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Managing burn victims of suicide bombing attacks: outcomes, lessons learnt, and changes made from three attacks in Indonesia.
Crit Care. 2007; 11(1):R15.CC

Abstract

INTRODUCTION

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 Centre 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

Thirty-one patients were treated at the SGH Burns Centre in three 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 years (range 20 to 50 years), median percentage of total burn surface area (TBSA) was 29% (range 5% to 55%), and median abbreviated burn severity index (ABSI) was 6 (range 3 to 10). Eight of 15 patients were admitted to the intensive care unit. For the 2003 Jakarta attack, median age was 35 years (range 24 to 56 years), median percentage of TBSA was 10% (range 2% to 46%), and median ABSI was 4 (range 3 to 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.

CONCLUSION

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 organisation 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.

Authors+Show Affiliations

Department of Plastic Surgery and Burns, Singapore General Hospital, Singapore 169608, Singapore. harveychim@yahoo.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17274813

Citation

Chim, Harvey, et al. "Managing Burn Victims of Suicide Bombing Attacks: Outcomes, Lessons Learnt, and Changes Made From Three Attacks in Indonesia." Critical Care (London, England), vol. 11, no. 1, 2007, pp. R15.
Chim H, Yew WS, Song C. Managing burn victims of suicide bombing attacks: outcomes, lessons learnt, and changes made from three attacks in Indonesia. Crit Care. 2007;11(1):R15.
Chim, H., Yew, W. S., & Song, C. (2007). Managing burn victims of suicide bombing attacks: outcomes, lessons learnt, and changes made from three attacks in Indonesia. Critical Care (London, England), 11(1), R15.
Chim H, Yew WS, Song C. Managing Burn Victims of Suicide Bombing Attacks: Outcomes, Lessons Learnt, and Changes Made From Three Attacks in Indonesia. Crit Care. 2007;11(1):R15. PubMed PMID: 17274813.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Managing burn victims of suicide bombing attacks: outcomes, lessons learnt, and changes made from three attacks in Indonesia. AU - Chim,Harvey, AU - Yew,Woon Si, AU - Song,Colin, PY - 2006/11/27/received PY - 2006/12/27/revised PY - 2007/02/02/accepted PY - 2007/2/6/pubmed PY - 2007/5/12/medline PY - 2007/2/6/entrez SP - R15 EP - R15 JF - Critical care (London, England) JO - Crit Care VL - 11 IS - 1 N2 - INTRODUCTION: 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 Centre 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: Thirty-one patients were treated at the SGH Burns Centre in three 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 years (range 20 to 50 years), median percentage of total burn surface area (TBSA) was 29% (range 5% to 55%), and median abbreviated burn severity index (ABSI) was 6 (range 3 to 10). Eight of 15 patients were admitted to the intensive care unit. For the 2003 Jakarta attack, median age was 35 years (range 24 to 56 years), median percentage of TBSA was 10% (range 2% to 46%), and median ABSI was 4 (range 3 to 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. CONCLUSION: 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 organisation 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. SN - 1466-609X UR - https://www.unboundmedicine.com/medline/citation/17274813/Managing_burn_victims_of_suicide_bombing_attacks:_outcomes_lessons_learnt_and_changes_made_from_three_attacks_in_Indonesia_ L2 - https://ccforum.biomedcentral.com/articles/10.1186/cc5681 DB - PRIME DP - Unbound Medicine ER -