caa a22 4500 605467803 CHVBK 20210128100313.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s10049-015-0028-6 doi (NATIONALLICENCE)springer-10.1007/s10049-015-0028-6 Dealing with terror-related mass casualty events [Elektronische Daten] Principles and lessons learned [K. Peleg, M. Rozenfeld] Umgang mit Massenanfällen von Verletzten nach Terroranschlägen Grundsätze und Erfahrungswerte Purpose: To describe the evidence-based insights and guidelines regarding the preparedness of health-care systems to deal with terror attacks. Methods: Review of the existing literature on the subject with an emphasis on data from the Second Intifada of 2000-2005. Results: The most critical components of dealing with terror attacks are not the clinical guidelines and protocols but organization, command, control, communication, and coordination (OCCCC). Creating universal protocols for dealing with terror attacks is problematic because they can differ greatly in injury characteristics, time to evacuation and treatment, and levels of hospital preparedness. Overall, terror casualties involve more severe injuries than other types of trauma and require more hospital resources. The most important clinical parameter of injuries from terrorist explosion attacks is a mix of different types of severe injury in the same patient. This complicates triage, and thus the dichotomic distinction of "urgent” and "not urgent” patients may be more helpful than the classic "color system.” The stream of severely injured patients into hospital frequently creates bottlenecks, especially in the emergency department, the intensive care unit, and imaging and operation rooms. Conclusions: The most important guidelines for the preparedness of health-care systems for terror attacks are: establishment of a central authority for coordinating preparedness and response; existence of clear preparedness goals; definition of standard operating procedures for all organizational levels; enhancement of surge in hospital capacity; quick clearance of emergency departments to receive urgent casualties with non-urgent patients directed elsewhere; quick reinforcement of emergency departments by additional staff; distribution of severe casualties between adjacent hospitals with possible definition of the closest one as triage hospital; training and exercising of medical staff on all levels. Springer-Verlag Berlin Heidelberg, 2015 Terror nationallicence Mass casualty events nationallicence Injuries nationallicence Preparedness nationallicence Medical management nationallicence Massenanfall von Verletzten nationallicence Verletzungen nationallicence Einsatzbereitschaft nationallicence Medizinische Versorgung nationallicence Peleg K. National Center for Trauma & Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 52621, Ramat-Gan, Israel aut Rozenfeld M. National Center for Trauma & Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 52621, Ramat-Gan, Israel aut Notfall + Rettungsmedizin Springer Berlin Heidelberg 18/4(2015-06-01), 285-292 1434-6222 18:4<285 2015 18 10049 https://doi.org/10.1007/s10049-015-0028-6 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10049-015-0028-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Peleg K. National Center for Trauma & Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 52621, Ramat-Gan, Israel aut NATIONALLICENCE 700 1- Rozenfeld M. National Center for Trauma & Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 52621, Ramat-Gan, Israel aut NATIONALLICENCE 773 0- Notfall + Rettungsmedizin Springer Berlin Heidelberg 18/4(2015-06-01), 285-292 1434-6222 18:4<285 2015 18 10049