Evidence-based terrorism

 Updated_20040830

 

     The world under threat

Evidence-based Disaster Medicine   
Arnold J. Yale New Haven Center for Emergency and Terrorism Preparedness. From 2004 Apr. Qatar Conf.

Journal of PREHOSPITAL AND DISASTER MEDICINE
Médicine Pre-Hospitalière et Médicine de Catastrophe
Medicina Prehospitalária y de Catástrofes

The Official Medical Journal of the World Association for Disaster and Emergency Medicine and the Nordic Society for Disaster Medicine


Terrorism history    Still pending

  9-11 NY WTC   March-11 Madrid


McKinsey independent initial report  


9/11 Commission full report

WTC and Pentagon 9/11Selected Resources

http://www.911investigations.net/
    One of the most complete documents database

http://www.911review.org
http://www.serendipity.li
   An iconoclast but interesting critical thinking about

Federal Building Fire Safety Investigation of the World Trade Center Disaster. Project #8. Emergency Response    
Lawson JR
  
 Preliminary prehospital analysis

March-11 Madrid EMS analysis. An analytical report.
   (Evidence-based March-11)
      
    
Serrano Moraza A, Briñas Freire MJ, Pacheco Rodríguez A, Pérez Belleboni A

March-11 Madrid SUMMA 112 Coordination   

     Briñas Freire MJ. EMD. Serrano Moraza A      
 
Análisis Técnico de la Respuesta sanitaria del 11-M     
    
Serrano Moraza A, Briñas Freire MJ  

 

 Hospital data

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   
 
  Peral Gutierrez de Ceballos J, Turégano-Fuentes F, Perez-Diaz D,Sanz-Sanchez M, 
   Martín Llorente C, Guerrero Sanz JE 
   Critical Care 2004;8 (DOI 10.1186/cc2995)

Terrorist bombings in Madrid [editorial]    

  
Frykberg E. 
Critical Care 2004;8 (DOI 10.1186/cc2997)

Madrid. 11 de marzo 2004. Datos Doce de Octubre   
   Blanco Echevarría A. www.jemu.net Biarritz, Nov. 2004.

Applied_Principles_Lessons-Learned   
  
David TE. From the CDC
        And some other articles about blast injury from the same source 

 

     Fighting against terrorism

The human dimension of disasters: improving societal resilence through the application of sociological research   
Tierney K

The human factors response to terrorism 
 
Hancock P

Information Fusion for Natural and Man-Made Disasters: Earthquakes and ChemBio Threats   
Llinas J

Emergency management & mass casualty terrorism     
Barbera JA 

* Next table is adapted from Gilmore X.
Structuring a strategic vision for the United States in the war of terrorism   

 
Awareness   Prevent   Prepare   Respond   Recover
 
Analyze
Assess
Advise
Predict
Monitor
Forecast
Detect
Intel

HSAS threat level
  Detect
Mitigate
Interdict
Immunize
Investigate
Quarantine
Protect
Preempt
Disrupt
Deter
Defend
Intel
  Train
Equip
Exercise
Stockpile
Readiness
Pre-deploy
Credential
Evaluate
Develop
Test
Shelter
Evacuate
  Rescue
Save lives

Protect property

Protect
environment

Investigate
  Restore

Return to normal

Reconstitute

Rebuild

Cleanup

Prosecute


a    Awareness

Changing relationship between science and government post 9-11-02   
Branscombe LM

Transportation Security: Safeguarding the Shipment of America's Most Dangerous Cargoes against Terrorist Attack   
Badolato E

Miniature integrated nuclear detection system (MINDS) 
 
Gentile C, Meixler L

Preparing for terrorism 
 
Mozingo A

A response to terrorism 
 
From Drexel Univ. Dpt. of Public Safety

a    Prevent

Natural disaster reduction   
Selvaduray G

The regulated research university, post 9/11/2001. Restrictions on University Research Activity
Biohazardous materials. Export controls
 
Bienstock R

Social science and disaster research. Perspectives on the September 11 attacks
 
Tierney K

a    Respond

Terrorism resources and information

The Medical Response to Modern Terrorism:
Why the “Rules of Engagement” Have Changed 

Eckstein M. Ann Emerg Med 1999;34:219-221
.

Telecommunications Systems in Support of Disaster Medicine: Applications of Basic Information Pathways 
Garshnek V, Burkle FM. Ann Emerg Med August 1999;34:213-218

Terrorism and the Ethics of EmergencyMedical Care 
Pesik N, Keim ME, Iserson KV. Ann Emerg Med. June 2001;37:642-646

The impact of mass casualties on the Health Care Delivery System - conventional injuries   
González MS

Wireless Internet Information System for Medical Response in Disasters (WIISARD)   
From UCSD School of Medicine

The vital role of communications in controlling crisis and emergency response   
Lynch K

Interoperability. A Guide to Communications Planning   
Worthington M

Explosions and blast injuries   
Wightman JM, Gladish SL. Ann 
Emerg Med. June 2001;37:664-678

Eardrum perforation in explosion survivors: Is it a marker of pulmonary blast injury?    Pending
Leibovici D, Gofrit ON, Shapira SC.
Ann Emerg MedAugust 1999;34:168-172

Argentine Jewish Community Institution Bomb Explosion   Pending
Biancolini CA, del Bosco CG, Jorge MA
J Trauma 1999;47(4):728

Life Sign Detection Component of WPSM for Casualty Care and Triage    Pending
Pearce FJ

Medical management of disasters and mass casualties from terrorist bombings: how can we cope?  Pending
Frykberg ER. J Trauma 2002;53(2):201-212.

Blast injuries: bus versus open-air bombings. A comparative study of injuries in survivors of open-air versus confined-space explosions  Pending

Leibovici, Dan MD; Gofrit, Ofer N. MD; Stein, Michael MD; Shapira, Shmuel C. MD; Noga, Yossi MD; Heruti, Rafael J. MD; Shemer, Joshua MD
J Trauma 1996;41(6):1030-1035


Incident Command System (ICS) and Emergency Management Training for  the Public Health Workforce
Denver Center for Public Health Preparedness (DCPHP). June 12, 2003

And see also Prehospital triage.


     Bioterrorism preparedness

Overview of bioterrorism research at the CDC   
Snider DE


Terrorism rebuttal   
Tolbert W

Bioterrorism Web Resources   
From the Public Health Preparedness Resource Guide. Aug 2003

Radiological terrorism: Introduction
 

Radiological terrorism. The "Dirty Bomb"
 

Bioterrorism preparedness   
Tisdale B


Air Quality and The World Trade Center Disaster  


     Post-traumatic stress disorder  PTSD

Syn: "soldier's heart", "shell shock", "traumatophobia", "war neurosis", "rape trauma syndrome" and so on.         
First included in DSM-III in 1980.

Prevalence
   Approx. 69 % population experience some form of PTSD during a lifetime
   Lifetime prevalence for PTSD 1-2.6 % in general population

Comorbid: substance abuse, major depresive disorder, suicide ideation

a    Highest-level evidence

Psychological debriefing for preventing post traumatic stress disorder (PTSD) (Cochrane Review) [abstract] 
Rose S, Bisson J, Wessely S. In: The Cochrane Library 2004;3. Chichester, UK: John Wiley & Sons, Ltd.

A Systematic Review of Single-Session Psychological Interventions ('Debriefing') following Trauma [abstract] 
Rose S, Bisson J, Wessely S. Psychotherapy and Psychosomatics 2003;72:176-184

Reviewers' conclusions: 
There is no current evidence that single session individual psychological debriefing is a useful treatment for the prevention of post traumatic stress disorder after traumatic incidents. Compulsory debriefing of victims of trauma should cease.

After 11 trials review and criticism, three studies associated the intervention with a positive outcome, six demonstrated no difference in outcome between intervention and non-intervention groups and 2 showed some negative outcomes in the intervention group (these studies had the longest follow-up periods).Those who received the intervention showed no significant short term risk (3-5 months) of PTSD (odds ratio 1.22 (95% CI 0.60 to 2.46)). At one year one trial reported that there was a significantly increased risk of PTSD in those receiving debriefing (odds ratio 2.88 (95% CI 1.11 to 7.53).There was also no evidence that debriefing reduced general psychological morbidity, depression or anxiety.

Evidence Based Practice and Psychological Debriefing 
Rose S

Crisis intervention and CISM: a research summary   
Mitchell JT
    And bibliographic references:

Debriefing, Social Support and PTSD in the New Zealand Police: Testing a Multidimensional Model of Organizational Traumatic Stress
Stephens Ch  

Individual differences and debriefing effectiveness 
Morgan CC  

A Critical View on Debriefing
Gist R

Social Science versus Social Movements: The origins and Natural History of Debriefing   
Gist R, Woodal SJ. The Australasian Journal of Disaster and Trauma Studies 1998-1
    And some evidence-based conclusions:

There is no reliable empirical evidence indicating demonstrable preventative effect (cf. Bisson & Deal, 1994; Foa & Meadows, 1997; Gist, 1996a, 1996b; Gist & Woodall, 1995; Kenardy & Carr, 1996; Meichenbaum, 1994; Raphael et al., 1995; Stephens, 1997).

What palliative effect may be derived it is no greater than that afforded by more traditional venues of discussion and social support (cf. Alexander & Wells, 1991; Hytten & Hasle, 1989; Gist et al., 1998; Stephens, 1997; Thompson & Solomon, 1991).

There have been no systematic data reported that suggest any superiority of the "Mitchell model" of debriefing compared to any other method or approach.

Paradoxical effects, possibly of iatrogenic origin, have been noted in independent studies (Bisson et al., 1997; Gist et al., 1998; Griffiths & Watts, 1992; Hobbs et al., 1996; McFarlane, 1988).

The more rigorous the study, the more objective its measurements, the more independent the researchers, and the more discerning the publication venue, the more likely has been neutral to negative assessment.

Psychological Trauma and Posttraumatic Stress Disorder: A Review   
Flannery RB
. International Journal of Emergency Mental Health, 1999, 2, 135-140

Psychological Debriefing for Road Traffic Accident Victims: Three-Year Follow-Up of a Randomised Controlled Trial [abstract]
Mayou RA, Ehlers A, Hobbs M

Contemporary Issues In The Treatment Of Trauma  
Devilly GJ

Effectiveness of psychological debriefing [abstract]
Arendt M, Elklit A.
Acta Psychiatr Scand 2001;104(6):423-437

When Doing the Right Thing Might Be Wrong    "Research questions the value of Critical Incident Stress Debriefings (CISD)"
Slawinski
TT, Blythe BT

Psychological Debriefing: Theory, Practice and Evidence  
Raphael B, Wilson JP. Wilson. New York, Cambridge University Press 2000, 376 pp, ISBN 0-521-64700-2

Does early psychological intervention promote recovery from posttraumatic stress?   
McNally RJ Bryant RA, Ehlers A.  Psychological science in the public interest 2003;4(2)

Mental health and mass violence. Evidence-based early psychological intervention for victims/survivors of mass violence     
A Workshop to Reach Consensus on Best Practices

a    General references

Handbook of post-traumatic therapy 
Williams MB, Sommer JF


Psychological debriefing  (PTSD history)     
Burns P. The Psychotherapist 2002:19:22-39

Behavioral Health Crisis Response with First Responders    
Havican GC. By The Center for Trauma Response/Recovery and Preparedness (CTRP). A Univ. of Connecticut and Yale Univ. Center of Excellence

Psychological debriefing   

The current status of psychological debriefing. It may do more harm than good   
Kenardy J. Br Med J 2000;321(28):1032-33.

Post-traumatic stress disorder in people with learning disability   
McCarthy J. PTS Advances in Psychiatric Treatment 2001;7:163–169. Advances in Psychiatric Treatment (2001) 7: 163-169

Randomised controlled trial of midwife led debriefing to reduce maternal depression after operative childbirth   
Small R, Lumley J, Donohue L, Potter A, Waldenström U. Br Med J 2000;321(28):1043-1047

Assessing PTSD. A guide for clinicians
Middleton WS

The Stress & Trauma of Deployment      Pending
Pincus SH.

Psychosocial Responses to Bioterrorism and Disaster: Care of Individual Patients 
 

Alcoholism and posttraumatic stress disorder   
Thornton JE

The Terrorist Attacks: Dealing With the Emotional Consequences
Goldberg R. Well-Being Committee. American College of Emergency Physicians

Psychological Intervention (II)      Pending
Ayers S

Psychological debriefing
.
National Center for PTSD Fact Sheet 
Bisson JL, McFarlane A, Rose S

Primary Care And PTSD 
Gebhart RJ, Neeley FL

A Review of Psychological Debriefing After Extreme Stress 
Kaplan Z, Iancu I, Bodner E. Psychiatr Serv 2001;52:824-827

The human factors response to terrorism    
Hancock P

Psychological debriefing for preventing post traumatic stress disorder (PTSD) (Cochrane Review) [abstract] 
Rose S, Bisson J, Wessely S.
From The Cochrane Library, Issue 3, 2004. Chichester, UK: John Wiley & Sons, Ltd.

The Critical Incident Stress Debriefing Process for the Los Angeles County Fire Department: Automatic and Effective  
Hokanson M, Wirth B.  International Journal of Emergency Mental Health.

Organisational Issues   
Hugh G.
Centre for Mental Health . Disaster Mental Health Response Workshops - June 2000 Session 1 1

Does debriefing after psychological trauma work? [editorial]
Raphael B, Meldrum L, Mcfarlane AC. Br Med J 1995;310:1479-1480.

Short reports. Questionnaire survey of post-traumatic stress disorder in doctors involved in the Omagh bombing   
Firth-Cozens J, Midgley SJ, Burges C

Post-traumatic stress disorder in doctors involved in the Omagh bombing [letter]
Summerfield D. Br Med J
2000;320:1276.

Critical incident stress debriefing   

The Mississippi Scale for Civilian PTSD (CMS)
Keane TM, Caddell JM, Taylor KL

Adult PTSD Self-Report Measures 


The Iraq War Clinician Guide, 2nd Edition

Meaning and the Modification of Posttraumatic Stress Disorder 
 
   
Taylor

The debriefing “controversy” and crisis intervention: a review of lexical and substantive issues   
Everly GS, Mitchell JT. International Journal of Emergency Mental Health 2000;2(4):211-225.

Trauma as etiology
Freyd JJ,
Birrell P. Spring 2003 Graduate Seminar. University of Oregon

Innovations in Training & Employee Assistance     

Guidelines for key personnel following a traumatic event      

The Mental Health Consequences of the WTC Attacks  

From the The NJ Division of Mental Health Services.

Attacked but Not Defeated. Bent but Not Broken 
Smith J, from Salus International. Business Leadership in the Aftermath of September 11th

International training and response center   
An excellent score

Psychological Debriefing: Theory, Practice and Evidence"  
Book review. Journal of Emergency Primary Health Care (JEPHC) 2003;1(1-2)
Beverley, Ed. Raphael and John P. Wilson. New York, Cambridge University Press 2000, 376 pp. ISBN 0-521-64700-2
Cooper A

Benjamin Psychiatric Response to Large Scale Disasters   
Carey BA 

The Evidence Base for Psychosocial and Psychopharmacological Interventions for Children with Attention-Deficit/Hyperactivity Disorder, Major Depressive Disorder,  Disruptive Behavior Disorders,  Anxiety Disorders, and Posttraumatic Stress Disorder 
Burns B, Compton SN, Egger HL, Farmer EMZ

Critical Incident Stress Management (CISM) 
Jones S

a    Some links

The National Center for Post Traumatic Stress Disorder

The American Academy of Expert in Traumatic Stress

The American Psychiatric Organization

The American Psychological Association and related www.helping.apa.org/therapy/traumaticstress.html

Posttraumatic Stress Disorder
Focus 2003; 1(3). Monographic number [abstracts only].

Mental Health Workers Without Borders
Click on "Disasters" to bring up "Responding to the Psychosocial Consequences of Disasters," a downloadable manual

The Walter Reed Army Medical Center
Click on "Clinical Departments" and then "Social Work." Once there, click on "Disaster Mental Health Services. A Manual for Clinicians and Administrators"

The Center for Mental Health Services of the Department of Health and Human Services
Click on "Mental Health: Disaster Mental Health Services

The International Critical Incident Stress Foundation

http://www.swin.edu.au/victims  + some links

David Baldwin's Trauma Information Pages

Dealing with disasters  
Complete list of bibliographic references

Office for victims of crime

International Critical Incident Stress Foundation

CISM debunking