Background

The Terrorism Injuries Information, Dissemination and Exchange (TIIDE) Project was established through a cooperative agreement in response to the urgent, ongoing need to develop, disseminate and exchange information about injuries from terrorism. Explosives are the weapon of choice for most terrorists, and terrorist bombings averaged two per day worldwide in 2005. According to the 2006 Institute of Medicine Report, The Future of Emergency Care in the United States Health System: Emergency Medical Services at the Crossroads, explosions are the most common cause of injuries associated with terrorism.

Blast injuries present unique triage, diagnostic, and management challenges as a consequence of the blast wave from high explosive detonations upon the body. See selected blast injuries for more information. Only a few civilian health care providers in the United States have experience treating patients with these injuries.

Traditionally, in many states and communities, acute care, emergency medical, and public health systems are poorly integrated, with separate infrastructures functioning independently of one another. Relationships among these organizations must be forged and strengthened to improve public health and safety, clinical management and healthcare system preparedness. TIIDE supports the collaboration of national organizations of professionals in acute medical care, trauma and emergency medical services (EMS) with state and local public health programs and CDC to efficiently and effectively respond to mass casualty events resulting from terrorism. Recent terrorist events worldwide indicate the real and urgent need to move toward an emergency health system that is truly interoperable and integrated.

About the Project

The TIIDE Project is constructed around three, interrelated areas that work to minimize the health consequences of terrorism and other public health emergencies:

• Lessons Learned from Terrorist Events - Certain problematic themes are recurrent in mass casualty responses, such as controlled dispatch, bystander and mutual aid response, and communications. To explore these themes, CDC and TIIDE partners convened meetings in 2005 and 2006 so that individuals and organizations with experience managing responses to international terrorist explosions could share their insight with U.S. acute care and public health organizations. Terrorist bombings such as those in Israel, London, and Mumbai may offer new information and provide insight into local, state, regional, and national responses to a terrorist event and the mitigation of recurrent problems. These experiences will be analyzed to improve the response to such an event in the United States.
• Partnerships - Partners enhance CDC's ability to coordinate with the emergency care community and to ensure that critical information is accessible to a broad spectrum of health care providers and organizations. Partnerships also provide an avenue and platform for disseminating the information gained through Lessons Learned from Terrorist Events
• Dissemination – Through Lessons Learned from Terrorist Events, CDC will determine the most appropriate method for disseminating and exchanging information before, during and after a terrorist bombing. TIIDE will also promote the use of the appropriate methods of communication - whether by electronic mail, fax machine, telephone or other methods - to convey information to the emergency care community and to public health partners on issues related to injuries from terrorism.