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EDITORIALS: Eddie Chaloner Blast injury in enclosed spaces BMJ 2005; 331: 119-120 [Full text]

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Enclosed spaces may protect open medical services

Andrew J Ashworth   (16 July 2005)

Enclosed spaces may protect open medical services 16 July 2005
Andrew J Ashworth, GP Principal Davidson's Mains Medical Centre, Edinburgh EH4 5BP Send response to journal: Re: Enclosed spaces may protect open medical services	All doctors should indeed be able to carry out first aid including immediate treatment of blast injuries, but shouldn't all medical commentators be aware of news reports in the non-medical literature? Naivety can lead to false conclusions that may not be applicable again. The title "Blast injury in enclosed spaces" excludes the injuries sustained in the Number 30 bus, since the fragility of the roof of the bus mercifully converted the environment to one that was not enclosed; the prompt and competent response of BMA representatives prevented this particular incident from being "uncontrolled". The injuries in the enclosed space of tube trains occurred deep underground, causing even the "walking wounded" considerable difficulty in "swamping emergency services": that a "reverse triage effect" did not occur may not be "testament to the outstanding integrated response" but a product of circumstance. Making unjustifiable heroes of those doing their jobs may be as dangerous as making guilty villains of those sharing a religion with misguided idealists. Leaders who seek to fuel the dichotomy that sustains “war” get succour from the “good” of “our” side as well as the “evil” of “theirs”. Competing interests: I receive a pension from the Royal Navy where I treated casualties of war.