Abstract
Madrid, the capital of Spain, is a highly Westernized metropolis with a well-developed and modern emergency system that has extensive experience responding to terror attacks. Nevertheless, the March 11, 2004 (M-11) train bombings resulted in a mass casualty incident (MCI) that produced a casualty load of 2062 victims, almost immediately overwhelming the medical emergency response system. Local ambulance services and hospitals were severely challenged by the multiple casualties, cadavers, inrush of both families and media representatives, etc. The M-11 train bombing stands as an important marker to prepare for similar catastrophic events and to prevent systemic failures in the response. This case study briefly presents the main lessons learned of this event and provides recommendations for improving emergency system readiness. One of the authors (IA) participated in post-event assessments of the response; the case study includes his personal observations as well as those of published post-incident reviews.
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Gutierrez de Ceballos JP, Turégano Fuentes F, Perez Diaz D, Sanz Sanchez M, Martin Llorente C, Guerrero Sanz JE. Casualties treated at the closest hospital in the Madrid, March 11, terrorist bombings. Crit Care Med. 2005;33(1 Suppl):S107–12.
Bolling R, Ehrlin Y, Forsberg R, Rüter A, Soest V, Vikström T, et al. KAMEDO Report 90: terrorist attacks in Madrid, Spain, 2004. Prehospital Disaster Med. 2007;22(3):252–7.
Gómez AM, DomÃnguez CJ, Pedrueza CI, Calvente RR, Lillo VM, Canas JM. Management and analysis of out-of-hospital health-related responses to simultaneous railway explosions in Madrid, Spain. Eur J Emerg Med. 2007;14(5):247–55.
Carresi AL. The 2004 Madrid train bombings: an analysis of pre-hospital management. Disasters. 2008;32(1):41–65.
de Ceballos JPG, Turégano-Fuentes F, Perez-Diaz D, Sanz-Sanchez M, Martin-Llorente C, Guerrero-Sanz JE. 11 March 2004: The terrorist bomb explosions in Madrid, Spain – an analysis of the logistics, injuries sustained and clinical management of casualties treated at the closest hospital. Crit Care. 2005;9(1):104–11.
Kluger Y, Kashuk J, Mayo A. Terror bombing-mechanisms, consequences and implications. Scand J Surg. 2004;93(1):11–4.
Agiv-Berland A, Ashkenazi I, Aharonson-Daniel L. The cross-national adaptability of EMS protocols for mass casualty incidents. J Homel Secur Emerg Manag. 2012;9(2):1–15.
Marghella P, Ashkenazi I. The lessons of tragedy: the 2004 Madrid train bombings. In: Landesman L, Weisfuse I, editors. Case studies in public health preparedness and response to disasters. Burlington, MA: Jones & Bartlett Learning; 2014. p. 134–48.
Ashkenazi I, Hunt R, Sasser S, Basavaraju S, Sullivent E, Kapil V, et al. Interim planning guidance for preparedness and response to a mass casualty event resulting from terrorist use of explosives [Internet]. Atlanta GA: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2010 [cited 2018 Aug 20]. Available from: https://stacks.cdc.gov/view/cdc/5705.
Hunt R, Ashkenazi I, Falk H. A tale of cities. Disaster Med Public Health Prep. 2011;5 Suppl 2:S185–8.
Ashkenazi I, McNulty E, Marcus L, Dorn B. The role of bystanders in mass casualty events: lessons from the 2010 Haiti earthquake. J Def Stud Resour Manag [Internet]. 2012 [cited 2018 Aug 22];01(02). Available from: http://www.scitechnol.com/2324-9315/2324-9315-1-103.php.
Bazerman M, Watkins M. Predictable surprises: the disasters you should have seen coming, vol. 317. Cambridge, MA: Harvard University Press; 2004. p. 54.
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Ashkenazi, I., Deitchman, S.D., Falk, H. (2020). Case Study: The Madrid Train Bombing of March 11, 2004. In: Callaway, D., Burstein, J. (eds) Operational and Medical Management of Explosive and Blast Incidents. Springer, Cham. https://doi.org/10.1007/978-3-030-40655-4_9
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DOI: https://doi.org/10.1007/978-3-030-40655-4_9
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