Terrorism in Spain: emergency medical aspects.

A terrorism movement has been active in Spain during the last 20 years, with a painful number of victims. Civil Defense is in charge of the coordination of all the structures that are implicated in a terrorist incident. There are three typical patterns of attacks: (1) individual attacks; (2) group attacks; and (3) mass attacks. The individual attacks are done with guns, usually 9 mm, fired from a short distance; victims die from serious intracranial damage. Collective attacks are done using explosives under vehicles, tramp bombs, or "bomb vehicles;" victims are of different severity with wounds, burns, and blast injuries. With mass attacks with "bomb vehicles" in buildings or crowded public places, the numbers of victims are elevated and produce brutal social consequences. Emergency Medical Services integrated in to "Civil Defense" try to minimize the damage by initializing treatment on-scene and with the rapid provision of definitive care. During the last year, post-traumatic stress disorder treatment groups have been providing care to the victims and personnel. Chemical or biological weapons have not been used, although this is a great concern to the authorities.