Skip to main content
Erschienen in: European Journal of Trauma and Emergency Surgery 2/2012

01.04.2012 | Original Article

Injury pattern of suicide bomb attacks in Pakistan

verfasst von: M. M. A. Yasin, G. Nasreen, S. A. Malik

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 2/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The aim of our study was to analyze the pattern of injuries, hospital care, and outcome of the victims of suicide bomb attacks in Pakistan.

Methods

This prospective, cohort study was conducted at the Combined Military Hospital Rawalpindi during the last 3 years. Seriously injured patients in the “immediate category” were resuscitated in the emergency operation theater adjacent to the emergency room and, after resuscitation, the patients were transferred to the main operation theaters, where consultant surgeons were available.

Results

During the study period, 1,296 terrorist victims presented to the emergency department and (86.9%) were admitted, with a mean hospital stay of 8.2 ± 2.1 days. The majority of patients arrived by ambulance (91%) and only 38 (3%) were evacuated by air. Penetrating splinter injuries were the most prevalent (87%), and 29% patients also had associated injuries. Open bone fractures were found in 48% and 42% had injured hollow and solid viscous. Overall, 33% of patients had thoracic injuries and neuro-trauma was observed in 16% of the study population. Deafness was a feature in 33% patients, 121 had to undergo limb amputations, and mortality remained in 7% of patients.

Conclusion

Most of the problems encountered were logistic in nature. Early evacuation of the victims remains pivotal in saving lives. The major causes of death in peripheral patients was hypovolemic shock, sepsis, and hypothermia. Mortality and morbidity can be enhanced by ample fluid resuscitation, tetanus prophylaxis, and proficient first aid at the site of injury.
Literatur
1.
Zurück zum Zitat Hirshberg A. Multiple casualty incidents: lessons from the front line. Ann Surg. 2004;239:322–4.PubMedCrossRef Hirshberg A. Multiple casualty incidents: lessons from the front line. Ann Surg. 2004;239:322–4.PubMedCrossRef
2.
Zurück zum Zitat Stein M, Hirshberg A. Medical consequences of terrorism. The conventional weapon threat. Surg Clin North Am. 1999;79:1537–52.PubMedCrossRef Stein M, Hirshberg A. Medical consequences of terrorism. The conventional weapon threat. Surg Clin North Am. 1999;79:1537–52.PubMedCrossRef
3.
Zurück zum Zitat Frykberg ER. Medical management of disasters and mass casualties from terrorist bombings: how can we cope? J Trauma. 2002;53:201–12.PubMedCrossRef Frykberg ER. Medical management of disasters and mass casualties from terrorist bombings: how can we cope? J Trauma. 2002;53:201–12.PubMedCrossRef
4.
Zurück zum Zitat Frykberg ER. Principles of mass casualty management following terrorist disasters. Ann Surg. 2004;239:319–21.PubMedCrossRef Frykberg ER. Principles of mass casualty management following terrorist disasters. Ann Surg. 2004;239:319–21.PubMedCrossRef
5.
Zurück zum Zitat Dhar D. Terrorist blast injuries. Internet J Rescue Disaster Med. 2007;7:1. Dhar D. Terrorist blast injuries. Internet J Rescue Disaster Med. 2007;7:1.
6.
Zurück zum Zitat Almogy G, Belzberg H, Mintz Y, Pikarsky AK, Zamir G, Rivkind AI. Suicide bombing attacks: update and modifications to the protocol. Ann Surg. 2004;239:295–303.PubMedCrossRef Almogy G, Belzberg H, Mintz Y, Pikarsky AK, Zamir G, Rivkind AI. Suicide bombing attacks: update and modifications to the protocol. Ann Surg. 2004;239:295–303.PubMedCrossRef
7.
Zurück zum Zitat Almogy G, Rivkind AI. Surgical lessons learned from suicide bombing attacks. J Am Coll Surg. 2006;202:313–9.PubMedCrossRef Almogy G, Rivkind AI. Surgical lessons learned from suicide bombing attacks. J Am Coll Surg. 2006;202:313–9.PubMedCrossRef
8.
Zurück zum Zitat American College of Surgeons. Advanced trauma life support (ATLS) manual. Chicago, IL; 1997. American College of Surgeons. Advanced trauma life support (ATLS) manual. Chicago, IL; 1997.
10.
Zurück zum Zitat Lewis B. The assassins. New York: Basic Books; 2002. Lewis B. The assassins. New York: Basic Books; 2002.
11.
Zurück zum Zitat Tsokos M, Paulsen F, Petri S, Madea B, Puschel K, Turk EE. Histologic, immunohistochemical, and ultrastructural findings in human blast lung injury. Am J Respir Crit Care Med. 2003;168:549–55.PubMedCrossRef Tsokos M, Paulsen F, Petri S, Madea B, Puschel K, Turk EE. Histologic, immunohistochemical, and ultrastructural findings in human blast lung injury. Am J Respir Crit Care Med. 2003;168:549–55.PubMedCrossRef
12.
Zurück zum Zitat DePalma RG, Burris DG, Champion HR, Hodgson MJ. Blast injuries. N Engl J Med. 2005;352:1335–42.PubMedCrossRef DePalma RG, Burris DG, Champion HR, Hodgson MJ. Blast injuries. N Engl J Med. 2005;352:1335–42.PubMedCrossRef
13.
14.
Zurück zum Zitat Mujeeb SA, Jaffery SH. Emergency blood transfusion services after the 2005 earthquake in Pakistan. Emerg Med J. 2007;24:22–4.PubMedCrossRef Mujeeb SA, Jaffery SH. Emergency blood transfusion services after the 2005 earthquake in Pakistan. Emerg Med J. 2007;24:22–4.PubMedCrossRef
15.
Zurück zum Zitat Gillet Y. Experience of Handicap International in providing humanitarian relief in region near Aceh, Indonesia from March 1 to 27, 2005. Med Trop. 2005;65:117–20. Gillet Y. Experience of Handicap International in providing humanitarian relief in region near Aceh, Indonesia from March 1 to 27, 2005. Med Trop. 2005;65:117–20.
16.
Zurück zum Zitat Kapila M, McGarry N, Emerson E, Fink S, Doran R, Rejto K, Profili MC. Health aspects of the Tsunami disaster in Asia. Prehospital Disaster Med. 2005;20:368–77.PubMed Kapila M, McGarry N, Emerson E, Fink S, Doran R, Rejto K, Profili MC. Health aspects of the Tsunami disaster in Asia. Prehospital Disaster Med. 2005;20:368–77.PubMed
17.
Zurück zum Zitat Emerson N, Pesigan A, Sarana L, Motus N, Buriak D, Randall T. Panel 2.7: first 30 days: organizing rapid responses. Prehospital Disaster Med. 2005;20:420–2.PubMed Emerson N, Pesigan A, Sarana L, Motus N, Buriak D, Randall T. Panel 2.7: first 30 days: organizing rapid responses. Prehospital Disaster Med. 2005;20:420–2.PubMed
18.
Zurück zum Zitat Peleg K, Aharonson-Daniel L, Michael M, Shapira SC. Patterns of injury in hospitalized terrorist victims. Am J Emerg Med. 2003;21:258–62.PubMedCrossRef Peleg K, Aharonson-Daniel L, Michael M, Shapira SC. Patterns of injury in hospitalized terrorist victims. Am J Emerg Med. 2003;21:258–62.PubMedCrossRef
19.
Zurück zum Zitat Leibovici D, Gofrit ON, Stein M, Shapira SC, Noga Y, Heruti RJ, Shemer J. Blast injuries: bus versus open-air bombings—a comparative study of injuries in survivors of open-air versus confined-space explosions. J Trauma. 1996;41:1030–5.PubMedCrossRef Leibovici D, Gofrit ON, Stein M, Shapira SC, Noga Y, Heruti RJ, Shemer J. Blast injuries: bus versus open-air bombings—a comparative study of injuries in survivors of open-air versus confined-space explosions. J Trauma. 1996;41:1030–5.PubMedCrossRef
20.
Zurück zum Zitat Lavery GG, Lowry KG. Management of blast injuries and shock lung. Curr Opin Anaesthesiol. 2004;17:151–7.PubMedCrossRef Lavery GG, Lowry KG. Management of blast injuries and shock lung. Curr Opin Anaesthesiol. 2004;17:151–7.PubMedCrossRef
21.
Zurück zum Zitat de Ceballos JP, Turégano-Fuentes F, Perez-Díaz D, Sanz-Sánchez M, Martin-Llorente C, Guerrero-Sanz JE. 11 March 2004: the terrorist bomb explosions in Madrid, Spain—an analysis of the logistics, injuries sustained and clinical management of casualties treated at the closest hospital. Crit Care. 2005;9:104–11.PubMedCrossRef de Ceballos JP, Turégano-Fuentes F, Perez-Díaz D, Sanz-Sánchez M, Martin-Llorente C, Guerrero-Sanz JE. 11 March 2004: the terrorist bomb explosions in Madrid, Spain—an analysis of the logistics, injuries sustained and clinical management of casualties treated at the closest hospital. Crit Care. 2005;9:104–11.PubMedCrossRef
22.
Zurück zum Zitat Frykberg ER, Tepas JJ. Terrorist bombings. Lessons learned from Belfast to Beirut. Ann Surg. 1988;208:569–76.PubMedCrossRef Frykberg ER, Tepas JJ. Terrorist bombings. Lessons learned from Belfast to Beirut. Ann Surg. 1988;208:569–76.PubMedCrossRef
23.
Zurück zum Zitat Pizov R, Oppenheim-Eden A, Matot I, Weiss YG, Eidelman LA, Rivkind AI, Sprung CL. Blast lung injury from an explosion on a civilian bus. Chest. 1999;115:165–72.PubMedCrossRef Pizov R, Oppenheim-Eden A, Matot I, Weiss YG, Eidelman LA, Rivkind AI, Sprung CL. Blast lung injury from an explosion on a civilian bus. Chest. 1999;115:165–72.PubMedCrossRef
24.
Zurück zum Zitat Biancolini CA, Del Bosco CG, Jorge MA. Argentine Jewish community institution bomb explosion. J Trauma. 1999;47:728–32.PubMedCrossRef Biancolini CA, Del Bosco CG, Jorge MA. Argentine Jewish community institution bomb explosion. J Trauma. 1999;47:728–32.PubMedCrossRef
25.
Zurück zum Zitat Bergman SA. Ketamine: review of its pharmacology and its use in pediatric anesthesia. Anesth Prog. 1999;46:10–20.PubMed Bergman SA. Ketamine: review of its pharmacology and its use in pediatric anesthesia. Anesth Prog. 1999;46:10–20.PubMed
26.
Zurück zum Zitat Green SM, Clem KJ, Rothrock SG. Ketamine safety profile in the developing world: survey of practitioners. Acad Emerg Med. 1996;3:598–604.PubMedCrossRef Green SM, Clem KJ, Rothrock SG. Ketamine safety profile in the developing world: survey of practitioners. Acad Emerg Med. 1996;3:598–604.PubMedCrossRef
Metadaten
Titel
Injury pattern of suicide bomb attacks in Pakistan
verfasst von
M. M. A. Yasin
G. Nasreen
S. A. Malik
Publikationsdatum
01.04.2012
Verlag
Springer-Verlag
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 2/2012
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-011-0090-9

Weitere Artikel der Ausgabe 2/2012

European Journal of Trauma and Emergency Surgery 2/2012 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

TEP mit Roboterhilfe führt nicht zu größerer Zufriedenheit

15.05.2024 Knie-TEP Nachrichten

Der Einsatz von Operationsrobotern für den Einbau von Totalendoprothesen des Kniegelenks hat die Präzision der Eingriffe erhöht. Für die postoperative Zufriedenheit der Patienten scheint das aber unerheblich zu sein, wie eine Studie zeigt.

Lever-Sign-Test hilft beim Verdacht auf Kreuzbandriss

15.05.2024 Vordere Kreuzbandruptur Nachrichten

Mit dem Hebelzeichen-Test lässt sich offenbar recht zuverlässig feststellen, ob ein vorderes Kreuzband gerissen ist. In einer Metaanalyse war die Vorhersagekraft vor allem bei positivem Testergebnis hoch.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

03.05.2024 Fibromyalgiesyndrom Nachrichten

Bewegungs-, Dehnungs- und Entspannungsübungen im Wasser lindern die Beschwerden von Patientinnen mit Fibromyalgie besser als das Üben auf trockenem Land. Das geht aus einer spanisch-brasilianischen Vergleichsstudie hervor.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.