Department of Surgery, Vestre Viken HE Ringerike Hospital, Hønefoss, Norway.
Br J Surg. 2013 Aug;100(9):1198-204. doi: 10.1002/bjs.9203.
Civilian mass casualty incidents may occur infrequently and suddenly, and are caused by accidents, natural disasters or human terrorist incidents. Most reports deal with trauma centre management in large cities, and data from small local hospitals are scarce. A rural hospital response to a mass casualty incident caused by a terrorist shooting spree was evaluated.
An observational study was undertaken to evaluate the triage, diagnosis and management of all casualties received from the Utøya youth camp in Norway on 22 July 2011 by a local hospital, using data from the hospital's electronic records. Descriptive data are presented for patient demographics, injuries and patient flow.
The shooting on Utøya youth camp left 69 people dead and 60 wounded. A rural hospital (Ringerike Hospital) triaged 35 patients, of whom 18 were admitted. During the main surge, the hospital triaged and treated 22 patients within 1 h, of whom 13 fulfilled the criteria for activating the hospital trauma team, including five with critical injuries (defined as an Injury Severity Score above 15). Ten computed tomography scans, two focused assessment with sonography for trauma (FAST) scans and 25 conventional X-rays were performed. During the first 24 h, ten surgical procedures were performed and four chest drains inserted. No patient died.
Critical deviation from the major incident plan was needed, and future need for revision is deemed necessary based on the experience. Communication systems and the organization of radiological services proved to be most vulnerable.
平民大规模伤亡事件可能偶尔且突然发生，由事故、自然灾害或人为恐怖袭击引起。大多数报告涉及大城市创伤中心的管理，而来自小地方医院的数据则很少。本文评估了一家农村医院对恐怖分子枪击事件引发的大规模伤亡事件的反应。
采用观察性研究方法，利用医院电子病历中的数据，评估 2011 年 7 月 22 日挪威乌托亚青年营发生的一起恐怖分子枪击事件中当地医院接收的所有伤员的分诊、诊断和处理情况。描述性数据用于患者人口统计学、损伤和患者流程。
乌托亚青年营的枪击事件造成 69 人死亡，60 人受伤。一家农村医院（林格克医院）对 35 名患者进行了分诊，其中 18 名入院。在主要涌入期间，医院在 1 小时内对 22 名患者进行了分诊和治疗，其中 13 名符合启动医院创伤小组的标准，包括 5 名重伤患者（定义为损伤严重程度评分超过 15 分）。进行了 10 次计算机断层扫描、2 次创伤超声重点评估（FAST）扫描和 25 次常规 X 射线检查。在最初的 24 小时内，进行了 10 次手术和 4 次胸腔引流。没有患者死亡。
需要对重大事件计划进行重大偏离，根据经验，未来需要进行修订。通信系统和放射服务的组织被证明是最脆弱的。
