Department of Traumatology, Oslo University Hospital, Ulleval, Nydalen, Oslo, Norway.
J Trauma Acute Care Surg. 2012 Jul;73(1):269-75. doi: 10.1097/TA.0b013e31825a787f.
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.
The in-hospital response is analyzed. Data on triage, patient flow, injuries, treatment, resources, and outcome were collected.
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%.
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.
Therapeutic/care management study, level V.
2011 年 7 月 22 日，挪威发生恐怖袭击，奥斯陆市中心发生爆炸，随后在青年营发生枪击事件。我们描述了创伤中心的应对措施，确定了可能的成功因素，并为机构重大事件计划提出了改进建议。
分析院内应对措施。收集了分诊、患者流程、损伤、治疗、资源和结局的数据。
爆炸造成 98 人伤亡，8 人当场死亡。10 名患者被分诊至创伤中心，第一名患者在爆炸后 18 分钟到达，7 名患者在随后的 19 分钟内到达。枪击事件造成现场 68 人死亡，61 人受伤。创伤中心共收治枪击事件 21 名患者。急诊分诊的紧急医疗部门负责人负责人员和沟通的控制，以及治疗的控制和监督，进行再次分诊和优化创伤外科资源的利用（双重指挥）。在急诊室、手术室或重症监护病房，从未出现过能力过剩的情况。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 名患者需要再次手术，在最初的 4 周内共进行了 125 次手术。1 名患者死亡，死亡率为 5%。
当受到大量流动伤员的影响时，创伤中心可以处理大量严重受伤的患者，其关键死亡率较低。采用双重手术指挥模式，可以管理有限的特定创伤外科能力。
治疗/护理管理研究，等级 V。
