Defining the problem, main objective, and strategies of medical management in mass-casualty incidents caused by terrorist events.

Based on the experience of managing > 20 such events during the last decade, the authors' understanding of a mass-casualty incident is that it is an event in which there may be many victims, but only a few that actually suffer from life-threatening injuries. To make an impact on survival, one must identify those who are severely wounded as quickly as possible and offer those patients optimal care. Experienced trauma physicians are the most important resource available to achieve this objective, and they should be allocated to the treatment of seriously injured victims instead of more traditional management roles such as triage and incident manager.

Effect of teleradiology upon pattern of transfer of head injured patients from a rural general hospital to a neurosurgical referral centre.

Objective: To assess the effect of teleradiology upon the need for transfer of head injured victims requiring hospitalisation but referred initially to a rural level 2 trauma centre without neurosurgical capacity.

Methods: Head injured patients requiring hospitalisation, admitted to a rural level 2 trauma centre between August 2003 and August 2005, were identified. A digitalised copy of the computed tomographic (CT) scan was transferred to the neurosurgical referral centre via teleradiology and was available for review by the neurosurgeon on-call, who then, together with the trauma surgeon in the rural level 2 trauma centre, decided whether to transfer the patient to the neurosurgical referral centre.

Significance of a Level-2, "selective, secondary evacuation" hospital during a peripheral town terrorist attack.

Introduction: Mass-casualty incidents (MCIs) can occur outside of major metropolitan areas. In such circumstances, the nearest hospital seldom is a Level-1 Trauma Center. Moreover, emergency medical services (EMS) capabilities in such areas tend to be limited, which may compromise prehospital care and evacuation speed.

Precision of in-hospital triage in mass-casualty incidents after terror attacks.

Introduction: Proper management of mass-casualty incidents (MCIs) relies on triage as a critical component of the disaster plan.

Objective: [corrected] The objective of this study was to assess the precision of triage in mass-casualty incidents.

Methods: The precision of decisions made by two experienced triage officers was examined in two large MCIs.