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About the TIIDE Project
The CDC-funded Terrorism Injuries: Information, Dissemination and Exchange (TIIDE) Project was established through a cooperative agreement in response to the urgent, ongoing need to develop, disseminate and exchange information about injuries from terrorism. Explosives are the weapon of choice for most terrorists, and terrorist bombings averaged two per day worldwide in 2005. According to the 2006 Institute of Medicine Report, The Future of Emergency Care in the United States Health System: Emergency Medical Services at the Crossroads, explosions are the most common cause of injuries associated with terrorism. Inaugural TIIDE organizations included:
About the Project
All disasters, regardless of etiology, have similar medical and public health consequences. Disasters differ in the degree to which these consequences occur and the degree to which they disrupt the medical and public health infrastructure of the disaster scene.
The key principle of disaster medical care is to do the greatest good for the greatest number of patients, while the objective of conventional medical care is to do the greatest good for the individual patient. 
Terrorism is the most challenging mass casualty incident for emergency responders. The spectrum of terrorist threats is limitless, ranging from suicide bombers, conventional explosives, and military weapons to weapons of mass destruction (nuclear, biological, or chemical). Terrorist events have the greatest potential of all man-made disasters to generate large numbers of casualties and fatalities.
The majority of terrorist bombings consist of relatively small explosives that produce low casualty rates. However, when strategically placed in buildings, pipelines, or moving vehicles, their impact can be much greater. Terrorists have also begun to use larger devices that traditionally have been confined to military operations. The high morbidity and mortality is related not only to the intensity of the blast, but to the subsequent structural damage that leads to collapse of buildings, a common phenomenon in large explosions.

The TIIDE Project is constructed around three, interrelated areas that work to minimize the health consequences of terrorism and other public health emergencies:
  • Lessons Learned from Terrorist Events - Certain problematic themes are recurrent in mass casualty responses, such as controlled dispatch, bystander and mutual aid response, and communications. To explore these themes, CDC and TIIDE partners convened meetings in 2005 and 2006 so that individuals and organizations with experience managing responses to international terrorist explosions could share their insight with U.S. acute care and public health organizations. Terrorist bombings such as those in Israel, London, and Mumbai may offer new information and provide insight into local, state, regional, and national responses to a terrorist event and the mitigation of recurrent problems. These experiences will be analyzed to improve the response to such an event in the United States.
  • Partnerships - Partners enhance CDC's ability to coordinate with the emergency care community and to ensure that critical information is accessible to a broad spectrum of health care providers and organizations. Partnerships also provide an avenue and platform for disseminating the information gained through Lessons Learned from Terrorist Events
  • Dissemination – Through Lessons Learned from Terrorist Events, CDC will determine the most appropriate method for disseminating and exchanging information before, during and after a terrorist bombing. TIIDE will also promote the use of the appropriate methods of communication - whether by electronic mail, fax machine, telephone or other methods - to convey information to the emergency care community and to public health partners on issues related to injuries from terrorism.

Click here to learn more and access the TIIDE Clinical Primer.

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