Glahn Jonas Erasmus Egede, Heltø Kim Minh Michael, Alstrøm Henrik, Petersen Marian Christin, Gärtner Rune
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Department of Anaesthesiology, Nordsjællands Hospital, Copenhagen University Hospital, Hillerød, Denmark.
Acta Anaesthesiol Scand. 2025 Mar;69(3):e70003. doi: 10.1111/aas.70003.
The purpose of this study was to introduce the concept of Tactical Emergency Medical Services (TEMS) in Denmark and to explore the TEMS providers' and the Danish Police Forces' confidence in the TEMS concept in case of a terrorist attack within the Capital Region of Denmark.
Terrorist attacks pose a major challenge to prehospital emergency medical services when it comes to reaching trapped victims. The threat to healthcare professionals limits access and creates a so-called therapeutic vacuum, leading to delayed treatment and evacuation of victims and ultimately increases mortality.
This study used a mixed methods triangulation approach, integrating qualitative data from an interview study and quantitative data from a register study. The interview study consisted of 18 semistructured interviews conducted across three interview groups (Copenhagen TEMS physicians/paramedics, senior on-site commanders, and tactical and medical officers from the Copenhagen Police Department) with six participants in each group. Data from the interview study were analyzed using thematic framework analysis. The register study used data from the TEMS database, including 61 assignments from 2019 to 2020, that were analyzed using descriptive statistics.
The interview study found three core themes in each interview group. The main findings included insights on the advantages of having healthcare professionals in the warm zone, the prerequisites for the concept's success, TEMS's cooperation with the Danish Police Force, and challenges concerning healthcare providers inside tactical zones. The participants expected TEMS' presence inside the warm zone could improve triage and medical treatment, free police resources, increase police safety, optimize preparedness of the health sector, and significantly reduce the therapeutic vacuum. Data from the register study demonstrated that TEMS have had prior assignments in the warm and hot zones.
All participating groups have high confidence in TEMS to close the gap of the therapeutic vacuum and deliver advanced physician and paramedic-based tactical medicine inside the warm zone in case of a terrorist attack in Copenhagen, Denmark.
This study includes both provider interviews and registry data to support insight into processes of Tactical Emergency Medicine. The authors discuss possible advantages of having emergency medical personnel in the major incident area early to support a coordinated response.
本研究的目的是在丹麦引入战术紧急医疗服务（TEMS）的概念，并探讨在丹麦首都地区发生恐怖袭击时，TEMS提供者和丹麦警察部队对TEMS概念的信心。
在解救被困受害者方面，恐怖袭击对院前紧急医疗服务构成了重大挑战。对医护人员的威胁限制了救援行动，造成了所谓的治疗真空，导致受害者治疗和撤离延迟，最终增加死亡率。
本研究采用混合方法三角测量法，整合访谈研究的定性数据和登记研究的定量数据。访谈研究包括对三个访谈组（哥本哈根TEMS医生/护理人员、高级现场指挥官以及哥本哈根警察局的战术和医疗官员）进行的18次半结构化访谈，每组6名参与者。访谈研究的数据采用主题框架分析法进行分析。登记研究使用了TEMS数据库中的数据，包括2019年至2020年的61项任务，并采用描述性统计进行分析。
访谈研究在每个访谈组中发现了三个核心主题。主要发现包括对在热区配备医护人员的优势、该概念成功的先决条件、TEMS与丹麦警察部队的合作以及战术区内医护人员面临的挑战的见解。参与者预计，TEMS在热区内的存在可以改善分诊和医疗，释放警察资源，提高警察安全性，优化卫生部门的准备工作，并显著减少治疗真空。登记研究的数据表明，TEMS此前曾在热区和高温区执行过任务。
所有参与组对TEMS在丹麦哥本哈根发生恐怖袭击时填补治疗真空差距并在热区内提供基于医生和护理人员的高级战术医疗服务充满信心。
本研究包括提供者访谈和登记数据，以支持对战术紧急医疗过程的深入了解。作者讨论了在重大事件区域尽早配备紧急医疗人员以支持协调应对的可能优势。
