Severe flooding in August 2002 devastated villages, towns, large areas of arable land, streets, roads, and industrial areas in the Czech Republic and Southeastern Germany. In the Czech Republic, 48,000 people were evacuated from Prague.Due to electrical outages, communication and the care of hospital patients suffered. Sanitation services and refuse collection also were not available, which increased the potential for the spread of disease. In Germany, five hospitals required evacuation. Electrical outages were problematic here as well, and it is recommended that the procedures for the longdistance transportation of a large number of severely ill or injured people be clarified in national plans.

The aim of the study is to evaluate the self-administered Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria-based inventory for the screening of post-traumatic stress disorder. Due to its low sensitivity (57%) and high specificity (88%), it could be useful as a second step of a screening procedure in combination with other validated, self-report instruments. The clinical implications of the findings and the limitations of the study are discussed.

A quick and simple technique for securing a chest tube in the prehospital setting is described. The technique makes use of a plastic tie with a self-locking mechanism that is wrapped around the tube and sutured to the skin. The use of a plastic tie is recommended as a valuable component to chest tube kits for use in the prehospital setting.

On 12 October 2002, two bombs exploded on the island of Bali in Indonesia, destroying two bars in the tourist district of the holiday resort Kuta Beach. The explosions killed 202 people from 21 different countries, and >300 people were injured. A team of observers conducted structured and unstructured interviews, and lessons learned from the experience were identified. This report summarizes various elements of the response including: (1) prehospital care; (2) coordination; (3) hospital response; and (4) Australia's efforts in air evacuation.

Vicarious traumatization is now a well-known entity and may have negative influences on those that are involved in rescue efforts in any disaster or traumatic events. Healthcare workers work with trauma survivors and witness an immense array of gruesome and ghastly images. This work has the potential to cause those engaged in rescue efforts to become affected subconsciously.

Job-related stress may cause psychological symptoms in care providers who provide support and listen to the survivors' account of trauma. A therapist working in disaster situations may become a victim of psychological anguish—undermining their physical and mental well-being as well as their profession, adversely affecting their traumatized patients, and leading to a counter-productive therapist-survivor relationship.

This significant theme of secondary trauma must be recognized in relief workers at early stages and must be addressed at an individual as well as organizational level. The key may lie in turning to social supports, adapting positive coping mechanisms, and subsequently seeking mental health consultation. Further research is required in this area to determine the best resolution.

This is a descriptive study of the medical responses to the bombings by terrorists in Madrid on 11 March 2004. The nature of the event, the human damage, and the responses are described. It describes the: (1) nature and operations associated with the alarm; (2) assignment of responding units and personnel; (3) establishment and operations of casualty collection points; (4) medical transport and distribution of injured victims; (5) prioritization and command; (6) hospital care; (7) psychosocial care; (8) identification of the dead; and (9) police investigation and actions. Each of these descriptions is discussed in terms of what currently is known and the implications for future planning, preparedness, and response.

Too often during major emergencies, those with specialty skills are perceived as unnecessary and are left sitting on the sidelines. Sometimes, they are not even considered. When they are utilized, they often are assigned menial tasks that, understandably, do not encourage a willingness to “buy in” to a response.