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Table 2 The Haddon matrix and the medical response to conventional bomb attacks in subway systems

From: Using the Haddon matrix to explore medical response strategies for terrorist subway bombings

Phase Host Agent/Vehicle Physical environment Social environment/Organizational culture
Pre-event •Adequacy of the medical and paramedical staff
•Standards of individuals’ training
•Mental preparation for the response to the attacks
•Malicious determination and abilities of the terrorists
•Sources of the explosives •Adequacy and effectiveness of first-aid kits and instruments
•Adequacy of the medical evacuation equipment
•Distribution of hospitals along the subway lines
•The subway design for passengers’ emergency evacuation
•Construction level of emergency command system for subway antiterrorism
•Implementation of subway security inspections
•Disaster emergency response preparedness for the subway system
•Relevant laws and regulations
Event •Suicide or nonsuicide attack
•Promptness of the emergency response
•First-aid capabilities at the scene
•Quality of command, coordination, and control at the scene
•The number of people exposed to the terrorist attack threat
•Power of explosion
•Secondary damage caused by the destruction of the subway station structures
•Working conditions at the scene
•Continuity and stability of communication
•Traffic conditions affecting the evacuation
•The public’s awareness of mutual rescue
•Implementation of the emergency command system for subway antiterrorism
Post-event •Health care for the staff
•Follow-up treatment for injured persons
•Evaluation quality of the medical response
•Residual quantity of harmful gases produced by the explosion in the subway •Maintenance of first-aid kits, supplements and instruments
•Maintenance of the evacuation equipment
•Psychological counseling needs of the public
•Post-event media coverage