Panamerican Journal of Trauma, Critical Care & Emergency Surgery

Register      Login

VOLUME 8 , ISSUE 3 ( September-December, 2019 ) > List of Articles

Original Article

Prehospital and First Hospital System Response to a Terrorist Attack in Bogotá, Colombia

Maria F Jimenez, Andrés Becerra, Sergio Cervera, Elio F Sánchez, Jorge Ospina, Francisco J Henao, Alexander Paz, Gabriel Paredes, María I Gutiérrez

Keywords : Bombing, Mass casualty, Medical response, Terrorist attack

Citation Information : Jimenez MF, Becerra A, Cervera S, Sánchez EF, Ospina J, Henao FJ, Paz A, Paredes G, Gutiérrez MI. Prehospital and First Hospital System Response to a Terrorist Attack in Bogotá, Colombia. Panam J Trauma Crit Care Emerg Surg 2019; 8 (3):143-147.

DOI: 10.5005/jp-journals-10030-1254

License: CC BY-NC 4.0

Published Online: 01-12-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: Assembling an effective medical response for an overwhelming number of casualties has become a priority worldwide. Terrorist attacks have been part of the Colombian contemporaneous history. On February 7, 2003, a terrorist car bomb explosion occurred inside a private club in Bogotá, causing the largest number of casualties of all terrorist attacks for over 15 years. The present study analyses the hospital and prehospital responses to this mass casualty event by characterizing the patterns of injury, resource allocation, and outcome in a tertiary-level hospital where most of the casualties were treated. Materials and methods: This is a retrospective chart review of the patients brought to a single hospital (La Clínica del Country), which was the nearest to the terrorist attack. Demographics, severity of injury, patterns of injury, prehospital care, and outcomes were determined from the hospital medical records and government registries. Results: Of the 240 victims, 35 died at the explosion site (immediate mortality 17%). The 205 survivors were dispersed throughout the city, of whom 63 patients came to La Clínica del Country hospital. Most of these patients were evaluated only clinically and deemed not serious. The main mechanism of trauma was blunt (81.4%). The mean injury severity score (ISS) was 5.6 ± 8.3. Ten patients required emergent surgical intervention and 14 patients were admitted. The in-hospital mortality was 20%. Conclusion: This mass casualty event was a true test for the Colombian emergency medical system and disaster preparedness. The medical response and resource optimization resulted in an overall mortality rate similar to those observed in the recent European and North American bombings. Despite the limited resources, the continuous challenge of terrorist\'s attacks in Colombia made the country feel the need for training and preparing the healthcare professionals, allowing effective delivery of medical care.


PDF Share
  1. Arnold JL, Tsai MC, Halpren P, et al. Mass-casualty, terrorist bombings: epidemiological outcomes, resource utilization, and time course of emergency needs (part I). Prehosp Disaster Med 2003;18(3):220–234. DOI: 10.1017/s1049023x00001096.
  2. Leibovici D, Gofrit ON, Stein M, et al. Blast injuries: bus versus open air bombings-a comparative study of injuries in survivors of open-air versus confined-space explosiosn. J Trauma 1996;41(6):1030–1035. DOI: 10.1097/00005373-199612000-00015.
  3. Medina E, Nieto A, Senior A. SIG para la Creación de Planes de Contingencia contra Actos Terroristas. Universidad Distrital Francisco Javier de Caldas. Proyecto Curricular de Ingeniería Catastral y Geodesia; 2006.
  4. Super G, Growth S, Hook R. START: simple triage and rapid treatment plan. Newport Beach (CA): Hoag Memorial Hospital Presbyterian; 1994. Funded in part by The Fogarty International Center: NIH Grant No. 1 D43 TW007560-01.
  5. Aylwin CA, Konig TC, Brennan NW, et al. Reduction in critical mortality in urban mass casualty incidents: analysis of triage, surge, and resource use after the London bombings on July 7, 2005. Lancet 2006;368(9554):2219–2225. DOI: 10.1016/S0140-6736(06)69896-6.
  6. Biancolini CA, DelBosco CG, Jorge MA. Argentine Jewish community institution bomb explosion. J Trauma 1999;47(4):728–732. DOI: 10.1097/00005373-199910000-00019.
  7. Hirschberg A, Scott BG, Granchi T, et al. How does casualty load affect trauma care in urban bombing incidents? A quantitative analysis. J Trauma 2005;58(4):686–693; discussion 694–695. DOI: 10.1097/01.ta.0000159243.70507.86.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.