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Advanced Management Saved Terror Victims' Lives

Robust trauma system helped reduce critical mortality after the 2005 London bombings

FRIDAY, Dec. 22 (HealthDay News) -- After the July 7, 2005 terrorist bombings in London, a fast and effective medical response helped reduce deaths among critically injured patients, according to a study published in the Dec. 23/30 issue of The Lancet.

Karim Brohi, M.D., of the Royal London Hospital in the U.K., and colleagues conducted a retrospective analysis of the London-wide prehospital response and the in-hospital response of one academic trauma center.

The researchers found that there were 775 casualties and 56 deaths (53 at the scene). Of 55 patients who were triaged to priority dispatch, 20 were critically injured. The investigators found that the Royal London's Helicopter Emergency Medical Service (London-HEMS) achieved 33 percent over-triage rates at Aldgate and King's Cross, which was significantly lower than the 89 percent rate seen after the Madrid train bombing in March 2004. They also found that the 15 percent death rate among critically injured patients was lower than that seen during most previous terrorist attacks.

"Critical mortality was reduced by rapid advanced major incident management and seems unrelated to over-triage," the authors conclude. "Hospital surge capacity can be maintained by repeated effective triage and implementing a hospital-wide damage control philosophy, keeping investigations to a minimum, and transferring patients rapidly to definitive care."

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