The World Trade Center attack. Is critical care prepared for terrorism?

Area of Science:

• Disaster Medicine
• Critical Care
• Public Health Preparedness

Background:

• The World Trade Center attack presented a unique mass casualty event.
• New York City's critical care services, like Montefiore Medical Center, have extensive disaster management experience.
• The US critical care system is well-resourced compared to other nations.

Purpose of the Study:

• To describe the critical care service's perspective during the initial hours of the World Trade Center attack.
• To outline the dispersal of victims and resource utilization within the New York City hospital system.
• To analyze the capacity and capability engagement of the US critical care system during this specific disaster.

Main Methods:

• Commentary based on the experience of a specific New York City critical care service.
• Description of local concerns, victim dispersal, and resource availability.
• Analysis of the US critical care system's response in the context of the attack's characteristics.

Main Results:

• The critical care service faced immediate local concerns and managed victim dispersal across the city.
• Significant resources were available, but their full utilization was constrained.
• The high ratio of dead to injured victims at the World Trade Center attack prevented the full engagement of the system's capacity.

Conclusions:

• The US critical care system possesses substantial capacity for disaster response.
• The specific nature of the World Trade Center attack, with its high mortality, did not allow for the full deployment of this capacity.
• Preparedness for diverse disaster scenarios remains crucial for effective critical care deployment.