, including a systematic multifaceted approach to identify malingering.

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Medical and psychiatric casualties caused by conventional and radiological (dirty) bombs

Cited by 11 publications

References 63 publications

Explosive attack: Lessons learned in Seyed Al Shohada mosque attack, April 2008, Shiraz, Iran

Explosive attack: Lessons learned in Seyed Al Shohada mosque attack, April 2008, Shiraz, Iran

Blast Injury

Detection of Malingered PTSD: An Overview of Clinical, Psychometric, and Physiological Assessment: Where Do We Stand?

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