Medical care in civil disorder

Cocks, Robert A.

doi:10.1177/146040869900100309

Cited by 5 publications

(5 citation statements)

References 18 publications

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“…Mumbai is a prosperous symbol of modern India and the most densely populated city in the world (29 650 people per square kilometer),1 which makes it a highly visible target for terrorists. Terrorist acts of violence induce a disproportionate state of fear in the public when compared to the number of people killed by other methods 2…”

mentioning

confidence: 99%

Mass Casualty Response in the 2008 Mumbai Terrorist Attacks

Roy¹,

Kapil²,

Subbarao³

et al. 2011

Disaster med. public health prep.

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ABSTRACTObjectives: The November 26-29, 2008, terrorist attacks on Mumbai were unique in its international media attention, multiple strategies of attack, and the disproportionate national fear they triggered. Everyone was a target: random members of the general population, iconic targets, and foreigners alike were under attack by the terrorists.Methods: A retrospective, descriptive study of the distribution of terror victims to various city hospitals, critical radius, surge capacity, and the nature of specialized medical interventions was gathered through police, legal reports, and interviews with key informants.Results: Among the 172 killed and 304 injured people, about four-fifths were men (average age, 33 years) and 12% were foreign nationals. The case-fatality ratio for this event was 2.75:1, and the mortality rate among those who were critically injured was 12%. A total of 38.5% of patients arriving at the hospitals required major surgical intervention. Emergency surgical operations were mainly orthopedic (external fixation for compound fractures) and general surgical interventions (abdominal explorations for penetrating bullet/shrapnel injuries).Conclusions: The use of heavy-duty automatic weapons, explosives, hostages, and arson in these terrorist attacks alerts us to new challenges to medical counterterrorism response. The need for building central medical control for a coordinated response and for strengthening public hospital capacity are lessons learned for future attacks. These particular terrorist attacks had global consequences, in terms of increased security checks and alerts for and fears of further similar “Mumbai-style” attacks. The resilience of the citizens of Mumbai is a critical measure of the long-term effects of terror attacks.(Disaster Med Public Health Preparedness. 2011;5:273–279)

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confidence: 99%

Mass Casualty Response in the 2008 Mumbai Terrorist Attacks

Roy¹,

Kapil²,

Subbarao³

et al. 2011

Disaster med. public health prep.

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“…Riot control agents such as CN [chloroacetophenone], CS [chlorobenzylidenemalononitrile] and chlorpicrin are classified separately and many are still in current use. 7 Possible terrorist use of incapacitating agents has received little attention, apart from considerations of a need for public health surveillance to detect biological attack.…”

Section: Ethical Considerationsmentioning

confidence: 99%

Incapacitating Agents: Weapons of Mass Disruption

Cocks

Chan

2005

Hong Kong Journal of Emergency Medicine

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Terrorism, and with it the possibility of hostage taking and sieges, has become a common feature of our times. The gas used to subdue terrorists in Moscow on 26 October 2002, which appeared to be responsible for the deaths of 123 of the 127 hostages killed in the crisis, remains unknown. Much criticism was levelled at the Russian security forces following the rescue of hostages for not revealing the exact agent used. This paper asks the questions: how deeply should doctors be drawn into the non-medical use of drugs and the unorthodox use of medical knowledge, and how can they help to predict and plan responses to misuse by others?

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“…In situations of civil disorder, initial management of the injured presents special hazards, and Police medical teams may be the most appropriate providers. 7 In some inner city areas, ambulance staff are routinely provided with bulletproof vests. 30…”

Section: The Perils Of Prehospital Carementioning

confidence: 99%

“…In addition, it proved useful at an incident in 1994 when a malicious pepper-spray attack affected 40 people in a crowded pub in London. 7 On that occasion, the van was loaded up with large numbers of hospital gowns and blankets. These were essential to cover patients who had to remove their contaminated clothes on the December night.…”

Section: A Personal Perspectivementioning

confidence: 99%

Reflections on Twenty Years of Prehospital Care

Cocks

2000

Hong Kong j. emerg. med.

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Although Accident and Emergency staff may feel that prehospital care is the province of the ambulance service alone, their interest in this area is important. Both A&E doctors and nurses have an important role to play in the training of paramedics, and in some circumstances in the direct provision of prehospital care. Physician involvement in routine prehospital care, whether by land or helicopter transport, is still controversial. This paper reviews some of the issues involved in prehospital care over the last twenty years, in addition to a personal perspective from the author. In the absence of a firm evidence base to lead the way to future development in Hong Kong, more research will be needed by doctors, nurses and ambulance staff.

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Medical care in civil disorder

Cited by 5 publications

References 18 publications

Mass Casualty Response in the 2008 Mumbai Terrorist Attacks

Mass Casualty Response in the 2008 Mumbai Terrorist Attacks

Incapacitating Agents: Weapons of Mass Disruption

Reflections on Twenty Years of Prehospital Care

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