The Great Belt train accident: the emergency medical services response

Abstract

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.

Construction of COVID-19 Epidemic Prevention and Control and Public Health Emergency Response System Based on Discrete Stochastic Mathematical Model

“…In terms of material reserve management and infrastructure construction, professional medical rescue agencies and rescue teams are an important foundation for urban disaster emergency medical work [ 19 , 20 ]. However, the basis of disaster emergency medical work in cities across China is weak.…”

Emergency medical services preparedness in mass casualty incidents: A qualitative study

“…As to strengthening skills, development and implementation of educational curricula in universities, exercise and training in simulated environments, scenario-based practices, presentation of case reports and lessons learned, and real experiences are important factors. 8,9,23 In this study, it was stated that the focus of EMS empowerment is on clinical skills rather than disasters. This empowerment should be a combination of training and standard courses to increase the EMS preparedness in MCIs.…”

“…In this study, important findings were communication challenges and the consequences of difficult access to the incident site. In addition, it was acknowledged that the Danish EMS system calls for an expansion of capacity in formal education in MCIs management 8 …”

Communication in Sudden-Onset Major Incidents: Patterns and Challenges—Scoping Review

“…Communication breakdown is frequent in MI 2,3 and may affect patient outcomes, safety of personnel, and the expedited return to normal conditions. Communication in MI has been sparsely quantified until recently in a case report by Hansen et al 4 Modes of communication may range from a verbal exchange of information to sophisticated digital platforms, depending on the geo-political and socio-economic settings of the MI. Low-to middle-income countries may be challenged by a lack of access to reliable, well-functioning communication systems or sufficient communication devices as well as limited planning, education, and training.…”

“…Communication breakdown is frequent in MI 2,3 and may affect patient outcomes, safety of personnel, and the expedited return to normal conditions. Communication in MI has been sparsely quantified until recently in a case report by Hansen et al 4…”