Jos christmas eve bomb blast: confronting new challenges with old resources

Abstract

Background: Jos, Nigeria has witnessed several mass casualty incidents from sectarian crises, with mechanisms of injury mainly from blunt forces and use of machetes and less from gunshots. In December 2010, for the first time, twin bomb blasts detonated at a market generating casualties and triggering another crisis. We sought to describe peculiarities of this novel mechanism of mass casualty.
Methods: A retrospective descriptive study of patients who presented to our hospital with injuries sustained following the Jos Christmas Eve bombing of 2010.
Results: Of the 90 patients that presented over 4 days, 81 were males and 9 females. Age ranged from 2 to 76 years with a mean of 36.2 years, SD=± 16. There were 31 (34.4%) blast injuries and 35 (38.9%) gunshot injuries. Majority of the wounds involved the lower limbs in 39(43.3%) patients, and upper limbs in 24(26.6%). Forty three (47.8%) patients required only debridement and 13(14.4%) needed only wound dressing. Definitive procedures done were open reduction and internal fixation in 7(7.7%) patients, laparotomy in 5(5.5%), amputation and local wound exploration in 3(3.3%) each, and chest tube insertion in 2(2.2%) patients. Duration of hospital stay ranged from 0-84 days. More than half of the 14(15.5%) complications were infective in origin. There were 7(7.7%) mortalities. The hospital cost was 14 times higher than that of previous crisis that did not involve bomb blast.
Conclusion: The bomb blasts generated predominantly limb injuries that required a lot of resources and prolonged hospital care..A disaster response protocol that envisages injuries arising from this mechanism is essential.