Emergency response to terrorist attacks: results of the federal-conducted evaluation process in Germany

Wurmb, Thomas; Franke, Axel; Schorscher, Nora; Kowalzik, Barbara; Helm, Matthias; Bohnen, Renate; Helmerichs, Jutta; Grueneisen, Ulrich; Cwojdzinski, Detlef; Jung, G.; Lücking, Gesa; Weber, M.

doi:10.1007/s00068-020-01347-8

Cited by 17 publications

(9 citation statements)

References 20 publications

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“…An analysis of the literature also provides possible recommendations on how to prepare for acute and long-term psychological effects experienced by health care professionals and victims who were exposed to mass-casualty terrorist incidents. Hospitals should identify appropriate response teams in advance and activate them when required in order to ensure that mental health interventions are immediately available on site in the event of an incident [52,62]. Such teams may be composed of psychiatrists, psychologists, and nursing personnel.…”

Section: Discussionmentioning

confidence: 99%

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

Hoth

Roth

Bieler

et al. 2023

Eur J Trauma Emerg Surg

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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.

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Section: Discussionmentioning

confidence: 99%

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

Hoth

Roth

Bieler

et al. 2023

Eur J Trauma Emerg Surg

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“…It should be mentioned at this point, that there was a federal conducted evaluation process in Germany after the European terror attacks in 2015/2016. The lessons learned [85]. Furthermore the terror and disaster surgical care (TDSC ® ) course was developed in 2017 by the Deployment, Disaster, Tactical Surgery Working Group of the German Trauma Society to enhance the preparation of hospitals to manage mass casualty incidents related to terror attacks [86].…”

Section: Discussionmentioning

confidence: 99%

Lessons learned from terror attacks: thematic priorities and development since 2001—results from a systematic review

Schorscher

Kippnich

Meybohm

et al. 2022

Eur J Trauma Emerg Surg

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Purpose The threat of national and international terrorism remains high. Preparation is the key requirement for the resilience of hospitals and out-of-hospital rescue forces. The scientific evidence for defining medical and tactical strategies often feeds on the analysis of real incidents and the lessons learned derived from them. This systematic review of the literature aims to identify and systematically report lessons learned from terrorist attacks since 2001. Methods PubMed was used as a database using predefined search strategies and eligibility criteria. All countries that are part of the Organization for Economic Cooperation and Development (OECD) were included. The time frame was set between 2001 and 2018. Results Finally 68 articles were included in the review. From these, 616 lessons learned were extracted and summarized into 15 categories. The data shows that despite the difference in attacks, countries, and casualties involved, many of the lessons learned are similar. We also found that the pattern of lessons learned is repeated continuously over the time period studied. Conclusions The lessons from terrorist attacks since 2001 follow a certain pattern and remained constant over time. Therefore, it seems to be more accurate to talk about lessons identified rather than lessons learned. To save as many victims as possible, protect rescue forces from harm, and to prepare hospitals at the best possible level it is important to implement the lessons identified in training and preparation.

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“…Communication breakdown is often seen in MI [5,33,34] due to network overload or outdated technology. This was not the case in the Great Belt Train Accident.…”

Section: Communicationmentioning

confidence: 99%

“…Most lessons learned from MI stem from safety boards [19], commissions [20,33], and government hearings [34,35]. Therefore, delayed or even lost information is inherent when purveying the experiences and potential misfits to improve future MI management [36].…”

Section: Major Incident Reportingmentioning

confidence: 99%

The Great Belt train accident: the emergency medical services response

Hansen

Jepsen

Mikkelsen

et al. 2021

Scand J Trauma Resusc Emerg Med

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Background Major incidents (MI) are rare occurrences in Scandinavia. Literature depicting Scandinavian MI management is scarce and case reports and research is called for. In 2019, a trailer falling off a freight train struck a passing high-speed train on the Great Belt Bridge in Denmark, killing eight people instantly and injuring fifteen people. We aim to describe the emergency medical services (EMS) response to this MI and evaluate adherence to guidelines to identify areas of improvement for future MI management. Case presentation Nineteen EMS units were dispatched to the incident site. Ambulances transported fifteen patients to a trauma centre after evacuation. Deceased patients were pronounced life-extinct on-scene. Radio communication was partly compromised, since 38.9% of the radio shifts were not according to the planned radio grid and presented a potential threat to patient outcome and personnel safety. Access to the incident site was challenging and delayed due to traffic congestion and safety issues. Conclusion Despite harsh weather conditions and complex logistics, the availability of EMS units was sufficient and patient treatment and evacuation was uncomplicated. Triage was relevant, but at the physicians’ discretion. Important findings were communication challenges and the consequences of difficult access to the incident site. There is a need for an expansion of capacity in formal education in MI management in Denmark.

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Emergency response to terrorist attacks: results of the federal-conducted evaluation process in Germany

Cited by 17 publications

References 20 publications

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

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

Lessons learned from terror attacks: thematic priorities and development since 2001—results from a systematic review

The Great Belt train accident: the emergency medical services response

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