Abstract
Recent terror attacks led the Norwegian government to develop a procedure for emergency and law enforcement services cooperation during Active Violent Incidents (AVI, abbreviated PLIVO in Norwegian). To address further national initiatives to improve preparedness for mass casualty events and penetrating injuries among emergency medical services (EMS) in Norway, training and equipment status were mapped. All EMS regions in Norway were invited to participate in an electronic nation-wide survey about practical medical training in PLIVO scenario training and specific training in hemorrhage control and penetrating injuries. Ninety percent (842/938) had attended at least 1 PLIVO training scenario. Of these, 76% (642/938) reported only evacuation training during the exercise, while only 20% (168/938) had practiced hemorrhage control. Eighty-one percent (760/938) respondents reported that they were equipped with tourniquets and 91% (853/938) were equipped with gauze to pack wounds. However, only 52% (487/938) and 48% (450/938) reported practical training in tourniquet application and wound packing, respectively, while 30% (280/938) reported that they had no training or only theoretical education in tourniquet application. Supervised practical training on penetrating thoracic injuries was reported by <20%, and <50% reported practical training in needle decompression of a tension pneumothorax. Enhanced focus on training in hemorrhage control and penetrating injuries is needed. This supports the recent decision from the Norwegian government to strengthen the training for EMS in AVI (PLIVO) exercises, by focusing on medical procedures in addition to evacuation training. Although the estimated response rate is 17%, we believe the large number of respondents still make the results valuable.
Highlights
On July 22, 2011, Norway experienced the worst terrorist attack since World War II
In the current curriculum for the emergency medical technicians (EMTs) training, examination and treatment of penetrating wounds is not specified, and we found it lacking in a previous study.[3]
We received almost 1000 answers on the survey, and almost all health trusts in Norway were represented. We considered this number of feedbacks sufficient to map the current status of hemorrhage control training and equipment in Norwegian emergency medical services (EMS)
Summary
All ambulance personnel in Norway are trained as advanced providers, compared with tiered EMT training in other countries. All EMS regions in Norway were invited to participate in an electronic survey concerning practical medical training within PLIVO scenario training as well as specific training in hemorrhage control and penetrating injuries. Demographic data such as geographic region, level of education, experience, age, and job description, were registered to allow to adjust for confounders in the final data analysis. We received almost 1000 answers on the survey, and almost all health trusts in Norway were represented We considered this number of feedbacks sufficient to map the current status of hemorrhage control training and equipment in Norwegian EMS. A logistic regression was conducted to examine the associations between equipment in the ambulances and the specific training on use of this equipment
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