Excerpt from EMS and Terrorism

Synonyms, Key Words, and Related Terms: Emergency Medical Services, EMS planning, terrorist attack, terrorist activities, suicide attack, suicide bombing, chemical weapons, biological weapons, nuclear weapons, explosives, conventional explosives, bombing, weapons of mass destruction, National Disaster Medical System, NDMS, Domestic Preparedness Program, terrorist incident management, mass casualty incidents, positive pressure wave, negative pressure wave, black powder, nitrostarch, nitrocellulose, high-grade explosives, nitroglycerin, ammonium nitrate, composition B, composition C-3, composition C-4, TNT, Amatol 80/20, RDX, PETN, dynamite, styphnate, lead azide, primary blast injury, secondary blast injury, tertiary blast injury, chemical agents, cyanide compounds, nerve agents, choking agents, vesicant agents, blistering agents, lacrimator agents, tear gases, emesis-inducing agents, nausea gases, incapacitating agents, infectious agents, anthrax, brucellosis, encephalitis viruses, Clostridium botulinum,Yersinia pestis, plague,Coxiella burnetii, Q fever, rift valley fever, smallpox virus, Francisella tularensis, tularemia, noninfectious agents

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Although present in various forms and locations for countless years, terrorism has increasingly been the focus of public concern. Emergency Medical Services (EMS) plays a vital role in responding to, evaluating, and intervening in potentially catastrophic events. EMS often co-manages initial scenes in many medium- to large-scale incidents involving large numbers of casualties. EMS may also manage the scene until state or federal agencies arrive.

Americans will never forget the tragic events of September 11, 2001. More than 3350 people were killed, and more than 10,000 people were injured in an incredibly complicated and choreographed attack. However, not all remember the World Trade Center bombing in 1993 that killed 6 people and injured more than 1000. In April 1995, the federal building in Oklahoma City was bombed, killing 168 people. A pipe bomb was detonated in Centennial Park during the 1996 Olympic Games in Atlanta, Georgia, killing 2 people and wounding 110. The bombing of 4 commuter trains in March 2004 claimed the lives of 190 and injured more than 1800 people in Madrid, Spain. Such events emphasize the potential loss of life and property caused by terrorist activities.

Many authorities consider the United States a continuing high-profile target. For all Americans, the attack on the World Trade Center on September 11, 2001, brought home the tragic realization that America is not immune to terrorism. Philip Stern, an expert on terrorism with the Fairfax Group, said, "As an open society and a democracy, this country is particularly vulnerable. We have free passage, coast-to-coast, anyone can apply for a visa to visit and the population is enormous and diversified."

Such an inviting atmosphere and free society may make terrorist activity inevitable. Many of the terrorist groups of today appear more and more willing to use weapons of mass destruction. Perhaps even more disturbing is the potential for terrorists to utilize more technologically advanced weapons and communications. Access to the Internet and information on the World Wide Web facilitates tremendous technological advancement in destructive potential.

All of these issues underscore the importance of proper education in EMS and advance planning. Terrorist activity may have various mechanisms, including chemical or biological weapons and explosives, as well as new and unanticipated methods of destruction. Full response to a terrorist incident requires in-depth interagency planning involving police; fire; EMS; regional, state, and national emergency organizations; as well as a wide array of ancillary community services. Each agency should be assigned respective roles as soon as possible, well in advance of potential terrorist acts.

For related information, see Medscape's Disaster Preparedness and Aftermath Resource Center.

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