Terror and disaster surgical care: training experienced trauma surgeons in decision making for a MASCAL situation with a tabletop simulation game

Achatz, Gerhard; Friemert, Benedikt; Trentzsch, Heiko; Hofmann, Mahulena; Blätzinger, Markus; Hinz-Bauer, Simone; Paffrath, Thomas; Franke, Axel; Bieler, Dan

doi:10.1007/s00068-020-01441-x

Cited by 29 publications

(17 citation statements)

References 15 publications

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“…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]. Finally it is important to mention, that hospitals and rescue systems must prepare not only for terrorist attacks, but also for a wide spectrum of disasters.…”

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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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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“…The last column of the table lists simulation technologies identified from the literature that have the potential to train these competencies and indexed using the terminology from the framework by Jacob Quick. 15 Our literature review identified a few examples of emerging technologies used for trauma training such as: virtual reality combined with haptics and manikins or requiring special equipment, for example, Oculus 49 ; virtual patients; 46,47,48 gamification; 43 and VR enabled with 360 cameras 52 not covered by the original framework.…”

Section: Ethnographic Field Observationsmentioning

confidence: 99%

Teams managing civilian and military complex trauma: What are the competencies required in austere environments and the potential of simulation technology to address them?

Stathakarou

Sonesson

Lundberg

et al. 2021

Health Informatics J

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Surgical training in civilian hospitals may not be sufficient for managing complex trauma in a setting where such care is not commonly practiced. Understanding the challenges that civilian teams face when moving to austere environments can inform the competencies that need to be trained. The aim of this study was to explore the competencies required in austere environments for teams managing complex trauma, and how they can be trained with simulation technologies. Ethnographic field observations were conducted, and field notes were synthesized. The field notes were structured with the elements of Activity Theory to generate the teams’ competencies that need to be trained. A literature review was conducted to verify the results and identify examples of relevant simulation modalities. The analysis resulted in a structured list of competencies for civilian teams to manage complex trauma in an austere environment and recommendations which simulation technologies could be used in training of those competencies based on published studies. Our study contributes to understanding the challenges that civilian teams face when operating in an austere environment. A systematized list of competencies with suggested simulation technologies directs future research to improve quality of complex trauma training in civilian and military collaboration.

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“…In [1,3,4,8,9]. Dazu kommt, dass gerade das Zusammenspiel mit öffentlichen Behörden aufgrund der verschiedenen Zuständigkeiten, Kommunikationsarten und -mittel und der strategischen Herangehensweisen einer ausgeklügelten, aber klaren Interaktion bedarf.…”

Section: Bisherige Bemühungen Und Ausblickunclassified

“…Abb 3. 8 Prozentuale Verteilung zur zeitlich letzten Aktualisierung der klinikeigenen Krankenhausalarm-und Einsatzplanung (KAEP)…”

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Sicherheitsaspekte und Vorbereitung zur Notfallvorsorge und Gefahrenabwehr in Kliniken bei MANV/TerrorMANV

et al. 2021

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Zusammenfassung Hintergrund Weltweite terroristische Aktivitäten seit „9/11“ und folgend auch im europäischen Raum haben im Rahmen der Bewertung von kritischer Infrastruktur in Deutschland zu einem Umdenken auch hinsichtlich der Sicherheit an und in Kliniken geführt. Ziel der Arbeit Die vorliegende Publikation befasst sich mit der Bewertung vorliegender Konzepte zu Themen wie „Alarmierung“, „Sicherheit“, „Kommunikation“ und „Vorbereitung“ im vorgenannten Kontext. Material und Methoden Anhand einer Literatursichtung sowie einer Umfrage unter den Teilnehmern*innen der 3. Notfallkonferenz der DGU (Deutsche Gesellschaft für Unfallchirurgie) werden diese Thematik und die aktuell vorliegende Situation weiter analysiert und vorgestellt. Ergebnisse Die gewonnenen Daten verdeutlichen, dass ein Großteil der Kliniken zwar über eine Krankenhausalarm- und Einsatzplanung verfügt, jedoch die Frequenz der Aktualisierungen und die innerklinische Kommunikation zur Steigerung der Wahrnehmung eine deutliche Streuung zeigen. Weiterhin verdeutlichen die Ergebnisse eine Heterogenität der vorliegenden innerklinischen Alarmierungskonzepte sowie einen Mangel an Sicherheitskonzepten und Kooperationen mit Sicherheits- und Wachdiensten. Zudem zeigt sich, dass die Thematik einer möglichen CBRN(chemical, biological, radiological, nuclear)-Bedrohung in der Risikoanalyse noch nicht adäquat wahrgenommen wird bzw. umgesetzt ist. Diskussion Zusammenfassend scheint die latente Bedrohung durch terroristische Aktivitäten dazu geführt zu haben, dass sich deutsche Kliniken in der Bewertung als kritische Infrastruktur mit der Thematik „Krankenhausalarm- und Einsatzplanung“ auseinandergesetzt und diese überwiegend auch umgesetzt haben. Allerdings zeigt sich für die nachgeordneten Bereiche und die aus der Alarmplanung ableitbaren Konsequenzen noch nicht die nötige Stringenz, um letztendlich adäquate Reaktionen in diesen besonderen Szenarien im Hinblick auf die Sicherheit in und an deutschen Kliniken zu gewährleisten.

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Terror and disaster surgical care: training experienced trauma surgeons in decision making for a MASCAL situation with a tabletop simulation game

Cited by 29 publications

References 15 publications

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

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

Teams managing civilian and military complex trauma: What are the competencies required in austere environments and the potential of simulation technology to address them?

Sicherheitsaspekte und Vorbereitung zur Notfallvorsorge und Gefahrenabwehr in Kliniken bei MANV/TerrorMANV

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