The Hartford Consensus IV: A Call for Increased National Resilience

Area of Science:

• Emergency Medicine
• Public Health Preparedness
• Trauma Care

Background:

• Despite advancements, a gap persists in national preparedness for active shooter and mass casualty events.
• Immediate responders, often volunteers, are an underutilized resource for enhancing national resilience.
• Previous reports established the Hartford Consensus principle: no death from uncontrolled bleeding.

Purpose of the Study:

• To highlight the critical role of immediate responders in mass casualty event response.
• To introduce and advocate for the THREAT acronym as a framework for saving lives.
• To improve national all-hazards resilience through optimized victim care.

Main Methods:

• Drawing on experiences from numerous mass casualty incidents.
• Developing and promoting the THREAT acronym: Threat suppression, Hemorrhage control, Rapid Extrication to safety, Assessment by medical providers, Transport to definitive care.
• Leveraging the Hartford Consensus principle of controlling hemorrhage.

Main Results:

• Immediate responders can significantly bolster national resilience.
• The THREAT acronym provides a structured approach to maximize victim survival.
• Effective hemorrhage control is paramount in saving lives during such events.

Conclusions:

• Immediate responders are a vital, yet underutilized, asset in mass casualty event preparedness.
• The THREAT protocol offers a comprehensive strategy for immediate life-saving interventions.
• Enhancing national resilience requires integrating immediate responders and structured protocols like THREAT.