Oslo government district bombing and Utøya island shooting July 22, 2011: The immediate prehospital emergency medical service response

Sollid, Stephen J. M.; Rimstad, Rune; Rehn, Marius; Nakstad, Anders Rostrup; Tomlinson, Ann-Elin; Strand, Terje; Heimdal, Hans Julius; Nilsen, Jan Erik; Sandberg, Mårten

doi:10.1186/1757-7241-20-3

Cited by 91 publications

(91 citation statements)

References 12 publications

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“…At the Utoya Island shooting in 2011, limited interagency communication and a persisting threat by the shooter resulted in EMS staff unable to get onto the island and access casualties for two hours and seven minutes [48] Similarly in the report on the Columbine Shootings of 1999, injured victims were still stranded in the school over two hours after the shooters had committed suicide. Furthermore due to a breakdown in communication a medical team almost came under friendly fire by the Special Weapons And Tactics (SWAT) team [36].…”

Section: Resultsmentioning

confidence: 99%

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Pre-hospital management of mass casualty civilian shootings: a systematic literature review

2016

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BackgroundMass casualty civilian shootings present an uncommon but recurring challenge to emergency services around the world and produce unique management demands. On the background of a rising threat of transnational terrorism worldwide, emergency response strategies are of critical importance. This study aims to systematically identify, describe and appraise the quality of indexed and non-indexed literature on the pre-hospital management of modern civilian mass shootings to guide future practice.MethodsSystematic literature searches of PubMed, Cochrane Database of Systematic Reviews and Scopus were conducted in conjunction with simple searches of non-indexed databases; Web of Science, OpenDOAR and Evidence Search. The searches were last carried out on 20 April 2016 and only identified those papers published after the 1 January 1980. Included documents had to contain descriptions, discussions or experiences of the pre-hospital management of civilian mass shootings.ResultsFrom the 494 identified manuscripts, 73 were selected on abstract and title and after full text reading 47 were selected for inclusion in analysis. The search yielded reports of 17 mass shooting events, the majority from the USA with additions from France, Norway, the UK and Kenya. Between 1994 and 2015 the shooting of 1649 people with 578 deaths at 17 separate events are described. Quality appraisal demonstrated considerable heterogeneity in reporting and revealed limited data on mass shootings globally.ConclusionKey themes were identified to improve future practice: tactical emergency medical support may harmonise inner cordon interventions, a need for inter-service education on effective haemorrhage control, the value of senior triage operators and the need for regular mass casualty incident simulation.

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Section: Resultsmentioning

confidence: 99%

“…Currently the methods of triage for mass shootings are not validated by reliable evidence [66]. In many of the papers included in this review, triage was identified as an area of potential improvement or concern [13, 30, 48, 49, 53, 54]. …”

Section: Resultsmentioning

confidence: 99%

Pre-hospital management of mass casualty civilian shootings: a systematic literature review

2016

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“…This was noted at the Utoya Island shooting of 2011 in Norway. Limited interagency communication and a persisting threat by the perpetrator resulted in emergency medical service (EMS) staff being unable to access casualties for 2 hours and 7 min 10. The island did provide a natural cordon allowing for a casualty clearing station in a place of safety although this was subsequently relocated to allow better helicopter access for evacuation.…”

Section: Scenesmentioning

confidence: 99%

Marauding terrorist attack (MTA): prehospital considerations

Chauhan

Conti²,

Keene

2018

Emerg Med J

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Terrorist attacks are increasing each year as are the number of deaths associated with them. Recent incidents have seen a shift in tactics with the use of multiple terrorists across multiple locations with firearms or knives, referred to as the marauding terrorist attack. These methods are becoming more prevalent alongside the use of vehicles deliberately aimed at pedestrians. Management of these incidents can be challenging. Not only it involves a large number of casualties but also the management of a dynamic scene in terms of both location and threat from attack. In order to improve response, and potentially outcomes, a system or response needs to have preplanned and practised procedures in place. This article reviews major incident management for those unfamiliar with current prehospital practice and details some of the findings from recent marauding terrorist firearm attacks, in particular the evolution of newer scene management tools such as 3 Echo and THREAT. It highlights the importance of haemorrhage control and the public initiatives focusing on actions during a terrorist incident.

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“…Verdien av prehospital triage utført av anestesileger ble framhevet under evaluering av helsevesenets innsats 22. juli 2011 (Helsedirektoratet, 2012a;Sollid et al, 2012).…”

Section: Nytteeffekten Av Legebemannet Ambulanseunclassified