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Fri Nov 10 18:11:23 GMT 2006

>From: bensonblues at comcast.net
>Reply-To: "Trauma &amp; Critical Care mailing list" 
><trauma-list at trauma.org>
>To: trauma-list at trauma.org
>Subject: Dr. Mattox at the Detroit Trauma Symposium
>Date: Fri, 10 Nov 2006 17:48:36 +0000
>
>Our revered "k" gave an excellent presentation on Disaster Management at 
>the 54th Detroit Trauma Symposium yesterday. What was most impressive to me 
>(besides k's oratory skills) was the gasps from the younger (probably 
>resident) attendees when the Dr. pointed out that a terrorist attack using 
>"dirty" bombs was probable in the near future. Do we not understand that we 
>are not living in the '60s any longer? Are these (mostly surgical) 
>residents so busy with their training that they don't get the news?
>
>The EM residents in my program receive lectures in biochemical terrorism 
>and blast injuries, as well as training in Hazmat and Mass Casualty 
>management - this is the best I can do in preparing them for their future. 
>Like Ken said yesterday, disaster readiness/management is a local issue 
>that is best managed by local yokles.

While radiologic weapons certainly are possible, may I offer a bit of 
perspective on other risks? When I'm presenting on disaster preparedness in 
the telecommunications/Internet industry, I point out that the first WWI 
chemical attack used 160 tons of chlorine, brought into position by rail, 
against an approximately 8 kilometer front.

In the US, chlorine typically is shipped in 90 or 55 ton rail cars. Far more 
toxic chemicals, of course, are routinely shipped throughout the country. 
What would be the effect of one or two shoulder-launched antitank rockets 
fired into chemical rail cars or fixed storage tanks, to say nothing of more 
sophisticated explosive systems intended to maximize release?  Do we all 
remember Bhopal?

There are such rockets in private hands, illegal as they may be, in the US.  
Of course, there are a wide range of explosive attack systems. Consider the 
relative difficulty, for the terrorist, of carrying stable explosives or 
military weapons, as opposed to transporting a hot radioisotope and a 
burster charge.  Why steal or smuggle radioactives when chemical facilities 
are there, with large quantities needing just a little help to go free?

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Dr. Mattox at the Detroit Trauma Symposium