The twin terrorist attacks in Norway on July 22, 2011: The trauma center response
The twin terrorist attacks in Norway on July 22, 2011: The trauma center response
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DOI：
10.1097/ta.0b013e31825a787f
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发表时间：
2012-07-01
影响因子：
3.4
通讯作者：
Naess, Paal Aksel
中科院分区：
文献类型：
--
作者：
Gaarder, Christine;Jorgensen, Joakim;Naess, Paal Aksel
背景技术背景：2011年7月22日发生在挪威的恐怖袭击包括奥斯陆市中心的炸弹爆炸，随后在一个青年营地发生的疯狂枪击事件。我们描述了创伤中心的反应，确定可能的成功因素，并提出改进机构的重大事件plannes.METHODS：在医院的反应进行了分析。结果：爆炸共造成98人伤亡，8人当场死亡。10名患者被分流到创伤中心，第一名患者在爆炸发生18分钟后抵达，7名患者在接下来的19分钟内抵达。枪击案造成现场68人死亡，61人受伤。创伤中心共接收了枪击事件中的21名患者。外科领导分为急诊科分诊与控制人员和沟通，以及控制和监督治疗与再取和创伤外科资源的最佳利用（双重命令）。在急诊室、手术室或重症监护室，浪涌能力从未超过。在创伤中心接受治疗的31名患者中，20名患者的损伤严重程度评分超过15分，25名患者需要重复手术，在前4周内共进行了125次手术。结论：一个创伤中心可以处理大量的严重创伤患者，在避免大量步行伤员的情况下，危重死亡率较低。通过采用双重手术命令模型管理有限的特定创伤手术能力（J Trauma Acute Care Surg. 2012; 73：269-275）。版权所有（C）2012 Lippincott威廉姆斯& Wilkins）。证据等级：治疗/护理管理研究，V级。
BACKGROUND: The terrorist attacks in Norway on July 22, 2011, consisted of a bomb explosion in central Oslo, followed by a shooting spree in a youth camp. We describe the trauma center response, identifying possible success factors and suggesting improvements for institutional major incident plans.METHODS: The in-hospital response is analyzed. Data on triage, patient flow, injuries, treatment, resources, and outcome were collected.RESULTS: The explosion caused a total of 98 casualties and 8 died at scene. Ten patients were triaged to the trauma center, with the first patient arriving 18 minutes after the explosion and 7 patients within the next 19 minutes. The shooting caused 68 deaths at the scene and 61 injured. The trauma center received a total of 21 patients from the shooting incident. Surgical leadership was divided between emergency department triage with control of personnel and communication as well as control and supervision of treatment with retriage and optimal use of trauma surgical resources (dual command). Surge capacity was never exceeded in the emergency department, operating rooms, or intensive care units. Of the 31 patients treated at the trauma center, 20 had an Injury Severity Score of more than 15 and 25 required repeated operation, for a total of 125 operations during the first 4 weeks. One patient died, for a critical mortality of 5%.CONCLUSION: A trauma center can handle many patients with severe injury, with low critical mortality when protected from a large number of walking wounded. Limited specific trauma surgical competence was managed by the adoption of a dual surgical command model (J Trauma Acute Care Surg. 2012; 73: 269-275. Copyright (C) 2012 by Lippincott Williams & Wilkins).LEVEL OF EVIDENCE: Therapeutic/care management study, level V.