Hospitals: soft target for terrorism?

In recent years, the world has been rocked repeatedly by terrorist attacks. Arguably, the most remarkable were: the series of four coordinated suicide plane attacks on September 11, 2001 on buildings in New York, Virginia, and Pennsylvania, USA; and the recent series of two coordinated attacks in Brussels (Belgium), on March 22, 2016, involving two bombings at the departure hall of Brussels International Airport and a bombing at Maalbeek Metro Station located near the European Commission headquarters in the center of Brussels. This statement paper deals with different aspects of hospital policy and disaster response planning that interface with terrorism. Research shows that the availability of necessary equipment and facilities (eg, personal protective clothing, decontamination rooms, antidotes, and anti-viral drugs) in hospitals clearly is insufficient. Emergency teams are insufficiently prepared: adequate and repetitive training remain necessary. Unfortunately, there are many examples of health care workers and physicians or hospitals being targeted in both political or religious conflicts and wars. Many health workers were kidnapped and/or killed by insurgents of various ideology. Attacks on hospitals also could cause long-term effects: hospital units could be unavailable for a long time and replacing staff could take several months, further compounding hospital operations. Both physical and psychological (eg, posttraumatic stress disorder [PTSD]) after-effects of a terrorist attack can be detrimental to health care services. On the other hand, physicians and other hospital employees have shown to be involved in terrorism. As data show that some offenders had a previous history with the location of the terror incident, the possibility of hospitals or other health care services being targeted by insiders is discussed. The purpose of this report was to consider how past terrorist incidents can inform current hospital preparedness and disaster response planning.status: publishe

Rockin’ Yourself Asleep

Background: Sleep-related rhythmic movement disorder occurs frequently in childhood with a minority of patients having persistent symptoms in adolescence. Phenomenology Shown: We describe a 14-year-old female showing a typical example of head banging at onset of sleep. Educational Value: Sleep-related rhythmic movement disorder usually has a benign and self-limiting nature and medication might only be warranted in cases of severe sleep disruption or frequent injuries

Work stress-related problems in physicians in the time of COVID-19

Objectives Healthcare workers in the emergency department are exposed to a wide range of physical and psycho-social risks or hazards in the workplace. The aim of this study was to investigate the impact of exposure to, the occurrence and perceived risks of, and the worry about, occupational hazards among emergency and hospital physicians in the time of COVID. Material and Methods Based on the review of occupational hazards in emergency physicians, a questionnaire already used and validated in another study, conducted in 2016, was constructed. The questionnaire consisted of both socio-demographic questions and questions regarding the exposure to, the occurrence and perceived risks of, and the worry about, the following occupational hazards: infectious diseases, COVID-19, physical hazards, violence at work, and stressful situations at work that can cause burnout. A total of 497 questionnaires were distributed to Belgian emergency and hospital physicians in April 20–May 26, 2020. Results Overall, 319 responses (out of 497 questionnaires) were collected, of which 196 were eligible for statistical analysis. Of the respondents, 32% stated to be confronted with violence and 54% to suffer from health problems related to their work. The exposure to, and the occurrence and perceived risks of, occupational hazards and, more specifically, the exposure to COVID-19 (88%) and its occurrence (10%), and also the worry about these hazards, appear to be high in physicians working in the emergency department. The worry about each of these outcomes is predicted by the supposed exposure, occurrence, and perceived risks. Conclusions The exposure to, and the occurrence and perceived risks of, physical hazards, violence and burnout are generally high in physicians in the time of COVID-19. Emergency and hospital physicians in Belgium worry the most about the impact of violence, burnout and COVID-19. Int J Occup Med Environ Health. 2021;34(3):373–8

Fight or flight: will hospital personnel go to work when disaster strikes?

status: publishe

Primary Care as Primary Target:A Review of Terrorist Attacks Against Primary Care Providers and Their Offices

BACKGROUND: Violence against primary care providers (PCPs) has increased during the current pandemic. While some of these violent acts are not defined as terrorist events, they are intentional events with an aim to disrupt, kill, or injure. Despite their pivotal role in health care, little is known about the risk for PCPs as targets of terrorism.METHODS: Data collection was performed using a retrospective database search through the Global Terrorism Database (GTD). The GTD was searched using the internal database search functions for all terrorist attacks against PCPs and their offices from January 1, 1970 - December 31, 2019. Years 2020 and 2021 were not yet available at the time of the study. Primary attack and weapon type, location (country, world region), and number of deaths and injuries were collated. Results were exported into an Excel spreadsheet (Microsoft Corp.; Redmond, Washington USA) for analysis.RESULTS: There were 29 terrorist attacks against PCPs and their offices from 1970-2019. The majority of attacks occurred during or after 2010. There were 58 fatalities, 52 injured, and 13 hostages. Most documented attacks took place in Pakistan, the United States, and Sri Lanka. Bombings concerned 55% of cases and 21% were hostage-takings.CONCLUSION: Although less common than attacks on other health care related targets, terrorist attacks against PCPs have occurred. The majority of attacks occurred during the last decade. Future studies are warranted to further assess the risk of terrorist attacks against PCPs: before, during, and beyond the current pandemic.</p