000			04047nam a22004697a 4500
008			190118s20182018 xxu||||| |||| 00| 0 eng d
022			_a1092-0684
024			_a10.3171/2018.9.FOCUS18390 [doi]
024			_a2018.9.FOCUS18390 [pii]
040			_aOvid MEDLINE(R)
099			_a30544311
245			_aThe shipboard Beirut terrorist bombing experience: a historical account and recommendations for preparedness in events of mass neurological injuries.
251			_aNeurosurgical Focus. 45(6):E18, 2018 Dec 01.
252			_aNeurosurg. focus. 45(6):E18, 2018 Dec 01.
253			_aNeurosurgical focus
260			_c2018
260			_fFY2019
265			_sppublish
265			_sppublish
266			_d2019-01-18
501			_aAvailable online from MWHC library: 1996 - present
520			_aOn a Sunday morning at 06:22 on October 23, 1983, in Beirut, Lebanon, a semitrailer filled with TNT sped through the guarded barrier into the ground floor of the Civilian Aviation Authority and exploded, killing and wounding US Marines from the 1st Battalion 8th Regiment (2nd Division), as well as the battalion surgeon and deployed corpsmen. The truck bomb explosion, estimated to be the equivalent of 21,000 lbs of TNT, and regarded as the largest nonnuclear explosion since World War II, caused what was then the most lethal single-day death toll for the US Marine Corps since the Battle of Iwo Jima in World War II. Considerable neurological injury resulted from the bombing. Of the 112 survivors, 37 had head injuries, 2 had spinal cord injuries, and 9 had peripheral nerve injuries. Concussion, scalp laceration, and skull fracture were the most common cranial injuries.Within minutes of the explosion, the Commander Task Force 61/62 Mass Casualty Plan was implemented by personnel aboard the USS Iwo Jima. The wounded were triaged according to standard protocol at the time. Senator Humphreys, chairman of the Preparedness Committee and a corpsman in the Korean War, commented that he had never seen such a well-executed evolution. This was the result of meticulous preparation that included training not only of the medical personnel but also of volunteers from the ship's company, frequent drilling with other shipboard units, coordination of resources throughout the ship, the presence of a meticulous senior enlisted man who carefully registered each of the wounded, the presence of trained security forces, and a drilled and functioning communication system.Viewed through the lens of a neurosurgeon, the 1983 bombings and mass casualty event impart important lessons in preparedness. Medical personnel should be trained specifically to handle the kinds of injuries anticipated and should rehearse the mass casualty event on a regular basis using mock-up patients. Neurosurgery staff should participate in training and planning for events alongside other clinicians. Training of nurses, corpsmen, and also nonmedical personnel is essential. In a large-scale evolution, nonmedical personnel may monitor vital signs, work as scribes or stretcher bearers, and run messages. It is incumbent upon medical providers and neurosurgeons in particular to be aware of the potential for mass casualty events and to make necessary preparations.
546			_aEnglish
650			_a*Bombs
650			_a*Brain Concussion/co [Complications]
650			_a*Craniocerebral Trauma/et [Etiology]
650			_a*Spinal Cord Injuries/co [Complications]
650			_aAdult
650			_aArmed Conflicts
650			_aHumans
650			_aLebanon
650			_aMale
650			_aMilitary Personnel
650			_aTerrorism
651			_aMedStar Washington Hospital Center
656			_aRadiology
657			_aJournal Article
700			_aArmonda, Rocco A
790			_aArmonda RA, Henderson F, Henderson F, Hubbard ZS, Rosenbaum R, Spiotta AM
856			_uhttps://dx.doi.org/10.3171/2018.9.FOCUS18390 _zhttps://dx.doi.org/10.3171/2018.9.FOCUS18390
942			_cART _dArticle
999			_c4030 _d4030