US Trauma Center Preparation for a Terrorist Attack in the Community

Background: Since the 2001 terrorist attacks on the United States, federal and state funding, primarily from the National Bioterrorism Hospital Preparedness Program, has resulted in a surge of hospital activity to prepare for future natural or human-caused catastrophes. Trauma centers were integrally involved in the response to the 2001 attacks as first receivers of patients, communication hubs, and as convergence sites for families, the worried well, volunteers, and donors. After the Madrid train station terrorist attack, Congress identified the need to study trauma center preparedness as an essential part of the nation's emergency management system. Methods: The NFTC received a one-year grant funded by the Centers for Disease Control and Prevention (CDC/NCIPC) to survey the capability and capacity of trauma centers to respond successfully to mass casualty incidents, particularly those brought about by acts of terrorism. This report summarizes responses to a US CDC/NCIPC-funded survey, R 49 CE000792-01, sent to all designated or verified Level I and II trauma centers in the US, to which 33% or 175 trauma centers replied. Results: The results are categorized by preparedness scoring, vulnerability, threats, and funding. Planning communication, surge capacity, diversion, sustainability, special populations, and finance represent additional categories examined in the survey. Conclusions: Trauma centers are a major resource in disaster management. One-hundred and seventy-five centers candidly reported their resources and vulnerabilities. This inventory should be expanded to all trauma centers and recommendations for change as discussed.