Lessons identified from the 2017 Manchester and London terrorism incidents. Part 1: introduction and the prehospital phase

Abstract

This is the first article in a three-part series detailing the lessons identified during the NHS England clinical debrief meetings which followed the response to the 2017 Manchester and London terrorist incidents. It covers the prehospital phase including the overall key learning points, timeline information, scene challenges, resource utilisation, triage, distribution and helicopter emergency medical service feedback.

Triage in Complex, Coordinated Terrorist Attacks

“…42 A report created from debriefs of the Westminster, Manchester and London Bridge/Borough Market terror attacks stated that the distinction between P1 and P2 triage categories was less relevant than the ability to walk. 43 Another paper written by an attending paramedic to the London Bridge/Borough terror attack, where eight were killed and 48 injured, describes the difficulty of using physiological ranges in the setting of mass penetrating trauma. 1 Many patients at this incident were mobile, however, had serious wounds, and were physiologically compensating at the time of initial triage.…”

Scholarship Supplement

“…In the 2017 London Bridge/Borough Market terror attack specialist firearms police had killed all the offenders within 8 minutes. Due to the unknown element of secondary attacks or other perpetrators, many patients were not accessed by advanced medical providers for a significant amount of time, with the first patient conveyed by ambulance arriving at hospital 52 minutes after the onset of the incident (Hunt, 2018). A number of critically injured patients were still barricaded in restaurants for up to 2 hours after the incident was resolved.…”

“…They had small first aid boxes on their belts and were not allowed to collect more from stores as the zones were closed off." (Hunt, 2018). At Westminster a multitude of 999 calls was received at the onset, creating confusion around the type of incident occurring.…”

Lessons identified from the 2017 Manchester and London terrorism incidents. Part 3: the postincident and recovery phase

“…The national clinical debrief process represented a unique opportunity to capture and collate learning points from each of the three UK terrorist-related incidents in 2017. The first two articles in this series7 8 have already detailed the lessons identified and feedback from the prehospital and hospital phases of the response. The most recent developments in terms of policy and doctrine since the debrief process include updated guidance on blood-borne virus risk management,9 the National Incident Response Plan1 and the Concept of Operations for Managing Mass Casualties 2…”