Citation

Chim H, Yew WS, Song C. Crit. Care 2007; 11(1): R15.

Copyright

(Copyright © 2007, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/cc5681

PMID

17274813

PMCID

PMC2151909

Abstract

BACKGROUND: Terror attacks in Southeast Asia were almost nonexistent until the 2002 Bali bomb blast, considered the deadliest attack in Indonesian history. Further attacks in 2003 (Jakarta), 2004 (Jakarta) and 2005 (Bali) have turned terrorist attacks into an ever-present reality. METHODS: The authors reviewed medical charts of victims evacuated to the Singapore General Hospital (SGH) Burns Center during three suicide attacks involving Bali (2002 and 2005) and the Jakarta Marriott hotel (2003). Problems faced, lessons learnt and costs incurred are discussed. A burns disaster plan drawing on lessons learnt from these attacks is presented. RESULTS: 31 patients were treated at the SGH Burns Center in 3 attacks (2002 Bali attack (n=15), 2003 Jakarta attack (n=14) and 2005 Bali attack (n=2)). For the 2002 Bali attack, median age was 29 (range 20 to 50), median total burn surface area (TBSA) was 29% (range 5 to 55) and median abbreviated burn severity index (ABSI) was 6 (range 3 to 10). 8/15 patients were admitted to the ICU. For the 2003 Jakarta attack, median age was 35 (range 24 to 56), median TBSA was 10 (range 2 to 46) and median ABSI was 4 ( range 3-9). A large number of patients had other injuries. Problems faced included manpower issues, lack of bed space, shortage of blood products and lack of cadaver skin. CONCLUSIONS: The changing nature of terror attacks mandates continued vigilance and disaster preparedness. The multidimensional burns patient, complicated by other injuries, is likely to become increasingly common. A burns disaster plan with emphasis on effective command, control and communication as well as organization of health care personnel following a team concept will do much to ensure that the sudden onset of a crisis situation at an unexpected time does not overwhelm hospital manpower and resources.

Language: en