Things that make EMS and ED worry

Bizarre event in a world already on edge from terrorist attempts:

More suspects held in UK terror attacks –
LONDON, England (CNN) — Two people were arrested in Cheshire, England, in connection with terrorist incidents in England and Scotland, bringing the total number of people in custody to four, Scotland Yard said early Sunday.

On Saturday, a sport utility vehicle was driven into an entrance at Scotland’s Glasgow International Airport and burst into flames. On Friday, two explosives-laden cars were discovered at two locations in London.

Two men were immediately arrested at the airport. One was hospitalized with severe burns; early reports that he had died were erroneous.

A third suspect is believed to have died in the Jeep Cherokee that crashed at the airport terminal’s main entrance about 3:15 p.m. (10:15 a.m. ET). …

That ‘s bad, but not the part that has me worried. It’s this bit:

William Rae, chief constable of the Strathclyde Police, said part of the Royal Alexandria Hospital in Glasgow was evacuated after a suspicious device was found on the injured suspect. The device was safely taken away and is being examined, Rae said.

That’s not something I’ve ever trained for. I (and you, if you’re in this business) need to at least consider what we’re going to do when and if this happens.


  1. William says:

    I have had no (medically related) training with this contingency either, however, it has been of concern prior to this. Unless there is someone with EOD experience handy the only option that I see available is to roll them out into a remote or shielded area of the parking lot and secure the area until they can be screened. Any response to the threat begs many legal and ethics review questions and I’m sure that the insurance companies will have a position once they turn their accountants loose on the question. I believe that “Do No Harm” starts with to yourself and the most vulnerable (such as the other patients in the treatment area.) My question* is how the device made it into the room. Granted, no one is perfect, but the pre-hospital folks should be embarrassed that they missed it.
    A good reference might be how Magan David Adom handles similar situations. This bears further thought. Thanks!

    William sends.

    *Please understand that this is not an accusatory question. It is more of an assessment style question intended to understand the entirety of the situation and spread the knowledge to assist others in their responses.

  2. Goatwhacker says:

    Yep, it shoulda been picked up before the patient made it to the hospital. This did come up in the military exercises I was involved with – enemy combatants or other bad guys were to be thoroughly searched in the field before coming to the hospital. This situation is analogous, obviously not just for the safety of the medical personnel but for the law enforcement and others at the scene.

    Anyway we did have an exercise where a bomb got into the ED on an injured patient. I think the response was pretty similar to what the Glasgow Hospital did – evacuate and call the MPs to handle it. If the patient was unstable, being bagged, etc that would certainly throw a wrinkle into it.

  3. There are many elements of medical practice that expose those in the hospital to risk, and it’s something we rarely stop to think about. How much risk do physicians have a duty to expose themselves to in helping patients. Common examples include, managing agitated delirium in the ED, difficult orthopedic surgery on HIV or Hep C +ve patients, and care of patients with violent criminal histories.
    I was a medical student in Ontario during the SARS outbreak, and the majority of doctors (and nurses, though in some cases nurses were bullied into working at threat of their jobs)in affected hospitals chose to work. Some of them died as a result.
    In an episode of Grey’s Anatomy a patient is taken to the OR in an attempt to remove a bomb that is some how stuck to them (I forget the details) and the anesthetist in the OR runs away (much to the chagrin of my anesthesiologist wife). The seen is supposed to convey his cowardice , but fails to ask some relevant questions:
    What is his duty to the patient and where does it end?
    As the show implies, is the patients life more important than his own?
    Does he have a duty to put his own life in jeopardy?
    What about his duty to his family and children?
    How does he balance it all?
    These are important questions, not only for occasional cases of bomb strapped and injured terrorists, but also in the case of planning for how we manage outbreak of highly contagious and potentially lethal infectious diseases (pandemic influenza for instance)….
    Food for thought….good post GruntDoc!

  4. re :bomb patient is taken to the OR
    I see two sides.
    Looking at it logically, a trained medical person should run away to be able to save other lives in the future days to come, but ethically if you started the operation aren’t you obliged to finish it? Since you took responsibility for the life at the start.

  5. Freddy Hill says:

    The risk to medical personnel is not the only medical aspect of this story. In fact, when I started reading your post I thought that were going to comment on this.

    Why would a physician, a healer of bodies, become a suicide bomber? The wags are already telling easy jokes (“When medicine becomes like the post office doctors go postal”, etc). But really, for me, a non-medical professional, this is beyond comprehension.

  6. Medical personnel are human just like the rest of the world; meaning that they have their fallabilities, their passions, obsessions. I would hope that someone who went into medicine would be averse to ending innocent life, but just as their have been physicians who have murdered patiets, it does not surprise me that there are physicians who are so militant they would be suicide bombers.

    Also, your comment reveals why being a physician would be a perfect cover for a “sleeper” agent. “He’s a doc…obviously a healer, and we can trust him.”