Report from ECR: CT assists in aftermath of terror attacks

March 12, 2008 Report from ECR: CT assists in aftermath of terror attacks Paula Gould -------------------------------------------------------------------------------- Radiologists are playing a central role in the aftermath of terror attacks in Israel, according to a report at the European Congress of Radiology. CT is now regarded as the primary diagnostic tool in incidents involving multiple casualties, Dr. Ahuva Engel told attendees at the "ESR meets Israel" session. Between 2000 and 2007, Israel was subject to 148 suicide attacks and involved in one war. The number of Israelis wounded in these events topped 8000. When a multiple-casualty event occurs, more than half of those injured will have reached nearby hospitals within 20 minutes, said Engel, a radiologist at the Rambam Medical Centre in Haifa. This influx of casualties can be overwhelming, and good workflow planning is essential. The aftermath of attacks can be split into two distinct phases, she said. The initial phase, when most patients are arriving, is typically chaotic. Radiologists' main objective at this stage is to identify those who are critically injured. The most commonly used imaging strategies are FAST (focused abdominal sonography in trauma) and chest radiography. Once the casualties stop arriving, radiologists' priorities change. Diagnostic workup typically involves skeletal x-rays and/or CT. The situation is slightly different in the event of war, Engel said. There is no "second phase" because the influx of casualties cannot be predicted. All patients must consequently be examined fully when they arrive.

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