Learning from terrorist mass casualty incidents: a global survey

Area of Science:

• Emergency Medicine
• Disaster Response
• Trauma Surgery

Background:

• Post-terrorist mass casualty incident reports often miss challenges.
• Anonymised platforms can facilitate discussion on encountered difficulties.
• The study aimed to pinpoint areas for improving future incident responses.

Purpose of the Study:

• To identify key challenges and successful strategies in managing terrorist mass casualty incidents.
• To gather clinician experiences on leading during mass casualty events.
• To inform improvements in disaster response protocols.

Main Methods:

• Mixed-methods study using email surveys.
• Initial survey identified successes, failures, challenges, and implemented changes.
• Follow-up quantitative survey assessed agreement on themes using a Likert scale.

Main Results:

• Thirty-three clinicians from 22 hospitals across 17 cities participated.
• Human resources were generally sufficient, but staff coordination was challenging.
• Key difficulties included communication, security, and blast injury management.
• Implemented changes focused on education, revised plans, and exercises.
• Persistent challenges involved training time and psychological well-being.
• High agreement on the need for hospital re-triage, coordination roles, flexibility, and large-scale exercises.

Conclusions:

• International clinician experiences in managing terrorist mass casualty incidents were collated.
• The primary finding emphasizes the organization of human response over physical supplies.
• Improvements in coordination, training, and psychological support are crucial for future responses.