Education and training as a key enabler of successful patient care in mass-casualty terrorist incidents

Abstract

Background and purpose The increase in terrorist attacks with sometimes devastating numbers of victims has become a reality in Europe and has led to a fundamental change in thinking and a reorientation in many fields including health policy. The purpose of this original work was to improve the preparedness of hospitals and to provide recommendations for training. Material and methods We conducted a retrospective literature search based on the Global Terrorism Database (GTD) for the period 2000 to 2017. Using defined search strategies, we were able to identify 203 articles. We grouped relevant findings into main categories with 47 statements and recommendations on education and training. In addition, we included data from a prospective questionnaire-based survey on this topic that we conducted at the 3rd Emergency Conference of the German Trauma Society (DGU) in 2019. Results Our systematic review identified recurrent statements and recommendations. A key recommendation was that regular training should take place on scenarios that should be as realistic as possible and should include all hospital staff. Military expertise and competence in the management of gunshot and blast injuries should be integrated. In addition, medical leaders from German hospitals considered current surgical education and training to be insufficient for preparing junior surgeons to manage patients who have sustained severe injuries by terrorist events. Conclusion A number of recommendations and lessons learned on education and training were repeatedly identified. They should be included in hospital preparations for mass-casualty terrorist incidents. There appear to be deficits in current surgical training which may be offset by establishing courses and exercises.

Evaluation of urological and gynecological surgeons as force multipliers for mass casualty trauma care

“…37 The identification and training of medical staff as a very central key element is one of the most important building blocks in planning for these types of events. [38][39][40][41][42] The military trauma system is composed of tiered levels of care that facilitate the stabilization of patients as near to the point of injury as possible, followed by transport between levels for further stabilization and "The mid to late career subspecialists (uro-oncology and gyn-oncology) performed well in the abdomen. They moved with a sense of purpose and were comfortable in the abdomen.…”

“…Both military and civilian health systems must make it a high priority to prepare for managing large influxes of traumatically injured patients, many of them with the types of injuries more commonly seen in combat 37 . The identification and training of medical staff as a very central key element is one of the most important building blocks in planning for these types of events 38–42 . The military trauma system is composed of tiered levels of care that facilitate the stabilization of patients as near to the point of injury as possible, followed by transport between levels for further stabilization and definitive care.…”

The impact of the three-level collaboration exercise on collaboration and leadership during scenario-based hospital evacuation exercises using flexible surge capacity concept: a mixed method cross-sectional study

“…The COVID-19 pandemic has served as a crucial turning point in healthcare services, exposing the insufficiencies in healthcare surge capacity and leadership capability, highlighting the urgency of multiagency collaboration among healthcare organisations and across public and private sectors. Moreover, evidence from previous studies shows that hospital staff often lack preparedness due to limited knowledge of disaster response principles and inadequate awareness of contingency plans [4,18,19,24,25]. During the COVID-19 pandemic, some hospitals faced contamination, necessitating patient evacuations, leading to substantial resource consumption and revealing their lack of preparedness [26,27].…”