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A Scientific Investigation of Blast Injuries: London 7/7 Terrorist Bombings

Publication date: Feb 11, 2013 01:55 PM

Start: May 08, 2012 12:00 AM

Dr Hasu Patel, Consultant Plastic and Reconstructive Surgeon at St Bartholomew’s and the Royal London Hospitals

On July 7th 2005, four suicide bombings occurred on the London transport systems. This was the first suicide bombing in the United Kingdom, resulting in 56 deaths and injuring many hundreds. The aim of this study was to analyse the positions of the victims at each of the scenes in relation to the bomber and the device, analyse the injury patterns and injury severity score (ISS) leading to allocation of a triage status.

Methods - The data captured from the bombings was obtained from forensic data, hospital records and witness statements released by the Metropolitan Police. The data was anonymised and then analysed to understand blast injury mechanisms in an enclosed and semi-enclosed environment. Each victim was allocated an injury severity score (ISS) and their positional analysis and triage status was determined on the three involved carriages or on the bus.

Results - The positional analysis of each victim is presented. The injuries of the survivors and fatalities were documented according to the anatomical body parts injured and sub-classified according to both the blast injury classification and their triage status.

Conclusions – Positional analysis of the victims needs to be accurately carried out as this determines patterns of injuries and possible mechanism in terms of blast wave characteristics. The environment in which bombs are detonated will add to the complexity of the blast wave. We present a comprehensive approach to positional analysis, patterns of injuries and triage which is key to emergency planning and resource allocation.


Miss Hasu D L Patel BSc(Hons), MB, ChB, PhD, FRCS(Plast) is a Consultant Plastic and Reconstructive Surgeon at St Bartholomew’s and the Royal London Hospitals. She trained in Plastic Surgery on the Pan-Thames rotation around London’s main teaching hospitals. She carried out specialist microsurgical training at Chang Gung Memorial Hospital, Taiwan. Her sub-speciality interests include trauma, head and neck and breast reconstruction. On 7/7/2005 she was involved in the immediate and subsequent management of the critically injured victims of the suicide bombings in London. Over the past six years she has intensively researched mechanisms of blast injuries, analysing the patterns of injury, the bombing device and the environment, in order to mitigate against future events.