Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Nov 8;20(1):362.
doi: 10.1186/s13054-016-1543-7.

Pre-hospital management of mass casualty civilian shootings: a systematic literature review

Conor D A Turner  1 , David J Lockey  2   3   4 , Marius Rehn  3   4   5
Affiliations

Pre-hospital management of mass casualty civilian shootings: a systematic literature review

Conor D A Turner et al. Crit Care. .

Erratum in

Abstract

Background: Mass casualty civilian shootings present an uncommon but recurring challenge to emergency services around the world and produce unique management demands. On the background of a rising threat of transnational terrorism worldwide, emergency response strategies are of critical importance. This study aims to systematically identify, describe and appraise the quality of indexed and non-indexed literature on the pre-hospital management of modern civilian mass shootings to guide future practice.

Methods: Systematic literature searches of PubMed, Cochrane Database of Systematic Reviews and Scopus were conducted in conjunction with simple searches of non-indexed databases; Web of Science, OpenDOAR and Evidence Search. The searches were last carried out on 20 April 2016 and only identified those papers published after the 1 January 1980. Included documents had to contain descriptions, discussions or experiences of the pre-hospital management of civilian mass shootings.

Results: From the 494 identified manuscripts, 73 were selected on abstract and title and after full text reading 47 were selected for inclusion in analysis. The search yielded reports of 17 mass shooting events, the majority from the USA with additions from France, Norway, the UK and Kenya. Between 1994 and 2015 the shooting of 1649 people with 578 deaths at 17 separate events are described. Quality appraisal demonstrated considerable heterogeneity in reporting and revealed limited data on mass shootings globally.

Conclusion: Key themes were identified to improve future practice: tactical emergency medical support may harmonise inner cordon interventions, a need for inter-service education on effective haemorrhage control, the value of senior triage operators and the need for regular mass casualty incident simulation.

Keywords: Civilian; Haemorrhage control; Mass shootings; Pre-hospital management; Tactical Emergency Medical Services; Triage.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flow chart depicting the stages of the systematic literature search. NHS National Health Service
Fig. 2
Fig. 2
Mass shootings descriptive
See this image and copyright information in PMC

References

    1. Blair JP, Schweit K. A study of active shooter incidents, 2000-2013. Washington DC: Texas State University and Federal Bureau of Investigation, US Department of Justice; 2014.
    1. Bjelopera JP, Bagalman E, Caldwell SW, Finklea KM, McCallion G. Public mass shootings in the United States: Selected implications for federal public health and safety policy (Congressional Research Service Report R43004) Retrieved from https://www.fas.org/sgp/crs/misc/R43004.pdf.
    1. Kelleher MD. Flash point: The American mass murderer. Westport: Praeger; 1997.
    1. Aitken L, Oosthuizen P, Emsley R, Seedat S. Mass murders: implications for mental health professionals. Int J Psychiatry Med. 2008;38(3):261–9. doi: 10.2190/PM.38.3.c. - DOI - PubMed
    1. Fattah S, Rehn M, Lockey D, Thompson J, Lossius HM, Wisborg T. A consensus based template for reporting of pre-hospital major incident medical management. Scand J Trauma Resusc Emerg Med. 2014;22(1):1. doi: 10.1186/1757-7241-22-1. - DOI - PMC - PubMed

Publication types