Oslo government district bombing and Utøya island shooting July 22, 2011: The immediate prehospital emergency medical service response

BackgroundOn July 22, 2011, a single perpetrator killed 77 people in a car bomb attack and a shooting spree incident in Norway. This article describes the emergency medical service (EMS) response elicited by the two incidents.MethodsA retrospective and observational study was conducted based on data from the EMS systems involved and the public domain. The study was approved by the Data Protection Official and was defined as a quality improvement project.ResultsWe describe the timeline and logistics of the EMS response, focusing on alarm, dispatch, initial response, triage and evacuation. The scenes in the Oslo government district and at Utøya island are described separately.ConclusionsMany EMS units were activated and effectively used despite the occurrence of two geographically separate incidents within a short time frame. Important lessons were learned regarding triage and evacuation, patient flow and communication, the use of and need for emergency equipment and the coordination of helicopter EMS.

[1]  Marius Rehn,et al.  Major incident patient evacuation: full-scale field exercise feasibility study. , 2011, Air medical journal.

[2]  P. Aitken,et al.  Disaster medicine reporting: The need for new guidelines and the CONFIDE statement , 2010, Emergency medicine Australasia : EMA.

[3]  H. Lossius,et al.  Scandinavian pre-hospital physician-manned Emergency Medical Services--same concept across borders? , 2010, Resuscitation.

[4]  A. Nakstad,et al.  Rapid response car as a supplement to the helicopter in a physician‐based HEMS system , 2004, Acta anaesthesiologica Scandinavica.

[5]  P. Steen,et al.  Prehospital advanced life support provided by specially trained physicians: is there a benefit in terms of life years gained? , 2002, Acta anaesthesiologica Scandinavica.

[6]  Jeffrey L Arnold,et al.  Mass-Casualty Terrorist Bombings In Istanbul, Turkey, November 2003: Report of the Events and the Prehospital Emergency Response , 2004, Prehospital and Disaster Medicine.

[7]  A. Langhelle,et al.  International EMS Systems: the Nordic countries. , 2004, Resuscitation.

[8]  F. Turégano-Fuentes,et al.  11 March 2004: The terrorist bomb explosions in Madrid, Spain – an analysis of the logistics, injuries sustained and clinical management of casualties treated at the closest hospital , 2004, Critical care.

[9]  H. Lossius,et al.  [Disaster triage--needs for a Norwegian standard]. , 2010, Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke.

[10]  Helse og omsorgsdepartementet.  Forskrift om krav til akuttmedisinske tjenester utenfor sykehus , 2005 .

[11]  P. Steen,et al.  The Utstein template for uniform reporting of data following major trauma: A joint revision by SCANTEM, TARN, DGU-TR and RITG , 2008, Scandinavian journal of trauma, resuscitation and emergency medicine.

[12]  D J Lockey,et al.  London bombings July 2005: the immediate pre-hospital medical response. , 2005, Resuscitation.

[13]  J. Boyd,et al.  Integrated model for providing tactical emergency medicine support (TEMS): analysis of 120 tactical situations , 2012, Acta anaesthesiologica Scandinavica.

[14]  Hans Morten Lossius.  The Scandinavian journal of trauma, resuscitation and emergency medicine – grown up at last , 2008, Scandinavian journal of trauma, resuscitation and emergency medicine.