Impact of London's terrorist attacks on a major trauma center in London.

During the morning rush hour on Thursday, 07 July 2005, a series of four bombs exploded, affecting London's public transport system. These terrorist attacks killed 52 people and injured > 700. A major incident was declared, and the Royal London Hospital (RLH) was a primary receiving hospital. A total of 194 patients presented to the RLH. Twenty-seven patients required admission. A total of 11 amputations were performed on eight patients. One patient died intra-operatively. Another patient died on Day 6 due to complications related to a head injury. Coordination is vital to the implementation of the hospital's Major Incident Plan in such an emergency. Subsequent internal reviews of the response of the RLH on 07 July 2005 highlighted problems with communication and documentation, as well as the need for extra staffing. These areas should be improved for the management of future major incidents.