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Walker M, d'Arville A, Lacey J, Lancman B, Moloney J, Hendel S. Mass casualty, intentional vehicular trauma and anaesthesia. Br J Anaesth 2021; 128:e190-e199. [PMID: 34654520 DOI: 10.1016/j.bja.2021.08.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 08/25/2021] [Indexed: 11/25/2022] Open
Abstract
The use of motor vehicles to initiate mass casualty incidents is increasing in frequency and such events are called intentional vehicular assaults. Perpetrators are inspired by a range of terrorist ideologies or have extremist views, criminal intent, or mental health issues. Assaults using a motor vehicle as the principal weapon of attack are easy to launch and require little to no forward planning. This makes them difficult for police and security agencies to predict, prevent, or interdict. With the increasing frequency of intentional vehicular assaults, anaesthesiologists in various settings may be involved in caring for victims and should be engaged in preparing for them. This narrative review examines the literature on vehicle assaults committed around the world and provides an overview of the unique injury patterns and considerations for the pre-hospital, perioperative, and critical care management of victims of these mass casualty events. The article discusses planning, education, and training in an attempt to reduce the mortality and morbidity of intentional vehicular assaults.
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Affiliation(s)
- Matthew Walker
- Department of Anaesthesiology & Perioperative Medicine, Alfred Health, Melbourne, Australia; Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Asha d'Arville
- Department of Anaesthesiology & Perioperative Medicine, Alfred Health, Melbourne, Australia
| | - Jonathan Lacey
- Department of Anaesthesiology & Perioperative Medicine, Alfred Health, Melbourne, Australia
| | - Benn Lancman
- Department of Anaesthesiology & Perioperative Medicine, Alfred Health, Melbourne, Australia
| | - John Moloney
- Department of Anaesthesiology & Perioperative Medicine, Alfred Health, Melbourne, Australia; Field Emergency Medical Officer Program, Ambulance Victoria, Melbourne, Australia; School of Health, Medical and Applied Sciences, Central Queensland University, Queensland, Australia
| | - Simon Hendel
- Department of Anaesthesiology & Perioperative Medicine, Alfred Health, Melbourne, Australia; Department of Anaesthesia and Perioperative Medicine, Central Clinical School, Monash University, Melbourne, Australia; National Trauma Research Institute, Monash University and Alfred Health, Melbourne, Australia; Trauma Service, Alfred Health, Melbourne, Australia.
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