TY  - JOUR
A1  - Schorscher, Nora
A1  - Kippnich, Maximilian
A1  - Meybohm, Patrick
A1  - Wurmb, Thomas
T1  - Lessons learned from terror attacks: thematic priorities and development since 2001 - results from a systematic review
JF  - European Journal of Trauma and Emergency Surgery
N2  - PURPOSE
The threat of national and international terrorism remains high. Preparation is the key requirement for the resilience of hospitals and out-of-hospital rescue forces. The scientific evidence for defining medical and tactical strategies often feeds on the analysis of real incidents and the lessons learned derived from them. This systematic review of the literature aims to identify and systematically report lessons learned from terrorist attacks since 2001.

METHODS
PubMed was used as a database using predefined search strategies and eligibility criteria. All countries that are part of the Organization for Economic Cooperation and Development (OECD) were included. The time frame was set between 2001 and 2018.

RESULTS
Finally 68 articles were included in the review. From these, 616 lessons learned were extracted and summarized into 15 categories. The data shows that despite the difference in attacks, countries, and casualties involved, many of the lessons learned are similar. We also found that the pattern of lessons learned is repeated continuously over the time period studied.

CONCLUSIONS
The lessons from terrorist attacks since 2001 follow a certain pattern and remained constant over time. Therefore, it seems to be more accurate to talk about lessons identified rather than lessons learned. To save as many victims as possible, protect rescue forces from harm, and to prepare hospitals at the best possible level it is important to implement the lessons identified in training and preparation.
KW  - terror attacks
KW  - evaluation
KW  - lessons learned
KW  - emergency preparedness
KW  - public health preparedness
KW  - mass casualties
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-264862
SN  - 1863-9941
VL  - 48
ER  - 
TY  - JOUR
A1  - Wurmb, T
A1  - Schorscher, N
A1  - Justice, P
A1  - Dietz, S
A1  - Schua, R
A1  - Jarausch, T
A1  - Kinstle, U
A1  - Greiner, J
A1  - Möldner, G
A1  - Müller, J
A1  - Kraus, M
A1  - Simon, S
A1  - Wagenhäuser, U
A1  - Hemm, J
A1  - Roewer, N
A1  - Helm, M
T1  - Structured analysis, evaluation and report of the emergency response to a terrorist attack in Wuerzburg, Germany using a new template of standardised quality indicators
JF  - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
N2  - Background:
Until now there has been a reported lack of systematic reports and scientific evaluations of rescue missions during terror attacks. This however is urgently required in order to improve the performance of emergency medical services and to be able to compare different missions with each other. Aim of the presented work was to report the systematic evaluation and the lessons learned from the response to a terror attack that happened in Wuerzburg, Germany in 2016.

Methods:
A team of 14 experts developed a template of quality indicators and operational characteristics, which allow for the description, assessment and comparison of civil emergency rescue missions during mass killing incidents. The entire systematic evaluation process consisted of three main steps. The first step was the systematic data collection according to the quality indicators and operational characteristics. Second was the systematic stratification and assessment of the data. The last step was the prioritisation of the identified weaknesses and the definition of the lessons learned.

Results:
Five important “lessons learned” have been defined. First of all, a comprehensive concept for rescue missions during terror attacks is essential. Furthermore, the establishment of a defined high priority communication infrastructure between the different dispatch centres (“red phone”) is vital. The goal is to secure the continuity of information between a few well-defined individuals. Thirdly, the organization of the incident scene needs to be commonly decided and communicated between police, medical services and fire services during the mission. A successful mission tactic requires continuous flux of reports to the on-site command post. Therefore, a predefined and common communication infrastructure for all operational forces is a crucial point. Finally, all strategies need to be extensively trained before the real life scenario hits.

Conclusion:
According to a systematic evaluation, we defined the lessons learned from a terror attack in 2016. Further systematic reports and academic work surrounding life threatening rescue missions and mass killing incidents are needed in order to ultimately improve such mission outcomes. In the future, a close international collaboration might help to find the best database to report and evaluate major incidents but also mass killing events.
KW  - terror attack
KW  - mass casualties
KW  - evaluation
KW  - quality indicators
KW  - rescue mission
Y1  - 2018
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-177054
VL  - 26
IS  - 87
ER  -