The twin terrorist attacks in Norway on July 22, 2011

Gaarder, Christine; Jorgensen, Joakim; Kolstadbraaten, Knut Magne; Isaksen, Knut Steinar; Skattum, Jorunn; Rimstad, Rune; Gundem, Trine; Holtan, Anders; Walløe, Anders; Pillgram-Larsen, J; Næss, Paal Aksel

doi:10.1097/ta.0b013e31825a787f

Cited by 58 publications

(54 citation statements)

References 13 publications

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“…Although terror attacks are rare in Norway, they do happen 7. The aim of this study was to examine the ability and preparedness of civilian EMTs in the aspect of preventing unnecessary deaths from extremity exsanguination.…”

Section: Discussionmentioning

confidence: 99%

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Performance of Norwegian civilian EMTs and army medics in penetrating trauma: a controlled simulation‐based assessment

Blix

Melau

Lund-Kordahl

2017

Acta Anaesthesiol Scand

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BackgroundPenetrating trauma kills rapidly. Thorough and efficient examination and aggressive hemorrhage control is important to save lives. The aim of this study was to assess the skills of civilian Emergency Medical Technicians (EMTs) in bleeding examination and control compared to Army Medics. Our hypothesis was that civilian pre‐hospital systems perform at a lower level compared to an expert group, and did not have sufficient focus on education and training in examination and treatment of penetrating injuries.Material and methodsWe included 60 volunteer Certified EMTs and Army Medics. First, the participants examined a wounded patient. Second, the participants were presented a patient with a penetrating injury on a pork side fixated to the thigh with an artificial arterial bleeding.ResultsThe EMTs took significantly shorter time examining, median 1 min 5 s vs. 3 min 58 s (P < 0.001). 5/30 (17%) of EMTs and 28/30 (93%) of army medics did an approved gauze wound packing of the penetrating injury (P < 0.001). EMTs took (median) 18 s and army medics 8 s to hemostasis regardless of approved packing or not (P < 0.001). Time spent on the packing was (median) 1 min 50 s vs. 5 min 47 s respectively (P < 0.001). Increasing time spent on the procedure showed significantly better chance of a successful procedure.ConclusionThe EMTs had lower accuracy in examination but used significantly shorter time than the Army Medics. The treatment part of the study showed poor EMT performance compared to the Army Medics. This study indicates that more wound packing training needs to be incorporated into initial and ongoing civilian EMT training.

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Section: Discussionmentioning

confidence: 99%

“…As we have seen, terror does happen and will probably happen again in the future 7. The aim of the present study was thus to assess the skills in examination and pre‐hospital/immediate treatment of penetrating injuries by EMTs compared to Army Medics.…”

mentioning

confidence: 96%

Performance of Norwegian civilian EMTs and army medics in penetrating trauma: a controlled simulation‐based assessment

Blix

Melau

Lund-Kordahl

2017

Acta Anaesthesiol Scand

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“…The mobilisation of hospital personnel is part of the red code activation, but the number of available staff will be influenced by factors unrelated to the hospital—in our case, the time coinciding with Friday afternoon shift overlap and July being the main summer vacation time in Norway. The redirection of all other emergency patients to other nearby hospitals relieved the overall capacity [5]. Although the workload on radiology staff might seem moderate for a large university hospital, the time-critical and unpredictable nature of MCIs challenges the logistics and capacity of the radiology services.…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, normal routines are replaced by a minimum acceptable care (MAC) strategy aimed at rapid assessment and limited to lifesaving procedures using minimal resources, including imaging, followed by movement of patients to more definitive diagnostics and management [2, 3, 5]. Whether during an MCI or not, trauma imaging in the emergency department (ED) should include plain x-rays of chest and pelvis, and focused assessment with sonography for trauma (FAST) as a screening tool for free fluid [5]. When applying a MAC strategy, the use of computed tomography (CT) in the ED is restricted to the assessment of severe head injuries.…”

Section: Introductionmentioning

confidence: 99%

“…The two sequential terrorist attacks in Norway on the afternoon of 22 July 2011—a bomb explosion in central Oslo and a shooting spree at Utøya—caused (as of September 2016) the largest MCI in Norway since World War II, with more than 220 casualties [5, 8–10]. The medical literature assessing the use and logistics of radiological imaging during MCIs is scarce, and is based in part on table-top exercises and practice simulations [11, 12].…”

Section: Introductionmentioning

confidence: 99%

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Radiology response in the emergency department during a mass casualty incident: a retrospective study of the two terrorist attacks on 22 July 2011 in Norway

et al. 2016

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ObjectivesTo describe the use of radiology in the emergency department (ED) in a trauma centre during a mass casualty incident, using a minimum acceptable care (MAC) strategy in which CT was restricted to potentially severe head injuries.MethodsWe retrospectively studied the initial use of imaging on patients triaged to the trauma centre following the twin terrorist attacks in Norway on 22 July 2011.ResultsNine patients from the explosion and 15 from the shooting were included. Fourteen patients had an Injury Severity Score >15. During the first 15 h, 22/24 patients underwent imaging in the ED. All 15 gunshot patients had plain films taken in the ED, compared to three from the explosion. A CT was performed in 18/24 patients; ten of these were completed in the ED and included five non-head CTs, the latter representing deviations from the MAC strategy. No CT referrals were delayed or declined. Mobilisation of radiology personnel resulted in a tripling of the staff.ConclusionsPlain film and CT capacity was never exceeded despite deviations from the MAC strategy. An updated disaster management plan will require the radiologist to cancel non-head CTs performed in the ED until no additional MCI patients are expected.Key points • Minimum acceptable care (MAC) should replace normal routines in mass casualty incidents. • MAC implied reduced use of imaging in the emergency department (ED). • CT in ED was restricted to suspected severe head injuries during MAC. • The radiologist should cancel all non-head CTs in the ED during MAC.

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Characteristics of Electric Scooter and Bicycle Injuries After Introduction of Electric Scooter Rentals in Oslo, Norway

et al. 2022

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The twin terrorist attacks in Norway on July 22, 2011

Abstract: Therapeutic/care management study, level V.

Cited by 58 publications

References 13 publications

Performance of Norwegian civilian EMTs and army medics in penetrating trauma: a controlled simulation‐based assessment

Performance of Norwegian civilian EMTs and army medics in penetrating trauma: a controlled simulation‐based assessment

Radiology response in the emergency department during a mass casualty incident: a retrospective study of the two terrorist attacks on 22 July 2011 in Norway

Characteristics of Electric Scooter and Bicycle Injuries After Introduction of Electric Scooter Rentals in Oslo, Norway

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