Terrorism, Mass Casualty, and Disaster Nursing
The possibility and reality of mass casualties associated with disasters, terrorism, and biological warfare are not new to human history; nor is the concept of using weapons of mass destruc-tion (WMDs). In fact, the use of WMDs dates as far back as the 6th century BC for biological weapons and the year 436 BC for chemical weapons (U.S. Army Medical Research Institute of Infectious Disease, 1996; U.S. Army Medical Research Institute of Chemical Defense, 1999). However, geopolitical forces and in-terests, the “shrinking globe,” and the availability of destructive technology have brought the possibility of more terrorist events to our doorsteps. Examples include the 1995 Oklahoma City bombing of the Murrah building; the 1993 bombing of the World Trade Center in New York City; the total destruction of the World Trade Center towers and the damage to the Pentagon on September 11, 2001; and the anthrax exposures that same year. Terrorism has become increasingly sophisticated, organized, and therefore effective. In is no longer a question of whether it will happen, but when it will happen again.
In 1999, a government agency called the National Domestic Preparedness Organization was developed to coordinate prepared-ness in the event of a terrorist attack (Kotzmann, 1999). The De-partment of Homeland Security was created after the September 11, 2001, attacks to coordinate federal and state efforts to combat ter-rorist activity. In 2001 and 2002, all acute care facilities across the nation were asked to present detailed plans to their health depart-ments on how they would handle situations involving WMDs.
As distressing as terrorism and warfare are, they are just two of the manmade reasons that health care providers need to plan for mass casualties. Airplane crashes, train crashes, and toxic substance spillages are other manmade disasters that can result in casualties and tax the resources of health care facilities and their communi-ties. In addition to manmade disasters, natural phenomena such as floods, tornadoes, hurricanes, fires, and earthquakes kill and injure hundreds of thousands of people worldwide each year. The acute care facility must be prepared for any and all of these disasters.