86 Aeromedical Staging Facility (ASF)

The Department of Homeland Security (DHS) in 2008, developed the initiative “Run, Hide, Fight” as a response strategy to an active shooter event. In the event of an active shooter they suggest run or evacuate first, if evacuation is not possible, hide and barricade doors, and as a last resort, fight back if your life is in imminent danger (DHS, 2008). All public places are vulnerable to active shooter attacks, but hospitals differ due to the vulnerability of its patients. Evacuation may not a possibility for all patients, as some may be non-ambulatory due medical conditions, or incapacitated due to anesthesia or sedation (e.g. surgical patients, ventilator dependent). Another factor increasing patient vulnerability is the patient’s ability to understand commands (e.g. Dementia, language barriers). In order to establish effective preparedness strategies, they should be tailored to the hospital environment and specific units (Cormier, 2016; Jacobs et al., 2017).

Beginning in 2001 Intelligence about the impending nature of an attack was increasing, not only from US Intelligence sources but also from 11 other countries such as Britain, Israel, India, Egypt, Morocco and even a top Taliban commander from Afghanistan (Thompson.) Beginning in August warnings become coming in from everywhere, foreign governments, CIA and FBI sources and so on however, next to none of this information was shared between the many intelligence agencies. In April, NORAD launched a training scenario in which the pentagon was to be incapacitated by a hijacked airliner however the Joint Chiefs of Staff disregarded the scenario as “too unrealistic” (September 11 attacks advance-knowledge debate.) On august 19th the Israeli’s gave US intelligence personnel credible information including, the list of 19 suspected terrorist’s names and the fact that a large aircraft would be the primary weapon involved. The names were not shared by the CIA with other intelligence agencies (Robinson.)

When the distraught son of an elderly woman undergoing cancer treatment at Johns Hopkins Hospital in Baltimore opened fire on his mother’s surgeon in September 2010, shock, panic and a total lockdown of the hospital set in. The surgeon recovered, but the hospital staff was traumatized.

The bombings on the United States embassies in East Africa were several attacks that happened on August 7, 1998 in Nairobi, Kenya and Dar es Salaam, Tanzania. These attacks occurred simultaneously and involved truck bomb explosions at the American embassies in these countries resulting in the death of hundreds of people and destruction of property. Moreover, these attacks happened on the same date that marked the eighth anniversary of the arrival of the United States forces in Saudi Arabia. The genesis of the attacks were largely associated to the members of the Egyptian Islamic Jihad that culminated in the placement of Osama bin Laden among the top ten most wanted fugitives by the United States. These attacks on the American embassies were not only shocking to the world but it also resulted in the understanding of the serious security threat posed by terrorists and terror organizations.

service members who have been deployed to either Iraq or Afghanistan have returned with an range of signs and symptoms that we are now calling post-deployment syndrome (PDS). Traumatic brain injury, combat stress, blast injury, post-traumatic stress disorder, or post-concussive syndrome each fit into the variety of symptoms called PDS. Four hundred thousand previously healthy service men and women now live with PDS that, at times, causes them to be entirely disabled or to suffer so much that they even may take their own lives. This number may seem shocking, however PDS doesn’t just affect these service members, reservists, and veterans, but also their friends, family members, employers, communities, and even the very health care workers who are desperately trying to help them. Surprisingly, despite how common this condition is, it still remains puzzling to fully define and

Hampson explains that the bloody attack on American servicemen was "…a seminal moment on a timeline that led to the 9/11 attacks, to the war the U.S. waged in Afghanistan" (Hampson, 2008). Moreover, Hampson notes that this attack drove the U.S. out of Lebanon but more than that, if led people like Osama bin Laden to "…conclude that when America gets its nose bloodied, it pulls back" (Hampson, p. 1). Previous to this attack the Cold War era was a time when the greatest enemy of the U.S. was Soviet communism; but following the attack, there were new and extremely dangerous enemies such as al Qaeda, Hezbollah, the Taliban and Iran, Hampson continues.

On April 19, 1995, a terrorist set off a bomb at the Alfred P. Murrah Federal building. The explosion killed 168 people and injured 842 more. The bomb went off at 9:02 a.m., and it “destroying a third of the building and left a thirty-foot-wide crater” (Casey 2).

On April 19, 1995 the world was thrown into shock. Terrorism was not a thing in the United States. It was even more of a shock to find out this terrorist was a resident of the United States. Not only did this tragedy effect the hundreds of people inside the Oklahoma City Murrah building, it also affected billions of rescue workers, families, and loved ones. All the different groups of people affected by this bomb copped in very different ways.

Terrorist attacks weaken the spirits of everyone in the world. On the day of September 11, 2000, you can hear the endless hearts and spirits breaking around the world. In the article, “ 9/11: Finding Answers in Ashes 16 years later,” Editorial Board, tells the story of how the chief medical examiner, Dr. Barbara Sampson explains the process and the work that was completed after the 9/11 attack.

Once the stuff of movies or perhaps newscasts covering a conflict in some third world backwater country, large scale terrorist operations are now a deadly reality in America. Few will ever forget the images of the Afred P. Murrah Federal Building: its remaining floors held up in a precarious cantilever; bloody, dust-covered survivors struggling to escape through the smoke and flames. These images will be repeated over and over again as our nation moves into the

Zamosky, L. (2011, September 05). A legacy of illnesses from 9/11. Retrieved June 10, 2016,

Kalynn Blassingame Cleary is a twenty-two-year-old Army combat medic stationed at West Point, NY. She currently is taking online classes to obtain her Bachelor’s degree in Psychology/Social Work at Collin College. Her current profession as a combat medic has permitted her to follow her lifelong dream and passion to help people when they are in need. During her enlistment process with the Army, she took a test that listed her aptitudes and it was determined that she would be a good fit as a combat medic. To be qualified as a combat medic, you have to go through 12 weeks of medical training and pass a 5-day final exam. Her current job as a combat medic is at the Cadet Health clinic, which is located at the United States Military Academy at West Point. “Every morning I run a sick call in the clinic, never knowing how many patients I am going to treat, the number normally ranges from five patients to fifty patients.” Kalynn said, “Every individual I treat has a unique set of qualities.” During her interview, Kalynn talked about how

During The 9/11 tragedies many people know it was definitely one of the worst things that happened in the US. On any given workday, up to 50,000 employees worked in the World Trade Center twin towers and an additional 40,000 passed through the complex, and more than 400 casualties were police officers and fighters, and over 10,000 people were treated for injuries after the attack (“11 facts about 9/11”). Although it may seem as though many people lost their lives in this tragic event, we have

With the world's largest volunteer fighting force in its service, America has long been a nation that kneels in bowed reverence to the service of our military men and women. National monuments stand as enduring testaments to the sacrifices made by ordinary citizens when political action dictates that war must be waged, and holidays commemorate the fallen who laid their lives down in defense of their homeland. Nonetheless, the storm clouds of crisis have begun to gather as the nation winds down its operations in two disparate fields of battle, with a decade of continuous warfare finally ending in Iraq and de-escalation occurring rapidly in Afghanistan. The devastating effects of a prolonged economic recession have crippled many segments of the federal government, but the crucial programs and departments associated with providing healthcare services to active military members and veterans have become severely overburdened by the extraordinary influx of soldiers returning from the Middle East as casualties of war. From amputees coping with the loss of one or more limb after an improvised explosive device attack, to veterans of so-called "stop-loss" deployment schedules who suffer from the invisible wounds of post-traumatic stress disorder (PTSD), and the thousands of soldiers with injuries and illnesses attributed to their service, America has positioned itself precariously on the precipice of domestic disaster the likes of which have

Like the recent explosions on the East Coast, the bombing of Pearl Harbor on 12-7, shattered our feeling of national security. How could this have happened? Ordinary