Vehicle Bomb

1
Vehicle Bomb

• May be moderate to huge in size
• Commercial, military, or improvised explosives
• Shrapnel varies
• May be devastating to a wide area

2
Vehicle Bombs

• Car Trunk - 1500 lbs.
• Small Truck - 3000 lbs.
• Large Truck - 4800 lbs.

3
Secondary Devices

• May be aimed at Emergency Response Personnel
• Used in Atlanta (Eric Rudolph), Israel

4
Secondary Devices

• Anticipate the secondary device
• Searches should be conducted by qualified
  explosive ordnance disposal (EOD) technicians
• Manage the scene effectively
• Extending boundaries of scene perimeters can save
  lives

5
Secondary Devices

• Rapid Evacuation
• Modify traditional load and go principle
• Maintain a safe perimeter

6
Blast Injuries

• Mechanisms of injury
• Primary blast wave, pressure changes
• Secondary acceleration of debris
• Tertiary victims thrown (70kg man at 18mph has
  50 mortality)

7
Blast Injuries -Briefcase Bomb IED
8
General Management

• ABCs
• Trauma care
• Air embolism, pneumothorax
• - Left-sided Trendelenberg
• Ruptured typanum

9
Medical Management

• Shrapnel

10
Acute Crush Injuries

• Crush injuries
• Cellular death
• Removal of pinning object
• - Sudden release of myoglobin and K
• - Lethal arrhythmias, acute renal failure, death

11
Bomb Incidents

• Evidence Recovery
• Document everything
• Save everything

12
Other Considerations

• Use of a conventional explosive device to
  dispense radioactive materials (Dirty Bomb) or
  chemicals
• Targeting of facilities that have nuclear or
  hazardous chemical materials
• Consider management issues for a contaminated
  trauma victim

13
Other Considerations

• Remember, the victim might be a bomber

14
Summary

• Consider secondary devices
• Knowledge of basic trauma care (ABCs)

15
Whale of a Good Time Dept.
16
References

• Department of Homeland Security
• Incident Response to Terrorist Bombings
• EMRTC / NM Tech
• Illinois Medical Emergency Response Team
• Dr. Moses Lee
• Magen David Adom