[Diagnostic imaging departments' responses to terrorist attempts with multiple victims.].
OBJECTIVE
To analyze whether the radiological management of seriously injured victims from the March 11 terrorist attempt was affected by the large number of victims treated at two hospitals in Madrid. To evaluate the organization for providing imaging services, detect failings, and propose a protocol for diagnostic imaging departments.


METHODS
Two hundred and fifty one patients arrived at hospital A and 36 at hospital B. Both centers have emergency imaging areas and protocols for the treatment of patients with multiple trauma. We compared organizational aspects (classification, identification), material resources, human resources, healthcare resources (number and type of examinations), as well as the initial radiological management with the usual protocol and with the recommendations for incidents with multiple victims.


RESULTS
In hospital A, patients' injuries were classified as severe (175) or minor (76); in hospital B, injuries were classified as extremely severe (13), severe (4), or minor (19). Additional staff were assigned to the emergency imaging areas in both hospitals. In hospital A, 62 portable plain-film radiographs, 39 ultrasonographic examinations, 25 cranial CT examinations, 6 cervical CT examinations, 2 chest CT examinations, and 2 abdominopelvic CT examinations were performed. In hospital B, 19 portable plain-film radiographs (74 in total), 9 ultrasonographic examinations, 17 cranial-chest-abdominopelvic CT examinations, 2 cervical CT examinations, 2 orbital CT examinations, and 2 CT examinations of the sinuses were performed.


CONCLUSIONS
In both hospitals, each victim was managed as if he or she were the only patient. The discrepancies between the two hospitals were due to differences in the usual protocol for multiple trauma patients. In light of the organizational errors discovered, we propose a plan of action based on the identification and progressive activation of material and human resources until sufficient levels are achieved.
Martí
M
M
Servicio de Radiodiagnóstico, Hospital Universitario La Paz, Madrid, España. mmarti.hulp@salud.madrid.org
Roldán
J
J
Parrón
M
M
Bernabeu
D
D
Alvarez Sala
R
R
D002959:Civil Defense; D004636:Emergency Service, Hospital; D006801:Humans; D009104:Multiple Trauma / Q000000981:diagnostic imaging* / Q000628:therapy*; D011859:Radiography; D011872:Radiology Department, Hospital; D013030:Spain; D023481:Terrorism