Review article: The nature of terror medicine

In recent years, the landscape of disasters, conflicts and terror events has become more frequent and complex. Climate change, armed conflicts, terrorism, disinformation, cyber-attacks, inequality and pandemics now present significant challenges to humanity. Emergency physicians today are likely to encounter ideologically motivated violent extremism or terrorist actions by radicalised lone actors. Terror medicine, distinct from disaster medicine, addresses the unique and severe injuries caused by terrorist incidents, including explosions, gunshots and chemical agents. The chaotic aftermath of such attacks demands rapid triage, prioritisation and strict adherence to scene safety protocols. Moreover, terrorist events have profound psychological impacts on victims and responders alike. Understanding the broader public health implications of these attacks is crucial for emergency physicians to enhance community safety and resilience. Terror medicine also brings unique ethical and legal challenges, such as patient confidentiality, mandatory reporting and mass casualty management. Effective responses to terror incidents necessitate close collaboration between healthcare providers and law enforcement. Familiarity with terror medicine principles fosters better communication and coordination, ultimately improving response efficiency and patient outcomes. This review offers a comprehensive approach to understanding terror medicine, defining the concept of ‘terror’, its significance for emergency physicians, and the known health impacts on patients, healthcare workers and responders. By delving into these aspects, the review aims to equip medical professionals with the knowledge and skills needed to navigate the complexities of terror-related emergencies effectively.