Triage in a Bomb Disaster with 166 Casualties

Background: We describe the surgical response of the Helsinki University Hospitals to a bomb disaster with 166 casualties. According to the Helsinki Area Disaster Plan, severely injured patients were transported to several hospitals with emergency facilities to avoid overtriage. Methods: The patient data were gathered from hospitals, health centers and other doctor visit/ appointments records. Injury Severity Scores (ISS), critical mortality rate and death/wounded ratio were calculated. Results: Of the 166 injured patients, 5 died immediately at the bombing site. Sixty-six patients were transported to the six affiliated hospitals. The mean ISS score for survivors was 12. Seventeen percent of the acute survivors were critically injured (ISS>15). The critical mortality rate was 8%. There were no later deaths; the dead/wounded ratio was 4.4. Operative treatment was performed for 38% of the patients treated in surgical emergency departments. Conclusion: The bombing attack in Myyrmanni shopping center led to 166 casualties, of whom 66 patients were received at six affiliated hospitals in Helsinki and Uusimaa Area. The critical mortality rate was low. A local disaster plan was implemented. The surgical response was rapid and well coordinated. In a mass casualty disaster not all disaster victims need to go to a trauma center. [PUBLICATION ABSTRACT]