Evaluation of prehospital preparedness for major incidents on a national level, with focus on mass casualty incidents.
Disaster planning
Major Incidents
Mass Casualty Incidents
Prehospital preparedness
Trauma
Journal
European journal of trauma and emergency surgery : official publication of the European Trauma Society
ISSN: 1863-9941
Titre abrégé: Eur J Trauma Emerg Surg
Pays: Germany
ID NLM: 101313350
Informations de publication
Date de publication:
20 Dec 2023
20 Dec 2023
Historique:
received:
07
06
2023
accepted:
21
10
2023
medline:
20
12
2023
pubmed:
20
12
2023
entrez:
20
12
2023
Statut:
aheadofprint
Résumé
To investigate prehospital preparedness work for Mass Casualty Incidents (MCI) and Major Incidents (MI) in Norway. A national cross-sectional descriptive study of Norway's prehospital MI preparedness through a web-based survey. A representative selection of Rescue and Emergency Services were included, excluding Non-Governmental Organisations and military. The survey consisted of 59 questions focused on organisation, planning, education/training, exercises and evaluation. Totally, 151/157 (96%) respondents answered the survey. The results showed variance regarding contingency planning for MCI/MI, revisions of the plans, use of national triage guidelines, knowledge requirements, as well as haemostatic and tactical first aid skills training. Participation in interdisciplinary on-going life-threatening violence (PLIVO) exercises was high among Ambulance, Police and Fire/Rescue Emergency Services. Simulations of terrorist attacks or disasters with multiple injured the last five years were reported by 21/151 (14%) on a regional level and 74/151 (48%) on a local level. Evaluation routines after MCI/MI events were reported by half of the respondents (75/151) and 70/149 (47%) described a dedicated function to perform such evaluation. The study indicates considerable variance and gaps among Prehospital Rescue and Emergency Services in Norway regarding MCI/MI preparedness work, calling for national benchmarks, minimum requirements, follow-up routines of the organisations and future reassessments. Implementation of mandatory PLIVO exercises seems to have contributed to interdisciplinary exercises between Fire/Rescue, Police and Ambulance Emergency Service. Repeated standardised surveys can be a useful tool to assess and follow-up the MI preparedness work among Prehospital Rescue and Emergency Services at a national, regional and local level.
Identifiants
pubmed: 38117294
doi: 10.1007/s00068-023-02386-7
pii: 10.1007/s00068-023-02386-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Laerdal Foundation for Acute Medicine
ID : (2022-0029)
Informations de copyright
© 2023. The Author(s).
Références
Lennquist S, editor. Medical response to major incidents and disasters: a practical guide for all medical staff. Heidelberg: Springer, Berlin; 2012.
Clarkson L, Williams M. EMS mass casualty triage. Treasure Island: StatPearls Publishing LLC; 2022.
Hugelius K, Becker J, Adolfsson A. Five challenges when managing mass casualty or disaster situations: a review study. Int J Environ Res Public Health. 2020;17(9):1.
doi: 10.3390/ijerph17093068
Moran ME, Baallas D, Blecker N, et al. Evolution of a mass casualty drill design team: A program evaluation. J Emerg Manag. 2021;19(4):367–77.
doi: 10.5055/jem.0542
pubmed: 34580852
Moss R, Gaarder C. Exercising for mass casualty preparedness. Br J Anaesth. 2022;128(2):e67–70.
doi: 10.1016/j.bja.2021.10.016
pubmed: 34799102
Moran CG, Webb C, Brohi K. Lessons in planning from mass casualty events in UK. BMJ. 2017;359: j4765.
doi: 10.1136/bmj.j4765
pubmed: 29070605
Skryabina EA, Betts N, Reedy G, et al. The role of emergency preparedness exercises in the response to a mass casualty terrorist incident: A mixed methods study. Int J Disaster Risk Reduct. 2020;46: 101503.
doi: 10.1016/j.ijdrr.2020.101503
pubmed: 33312855
pmcid: 7709486
Moran ME, Zimmerman JR, Chapman AD, et al. Staff perspectives of mass casualty incident preparedness. Cureus. 2021;13(6): e15858.
pubmed: 34322342
pmcid: 8299895
Turner CD, Lockey DJ, Rehn M. Pre-hospital management of mass casualty civilian shootings: a systematic literature review. Crit Care. 2016;20(1):362.
doi: 10.1186/s13054-016-1543-7
pubmed: 27825363
pmcid: 5101656
Gabbe BJ, Veitch W, Mather A, et al. Review of the requirements for effective mass casualty preparedness for trauma systems A disaster waiting to happen? Br J Anaesth. 2022;128(2):e158–67.
doi: 10.1016/j.bja.2021.10.038
pubmed: 34863512
Bachman SL, Demeter NE, Lee GG, et al. The impact of trauma systems on disaster preparedness: a systematic review. Clin Pediatric Emergency Med. 2014;15(4):296–308.
doi: 10.1016/j.cpem.2014.09.004
Cryer HG, Hiatt JR. Trauma system: the backbone of disaster preparedness. J Trauma. 2009;67(2 Suppl):S111–3.
pubmed: 19667842
Montán KL, Riddez L, Lennquist S, et al. Assessment of hospital surge capacity using the MACSIM simulation system: a pilot study. Eur J Trauma Emerg Surg. 2017;43(4):525–39.
doi: 10.1007/s00068-016-0686-1
Gabbe BJ, Veitch W, Curtis K, et al. Survey of major trauma centre preparedness for mass casualty incidents in Australia, Canada. England New Zealand EClinical Med. 2020;21: 100322.
Kristiansen T, Søreide K, Ringdal KG, et al. Trauma systems and early management of severe injuries in Scandinavia: review of the current state. Injury. 2010;41(5):444–52.
doi: 10.1016/j.injury.2009.05.027
pubmed: 19540486
Haeberer M, Tsolova S, Riley P, et al. Tools for assessment of country preparedness for public health emergencies: a critical review. Disaster Med Public Health Prep. 2021;15(4):431–41.
doi: 10.1017/dmp.2020.13
pubmed: 32366350
Montán KL, Örtenwalle P, Blikmark M, et al. A method for detailed determination of hospital surge capacity: a prerequisite for optimal preparedness for mass-casualty incidents. Eur J Trauma Emerg Surg, 2022: p. 1–14.
Aylwin CJ, König TC, Brennan NW, et al. Reduction in critical mortality in urban mass casualty incidents: analysis of triage, surge, and resource use after the London bombings on July 7, 2005. Lancet. 2006;368(9554):2219–25.
doi: 10.1016/S0140-6736(06)69896-6
pubmed: 17189033
Agri J, Montán C, Söderin L, et al. Prehospital Preparedness for Major Incidents in Sweden: A National Survey with Focus on Mass-Casualty Incidents. Prehospital and Disaster Medicine, 2022: p. 1–8.
Norwegian Ministry of Health and Care Services. National health preparedness plan version 2.0.2014. https://www.regjeringen.no/contentassets/261879a38c3e438d82ab4729e0661cf1/hod_national_health_preparedness_plan_eng.pdf . Accessed 28 Feb 2023.
Saunes IS, Karanikolos M, Sagan KM, editors. Norway Health system review. 2020. Norwegian Institute of Public Health. https://hdl.handle.net/11250/3024406 . Accessed 31 May 2023.
Nasjonal Kompetansetjeneste for traumatologi. Nasjonal traumeplan. Versjon 1.1. 2020. https://traumeplan.no . Accessed 28 Feb 2023.
Aasland T, Braut GS. Samvirke – the core concept of Norwegian search and rescue services – as seen by voluntary organizations. Int Public Manag Rev. 2019;19(2):7–25.
Hovedredningssentralen. Håndbok for redningstjenesten Systembeskrivelse-prinsipper-verdier.2018. https://www.hovedredningssentralen.no/wp-content/uploads/2018/09/Den-norske-redningstjenesten.pdf . Accessed February 28, 2023.
Hovedredningssentralen. Nasjonal veileder for planverk og samvirke i redningstjenesten. 2018. https://www.hovedredningssentralen.no/nasjonal-veileder-for-planverk-og-samvirke-i-redningstjenesten . Accessed 28 Feb 2023.
Cone DC, Serra J, Burns K, et al. Pilot test of the salt mass casualty triage system. Prehosp Emerg Care. 2009;13(4):536–40.
doi: 10.1080/10903120802706252
pubmed: 19731169
Helsedirektoratet.Nasjonal veileder for masseskadetriage. https://www.helsedirektoratet.no/veiledere/masseskadetriage/Masseskadetriage%20-%20Nasjonal%20veileder.pdf/_/attachment/inline/5f964973-5fb1-4075-a6a4-7c0007896184:4f74d7c6b78f6322bf03dc5a96ba4bb776edfa43/Masseskadetriage%20-%20Nasjonal%20veileder.pdf . Published 2020. Accessed February 28, 2023.
Helsedirektoratet. Nasjonalveileder for helsetjenestens organisering på skadested. 2020. https://www.helsedirektoratet.no/veiledere/helsetjenestens-organisering-pa-skadested/Helsetjenestens%20organisering%20på%20skadested%20-%20Nasjonal%20veileder.pdf/_/attachment/inline/9ecfef15-cefc-434d-a37c-387d3f6f8707:8ce3cc0fd8bf3fbea1d746bd68c1f71bcad47234/Helsetjenestens%20organisering%20på%20skadested%20-%20Nasjonal%20veileder.pdf . Accessed 28 Feb 2023.
Helsedirektoratet. Pågående livstruende vold (PLIVO). 2017. https://www.helsedirektoratet.no/tema/akuttmedisin/pagaende-livstruende-vold-plivo . Accessed February 28, 2023.
Direktoratet for Samfunnsikkerhet og Beredskap. Nod- og beredskapskommunikasjon (Nødnett). https://www.dsb.no/menyartikler/nod--og-beredskapskommunikasjon-nodnett/ . Accessed 28 Feb 2023.
Rimstad R, Braut GS. Literature review on medical incident command. Prehosp Disaster Med. 2015;30(2):205–15.
doi: 10.1017/S1049023X15000035
pubmed: 25659266
Rimstad R, Sollid SJ. A retrospective observational study of medical incident command and decision-making in the 2011 Oslo bombing. Int J Emerg Med. 2015;8:4.
doi: 10.1186/s12245-015-0052-9
pubmed: 25852774
pmcid: 4385130
Johnsen AS, Sollid JS, Vigerust T, et al. Helicopter emergency medical services in major incident management: A national Norwegian cross-sectional survey. PLoS ONE. 2017;12(2): e0171436.
doi: 10.1371/journal.pone.0171436
pubmed: 28192440
pmcid: 5305240
Hansen EH, Hunskaar S. Development, implementation, and pilot study of a sentinel network (“The Watchtowers”) for monitoring emergency primary health care activity in Norway. BMC Health Serv Res. 2008;8(1):62.
doi: 10.1186/1472-6963-8-62
pubmed: 18366754
pmcid: 2279126
Levi L, Michaelson M, Admi H, et al. National Strategy for Mass Casualty Situations and its Effects on the Hospital. Prehosp Disaster Med. 2002;17(1):12–6.
doi: 10.1017/S1049023X00000054
pubmed: 12357558
Blix SW, Melau J, Thorvaldsen N, et al. Norwegian Emergency Medicine Systems’ Training and Equipment for Penetrating Injuries: A National Survey-Based Study. Disaster Med Public Health Prep, 2021: p. 1–4.
Fattah S, Krüger AJ, Andersen JE, et al. Major incident preparedness and on-site work among Norwegian rescue personnel - a cross-sectional study. Int J Emerg Med. 2012;5(1):40.
doi: 10.1186/1865-1380-5-40
pubmed: 23134634
pmcid: 3552867
Bulger EM, Snyder D, Schoelles K, et al. An evidence-based prehospital guideline for external hemorrhage control: American college of surgeons committee on Trauma. Prehosp Emerg Care. 2014;18(2):163–73.
doi: 10.3109/10903127.2014.896962
pubmed: 24641269
Kragh JF, Walters TJ, Baer DG, et al. Survival with emergency tourniquet use to stop bleeding in major limb trauma. Ann Surg. 2009;249(1):1–7.
doi: 10.1097/SLA.0b013e31818842ba
pubmed: 19106667
Kotwal RS, Howard JT, Orman JA, et al. The Effect of a golden hour policy on the morbidity and mortality of combat Casualties. JAMA Surg. 2016;151(1):15–24.
doi: 10.1001/jamasurg.2015.3104
pubmed: 26422778
Dyrseth TK, editor. Direktoratet for Nødkomunikasjon. Nødnettmagasinet, November 2016.
Hals I, Tveit AK. Ulykken ved Turøyna, in Studie for ingeniørfag. 2017, Høyskolen på Vestlandet.
Englund L, Michel PO, Riddez L, et al. The bomb attack in Oslo and the shootings at Utøya, 2011 : – Kamedo Report No.97, 2012. 2015.
Turégano-Fuentes F, Pėrez-Díaz D, Sanz-Sánchez M, et al. Overall asessment of the response to terrorist bombings in trains, madrid. Eur J Trauma Emerg Surg. 2008;34(5):433.
doi: 10.1007/s00068-008-8805-2
pubmed: 26815987
Schorscher N, Kippnich M, Meybohm P, et al. Lessons learned from terror attacks: thematic priorities and development since 2001-results from a systematic review. Eur J Trauma Emerg Surg. 2022;48(4):2613–38.
doi: 10.1007/s00068-021-01858-y
pubmed: 35024874
pmcid: 8757406
Hjortdahl M, Zakariassen E, Halvorsen PA. Self reported involvement in emergency medicine among GPs in Norway. Scand J Prim Health Care. 2018;36(2):161–9.
doi: 10.1080/02813432.2018.1459234
pubmed: 29633648
pmcid: 6066289
Hirsch M, Carli P, Nozard R, et al. The medical response to multisite terrorist attacks in Paris. Lancet. 2015;386(10012):2535–8.
doi: 10.1016/S0140-6736(15)01063-6
pubmed: 26628327
Gulland A. “It wasn’t a medical miracle—we made our own luck”: lessons from London and Manchester terror attacks. BMJ. 2017;358: j4309.
doi: 10.1136/bmj.j4309
pubmed: 28928143
Sollid SJ, Rimstad R, Rehn M, et al. Oslo government district bombing and Utøya island shooting July 22, 2011: the immediate prehospital emergency medical service response. Scand J Trauma Resusc Emerg Med. 2012;20:3.
doi: 10.1186/1757-7241-20-3
pubmed: 22280935
pmcid: 3266631
Hardy SE, Fattah S, Wisborg T, et al. Systematic reporting to improve the emergency medical response to major incidents: a pilot study. BMC Emerg Med. 2018;18(1):4.
doi: 10.1186/s12873-018-0153-x
pubmed: 29368642
Hardy SE, Fattah S. Trials and tribulations: how we established a major incident database. Scand J Trauma Resusc Emerg Med. 2017;25(1):7.
doi: 10.1186/s13049-017-0351-7
pubmed: 28122602
pmcid: 5267420