London doctor: What it was like in my hospital after Saturday's terror attacks

Malik Ramadhan, the divisional director of emergency care for the Royal London Hospital, reflected on his hospital's experience treating victims of Saturday's terror attacks in London, telling The Guardian's Denis Campbell that he is "proud" of how staff came together to care for patients.

From bombings to hurricanes: How can hospitals prepare for disasters?

According to the New York Times, a group of terrorists on Saturday night rammed a van into numerous pedestrians along the London Bridge and then proceeded to attack London's Borough Market—a crowded nightspot—with knives. At least seven individuals were killed and dozens were wounded, the Times reports.

A doctor's experience

In an interview with the Guardian, Ramadhan, who'd been serving as the duty Accident & Emergency (A&E) consultant at the hospital Saturday night, said he was on his way home around 10 p.m. when he saw a fleet of police cars headed toward central London. Ramadhan said he "knew something was happening," and immediately "rang the London Ambulance Service, and returned straight back to work."

According to Ramadhan, in response to the incident, the hospital "activated our major incident plan," which is designed for emergency events such as Saturday night's attack. Fellow clinicians "came flooding into the hospital to help," Ramadhan said, with 10 consultants, 10 junior doctors, and between 20 and 30 nurses coming into A&E, as well as an additional 50 other doctors, nurses, and technicians who came in so that the hospital could open more operating theaters. While the hospital typically has one operating theater open and can open two more if necessary, on Saturday, the hospital had five theaters going, Ramadhan said.

Overall, providers treated more than 12 patients and performed emergency surgery on six, with each lasting between one and four hours, according to Ramadhan. Each of the injured individuals arrived separately, Ramadhan said, and the hospital was able to assess each patient in "a fully staffed resuscitation bay, with two consultants to oversee their care." All of the patients, Ramadhan added, "received the same standard of care they would have got at three o'clock in the afternoon, even though it was the middle of the night."

According to Ramadhan, "the atmosphere was subdued, because of the reason we were all in work—a major terrorist attack." He explained that atmosphere wasn't necessarily emotional, either. "Emotions happen outside of work," he said, and the "hospital staff is used to working as a team and dealing with this sort of stuff together." Nonetheless, he said the hospital does "plan to talk to all staff next week."

"I'm really proud that we offered world-class care at 11 o'clock on a Saturday night at short notice," Ramadhan said. "We absorbed those 12 patients into our system and were open for business as usual again by Sunday, so London can cope with this sort of thing. ... The public should know that the [National Health System (NHS)] and NHS staff are geared up for things like this and that if they do happen, they will be looked after to a very high standard" (Campbell, The Guardian, 6/4; Erlanger, New York Times, 6/4).

From bombings to hurricanes: How can hospitals prepare for disasters?

Hospitals ust be prepared for myriad disasters that can stress health care systems to the breaking point and disrupt delivery of vital health care services.

Advisory Board has compiled step-by-step procedures for various threats your facility may encounter—though we hope you'll never need to use them.

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