Doctors share expertise on handling terror attacks

Doctors with first-hand experience treating victims of terrorist attacks around the world are sharing their expertise today with several hundred medical and emergency officials from greater Boston.

The title of the conference, being held at the John F. Kennedy Library, is explicit: "Tales of Our Cities: Planning for Interdisciplinary Response to Terrorist Use of Explosives."

Doctors from India, Spain, Britain, Israel and Pakistan are explaining in often grim detail about the nature of the blast wounds they treated, the triage systems they use and other issues that could save lives and improve preparedness in the event of an attack.

The conference was organized by the DelValle Institute for Emergency Preparedness, which was set up Boston's Emergency Medical Service and the Public Health Commission. I wrote a story in the Globe today explaining the six-year-old institute's work in training emergency personnel in greater Boston for potential terror attacks.

The head of Boston's EMS system, Chief Richard Serino, pulled together the conference to learn from medical professionals who have gone through recent terror attacks. Top officials from the disaster preparedness section of the US Centers for Disease Control and Prevention are also attending. After today's open session with doctors, police and emergency medical responders from around the region, the CDC officials will meet with the international visitors to update the American emergency response plans.

Among those speaking today was Dr. Aparna Deshpande, a professor of surgery at the huge King Edward Memorial Hospital in Mumbai, which was the principal hospital treating victims of the horrific train bombings in Mumbai in 2006 that killed more than 200 people.

She said that attack was just one in a series of terror bombings in Mumbai, dating back to 1993. In 2006, there were seven serial blasts within 11 minutes. She noted that victims will flood to the nearest hospital, on foot or in vehicles, and the casualty unit at her hospital was flooded with victims within 15 minutes.

"The surge is the critical phase in a bomb blast," Deshpande said. Constantly reviewing the patients arriving in an ongoing triage process is also important, she said, because injuries evolve over time. For example, "blast lung" trauma can worsen over a couple of hours and needs careful monitoring.

Surprisingly, she noted, "you do not need extensive surgical support right away to save lives." She said the immediate surgery needs are vital but fairly straightforward. A major priority is good crowd control at a hospital flooded with blast victims to keep relatives and media and volunteers from flooding in.