The key for a metropolis in coping with a terrorist attack is how fast and co-ordinated are the cities emergency medical services.
Yesterday London witnessed one of the worst terrorist attacks when it was still celebrating the successful 2012 Olympics hosting bid. In the morning rush hours at 8.51 am a bomb explosion took place at Liverpool Street subway station and a call was received .by the ambulance service "reports of an incident". Within the next 60 minutes many more calls were received from various parts of city as serial bomb blasts affected many locations.
Within minutes all elective surgeries were postponed. All staff on post duty off were called using Cell phones and pagers. The emergency services were co-ordinated in such a way that there was maximum concentration of efforts where there were maximum casualties.
The Royal London Hospital, a major teaching hospital in the East End, treated around 200 casualties. The plan also included getting patients less injured by buses to the hospitals. Paul White, the hospital's chief executive in an interview with BBC said: "Emergency plans had worked well" he added, "We had a well-rehearsed plan and our staff responded in their usual professional way, we are not over-stretched -- staff came in response to our major incident alert."
Although there were about 37 deaths by the end of the day and over 300 major casualties. The workload was distributed to many major hospitals like Royal Free Hospital, University College Hospital, Guys and St Thomas', and St Mary's.
London is no stranger to such attacks and for the last 25 years has always been under the threat either of IRA or 9/11 or Alqeda. The hospitals have well rehearsed routine to deal with such emergencies. Special systems have been put in place at each hospital, including a 'Hospital Coordination Team' to manage the response and deploy staff effectively. The team must include a senior clinician, manager and nurse. Hospitals are asked to decide what method of triage they would follow at the start of any 'major incident' as well as during the incident.
London's professional way of dealing with the attack yesterday has brought it praise from their grateful public and the international media. This is a lesson to countries like India where most cities have no such coordinated
action plan in place.