Rural hospital mass casualty response to a terrorist shooting spree

Area of Science:

• Emergency Medicine
• Trauma Surgery
• Disaster Medicine

Background:

• Mass casualty incidents (MCIs) are infrequent but devastating, with limited data from rural hospitals.
• Terrorist events pose unique challenges to healthcare systems.
• This study examines a rural hospital's response to a mass shooting MCI.

Purpose of the Study:

• To evaluate the triage, diagnosis, and management of casualties from the Utøya youth camp attack.
• To identify challenges and areas for improvement in rural hospital MCI response.

Main Methods:

• Observational study using electronic health records from Ringerike Hospital.
• Analysis of patient demographics, injury patterns, and patient flow during the MCI.
• Descriptive data presentation of hospital resource utilization.

Main Results:

• Ringerike Hospital triaged 35 patients, admitting 18, with 22 treated within the first hour.
• Five patients had critical injuries (Injury Severity Score > 15).
• No patient deaths occurred at the hospital; 10 surgical procedures and 4 chest drains were performed within 24 hours.

Conclusions:

• The hospital's major incident plan required critical deviations, necessitating future revisions.
• Communication systems and radiological service organization were identified as vulnerable areas.
• The rural hospital's response demonstrated effective patient management despite challenges.