The Time Has Come to Rethink our Mass Casualty Preparedness Level in Response to Terrorist Attacks: Initial Contribution from the Department of War Surgery in Gülhane Military Medical Academy

Abstract

Objective: Urban terrorist attacks are increasing worldwide. After suicide bombings in Ankara and Urfa in 2015, the Department of War Surgery in Gülhane Military Medical Academy (GATA) started the "Current Approaches to Firearms Injuries Course" for training civilian doctors potentially unfamiliar with these injury mechanisms. Here we present the attending doctors' pretest and posttest results. Materials and Methods:The course comprised 30 lectures from 16 departments. Medical deontology was excluded; the remaining 29 lecturers prepared one multiple-choice question each for the study. These questions were randomized in order to select 15 questions for the pretest. The order of the 15 questions was changed in the posttest.Results: All 46 attendees were male, and their mean age was 36.8±6.3 years. General surgeons and thoracic surgeons accounted for 23 (50%) and 7 (15.2%) of the 46 attendees. Compared with their pretest scores, doctors' posttest scores were significantly higher. Most profoundly, 95.2% of attending doctors' answers on Chemical Biological Radiological and Nuclear (CBRN) were improved by the lecture. Overall, the accuracy of the posttest answers on 11 of the 15 (73.3%) trauma lectures was improved, and the difference was significant. Conclusion:The severity of combat and terrorist attack injuries is higher than that of the usual civilian mechanisms of injury. The only question is when the next terrorist attack will occur instead of "if it will occur," and as such, all relevant clinical specialties and interested health care providers should participate in such trauma-training programs.