Bombing attacks by terrorists in the three most southern provinces of Thailand increased both in
frequency and intensity from the year 2004 until now. Patterns of bombing were not only destroying buildings
or killing targets victims by dropping bombs under roads and in public places but also harming scene
investigators by dropping second bombs nearby. Emergency medical personnel working there also had some
risks from these second bombs while helping victims at the scene. The purposes of the present study aimed to
describe patterns and risks of bombing attacks, analyze locations of wounds of bombing casualties and
propose a standing operation procedure for emergency medical technicians (EMTs) in helping victims at
scenes to reduce harm from second bombs. The authors gathered some information about patterns of bombing
from the Forward 4th Army Area Explosive Ordnance Disposal (EOD) team and reviewed insurgency related
casualty reports from Yala, Pattani and Narathivasrajanakarin Hospital from January 2004 to December
2006. From these reports, data of deep wounds or wounds that caused serious injuries or deaths of 144
improvised explosive devices (IED) victims was collected and separated into fatal (45 casualties) and nonfatal
groups (99 casualties). In each group, casualties’ demographic data and number of casualties separated
by locations of wounds and occupations are shown and compared by percentage of the total number of each
group and was found that most of fatal casualties had wounds on head (42.22%), chest (33.33%) and abdomen
(33.33%) that should be protected by wearing helmets and body armors. But there was a higher proportion of
extremity injuries in non-fatal casualties (63.64%). Thus, the authors proposed measures for EMTs in helping
victims at scenes to reduce their risks by wearing helmets and body armors and quickly removal of the injured
with minimal medical intervention.

Keywords: Emergency medical technicians, Injuries, bombing attacks improvised explosive devices, Thailand