Preparedness for treating victims of terrorist attacks in Australia: Learning from recent military experience

The Australian health system is generally well prepared for mass casualty events. Fortunately, there have been very few terrorist attacks and these have involved low numbers of casualties compared with events overseas. Nevertheless, Australian health professionals need to be prepared to treat mass casualties with blast and ballistic trauma. The US military and its allies including Australia have had extensive experience with mass casualty management in the Middle East and Afghanistan wars for more than a decade. To define their experience, they developed the Tactical Combat Casualty Care Guidelines that have saved many lives. It is now prudent to incorporate this knowledge and experience into civilian practice in Australia.

A Challenging Penetrating Trauma Case

We present the prehospital management of a 23-year-old Australian Aboriginal man with an isolated knife stab wound to the posterior right chest. The lead author attended to the prehospital management of this young man during tenure as a registrar in retrieval medicine for CareFlight Medical Services (CMS) in North Queensland, Australia. The case is noteworthy because it involved a combination of a life-threatening injury with a superimposed iatrogenic injury. The case will be of interest to physicians and clinicians in prehospital medicine as well as those in low-volume emergency departments or facilities in which major trauma may present infrequently.