title: Measures for emergency medical technicians in helping victims at scenes guided by the pattern of injuries and bombing attacks in the three most southern provinces of Thailand.
abstract: Bombing attacks by terrorists in the three most southern provinces of Thailand increased both in frequency and intensity from the year 2004 until now. Patterns of bombing were not only destroying buildings or killing targets victims by dropping bombs under roads and in public places but also harming scene investigators by dropping second bombs nearby. Emergency medical personnel working there also had some risks from these second bombs while helping victims at the scene. The purposes of the present study aimed to describe patterns and risks of bombing attacks, analyze locations of wounds of bombing casualties and propose a standing operation procedure for emergency medical technicians (EMTs) in helping victims at scenes to reduce harm from second bombs. The authors gathered some information about patterns of bombing from the Forward 4th Army Area Explosive Ordnance Disposal (EOD) team and reviewed insurgency related casualty reports from Yala, Pattani and Narathivasrajanakarin Hospital from January 2004 to December 2006. From these reports, data of deep wounds or wounds that caused serious injuries or deaths of 144 improvised explosive devices (IED) victims was collected and separated into fatal (45 casualties) and nonfatal groups (99 casualties). In each group, casualties' demographic data and number of casualties separated by locations of wounds and occupations are shown and compared by percentage of the total number of each group and was found that most of fatal casualties had wounds on head (42.22%), chest (33.33%) and abdomen (33.33%) that should be protected by wearing helmets and body armors. But there was a higher proportion of extremity injuries in non-fatal casualties (63.64%). Thus, the authors proposed measures for EMTs in helping victims at scenes to reduce their risks by wearing helmets and body armors and quickly removal of the injured with minimal medical intervention.
authors.affiliation: Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand. piyapan84@hotmail.com
authors.forename: Piyapan
authors.initials: P
authors.lastname: Cheeranont
mesh_terms: D000062:Accidents, Occupational / Q000517:prevention & control; D000293:Adolescent; D000328:Adult; D000368:Aged; D054042:Bombs / Q000145:classification; D004189:Disaster Planning / Q000458:organization & administration*; D004632:Emergency Medical Services / Q000458:organization & administration*; D004634:Emergency Medical Technicians; D005107:Explosions; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D054527:Mass Casualty Incidents; D008875:Middle Aged; D012307:Risk Factors; D023481:Terrorism; D013785:Thailand; D014218:Triage; D014947:Wounds and Injuries / Q000401:mortality / Q000628:therapy; D055815:Young Adult