‘Terrorism is a global problem [and] it’s imperative that we learn about bomb blast injuries.’

Explosions are the most common cause of injuries associated with terrorism, according to the 2007 Institute of Medicine Report “The Future of Emergency Care in the United States Health System: Emergency Medical Services at the Crossroads.” Terrorist bombings have the potential to inflict multisystem, life-threatening injuries upon many people simultaneously, and they often present profound challenges to surge capacity at a moment’s notice.

And the scariest fact of all is that no one is immune to this ever-growing threat.

Nothing drove that point home more than the November 2008 terrorist attacks in Mumbai that killed more than 170 people. Since the 9/11 attacks utilizing aircraft in the United States, numerous high-profile attacks involving explosives have occurred in many countries worldwide.

But just how prepared are the world’s emergency physicians to treat the unique injuries often associated with blasts? The Centers for Disease Control and Prevention (CDC) approached ACEP 4 years ago with that exact question, awarding ACEP a grant to explore the issue further.

“There are some very unique injuries caused by blasts, especially those in closed spaces,” said Rick Murray, EMT-P, director of ACEP’s department of EMS and disaster preparedness. “We began these efforts with terrorist attacks in mind, but we soon realized that it didn’t matter if it was a terrorist attack, a propane explosion, or a suicide bomber on a subway—blast injuries would still result, and emergency physicians need to be prepared.”

ACEP convened experts in injury care to review the types of blast injury training that were available. “It was a huge thing for ACEP to facilitate bringing the international community from places like India and Pakistan to the United States to help us learn about bombings,” said Dr. Richard Hunt, director of the CDC’s Division of Injury Response and an ACEP member. “All of the efforts have been extremely worthwhile, and these experts have provided clinicians and public health professionals here in the United States with unique insights into the challenges of dealing with blast injuries.”

“This has very much been a two-way collaboration with our colleagues in the Indian government, because they have a great deal of experience in managing bombing and blast injury victims in circumstances that we in this country have rarely had to face,” said Vikas Kapil, D.O., M.P.H., associate director for science in the CDC’s Division of Injury Response.