ABSTRACT
Terrorism represents a public health emergency with the potential for mass casualties. Terrorist incidents have the potential to load mass casualties via emergency medical services (EMSs) into the emergency rooms, trauma bays, operating rooms, and intensive care units of any community. The trauma systems of most communities represent the system most likely to be used in response to mass casualties, because they have built-in triage, prehospital care, integration with emergency services agencies, and rapid assessment and life-saving care in trauma centers. Trauma systems evolved in response to the epidemiology of traumatic injury in the 1960s, and will undergo further evolution in order to respond to chemical, biological, radiological, and explosive terrorism. This has already been recognized by federal agencies such as the Centers for Disease Control (CDC) and some states have formally designated the trauma system as the prime planner and responder for such casualties (1).
