[Terrorist attack training exercise-What can be learned? : Baden-Württemberg counterterrorism exercise (BWTEX)].

Area of Science:

• Disaster medicine
• Emergency preparedness
• Public health security

Background:

• Terrorist attacks pose a significant threat in Germany, necessitating robust strategies for mass casualty management.
• Effective emergency plans require comprehensive training, yet data on training effectiveness is scarce.

Purpose of the Study:

• To collect data from a simulated terrorist attack to improve preclinical and clinical management.
• To identify and address interface challenges in mass casualty response.

Main Methods:

• A large-scale terrorist attack simulation (BWTEX) was conducted in Constance, Germany, involving a car bomb and firearms.
• Military and civil forces collaborated to treat simulated casualties, recording prehospital and hospital arrival data, triage scores, and injury severity.

Main Results:

• Of 84 simulated casualties, 55 were hospitalized; 80% were triaged prehospital.
• Critically injured patients (TK1) arrived significantly later (198 min) than others, with an estimated 44% mortality risk due to time delays.
• Prehospital and hospital documentation quality was insufficient in 78% and 65% of cases, respectively.

Conclusions:

• Mass casualty incidents from terrorist attacks differ from conventional ones, requiring rapid scene evacuation and potentially avoiding city-center treatment facilities.
• Time delays in treatment significantly increase mortality risk for victims of terrorist attacks.
• Training for terrorist attacks must incorporate these specific challenges to improve patient outcomes.