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 •Budget |
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 |