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

01-04-2012 | Original Article

Injury pattern of suicide bomb attacks in Pakistan

Authors: M. M. A. Yasin, G. Nasreen, S. A. Malik

Published in: European Journal of Trauma and Emergency Surgery | Issue 2/2012

Login to get access

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.
Literature
1.
2.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference Lewis B. The assassins. New York: Basic Books; 2002. Lewis B. The assassins. New York: Basic Books; 2002.
11.
go back to reference 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.
13.
14.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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
Metadata
Title
Injury pattern of suicide bomb attacks in Pakistan
Authors
M. M. A. Yasin
G. Nasreen
S. A. Malik
Publication date
01-04-2012
Publisher
Springer-Verlag
Published in
European Journal of Trauma and Emergency Surgery / Issue 2/2012
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-011-0090-9

Other articles of this Issue 2/2012

European Journal of Trauma and Emergency Surgery 2/2012 Go to the issue