Terrorist attacks against emergency departments

Introduction: Emergency departments (EDs) play an integral role in a community's response to disaster. Terrorist attacks targeting EDs have the potential to disrupt the emergency response apparatus. Understanding prior attacks against EDs can yield important lessons to mitigate the impact of future violence. Methods: In this review, the authors used the Global Terrorism Database to conduct a search on terrorist attacks targeting EDs between 1970 and 2018. Using the search terms “doctor,” “nurses,” “hospital,” “healthcare,” “clinic,” “vaccinators,” and “vaccinations,” a total of 2322 healthcare-specific incidents were isolated. The database was further narrowed down to terrorist attacks targeting EDs, using the search terms “emergency,” “emergency department,” and “emergency ward.” Results: A total of six attacks involving five countries were isolated. These attacks occurred between 1991 and 2016, with the majority involving the use of explosive devices, killing a total of 57 victims and leaving 26 wounded. Conclusion: Attacks against EDs, while rare, have the potential to lead to loss of life through both the direct attack and subsequent disruptions to healthcare.