RT Journal Article
SR Electronic
T1 Disaster preparedness should represent an augmentation of the everyday trauma system, but are we prepared?
JF Trauma Surgery & Acute Care Open
JO Trauma Surg Acute Care Open
FD BMJ Publishing Group Ltd
SP e000760
DO 10.1136/tsaco-2021-000760
VO 6
IS 1
A1 Jørgen Joakim Jørgensen
A1 Peter Wiel Monrad-Hansen
A1 Christine Gaarder
A1 Paal Aksel Næss
YR 2021
UL http://tsaco.bmj.com/content/6/1/e000760.abstract
AB Background The increased frequency, geographical spread and the heterogenicity in mass casualty incidents (MCIs) challenge healthcare systems worldwide. Trauma systems constitute the base for disaster preparedness. Norway is sparsely populated, with four regional trauma centers (TCs) and 35 hospitals treating trauma (non-trauma centers (NTCs)). We wanted to assess whether hospitals fill the national trauma system requirements for competence and the degree of awareness of MCI plans.Methods We conducted a cross-sectional survey of on-call trauma teams in all 39 hospitals during two time periods: July–August (holiday season (HS)) and September–June (non-holiday season (NHS)). A standardized questionnaire was used to evaluate the MCI preparedness.Results A total of 347 trauma team members participated (HS: 173 and NHS: 174). Over 95% of the team members were aware of the MCI plan; half had read the plan during the last 6 months, whereas 63% at the TCs and 74% at NTCs were confident with their MCI role. Trauma team exercises were conducted regularly and 86% had ever participated. Only 63% at the TCs and 53% at the NTCs had participated in an MCI exercise. The proportion of resident surgeons and anesthetists with >4 years’ clinical experience was significantly higher in TCs (88% and 63%) than in NTCs (27% and 17%). All the on-call consultant surgeons were at home, leaving interns in charge at several of the hospitals. All resident surgeons at the TCs were ATLS providers compared with 64% at the NTCs, and almost 90% of the consultant surgeons had participated in advanced trauma surgical courses.Discussion Despite increased national focus on disaster preparedness, we identified limited compliance with trauma system requirements concerning competency and training. Strict guidelines to secure immediate notification and early presence of consultants whenever a situation that might turn into an MCI occurs should be a prerequisite.Level of evidence Level IV. Study type: cross- sectional.Data are available upon reasonable request. Deidentified participant data are available upon reasonable request from the corresponding author.