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Fri Nov 10 18:18:27 GMT 2006

Exactly. And as Dr. Frykberg used to point out, 99+% of all terrorist events
involve explosion and subsequent injury. Bioterrorism is a huge boondoggle
industry. IMHO.

And as Ron Gross would point out, once you get it, whatever toxic or
biological thing it would theoretically be, you're either dead or will be by
the time you realize you "got it".
R. Smith 

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Howard Berkowitz
Sent: Friday, November 10, 2006 1:11 PM
To: trauma-list at trauma.org
Subject: RE: Dr. Mattox at the Detroit Trauma Symposium

>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