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Published in: European Journal of Trauma and Emergency Surgery 2/2023

Open Access 13-12-2022 | Triage | Review Article

Education, training and technological innovation, key components of the ESTES-NIGHTINGALE project cooperation for Mass Casualty Incident preparedness in Europe

Authors: Carlos Yánez Benítez, Jonathan Tilsed, Eric S. Weinstein, Marta Caviglia, Simon Herman, Carl Montán, Gerhard Achatz, Joe Cuthbertson, Luca Ragazzoni, Evangelos Sdongos, Itamar Ashkenazi, Roberto Faccincani

Published in: European Journal of Trauma and Emergency Surgery | Issue 2/2023

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Abstract

Disasters induced by extreme weather events and terrorism-related activities, causing mass casualty incidents (MCIs) in Europe, are expected to increase in the upcoming years. This challenging scenario demands a high level of readiness and coordinated multi-disciplinary response to reduce morbidity and mortality. The European Society of Trauma and Emergency Surgery (ESTES) is one of the 23 partners of the European-funded project Novel Integrated Toolkit for Enhanced Pre-Hospital Life Support and Triage in Challenging and Large Emergencies (NIGHTINGALE), whose primary objective is to promote the exchange in experiences and define the best practices among first responders. Additionally, the project promotes multi-disciplinary and multi-institutional efforts to achieve technological innovation that will enhance preparedness in MCI management. This manuscript aims to describe the challenges of MCI triage, the education and training programs for MCI response in Europe, and the technological innovation that may aid optimal response. These three elements were discussed by ESTES Disaster and Military Surgery Section members during the German Society for Trauma Surgery session at the ECTES 2022 in Oslo “TDSC® and beyond: ideas and concepts for education and training in Terror Preparedness”, additionally the manuscript describes the first steps of the cooperation between ESTES and the rest of the NIGHTINGALE consortium.
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Metadata
Title
Education, training and technological innovation, key components of the ESTES-NIGHTINGALE project cooperation for Mass Casualty Incident preparedness in Europe
Authors
Carlos Yánez Benítez
Jonathan Tilsed
Eric S. Weinstein
Marta Caviglia
Simon Herman
Carl Montán
Gerhard Achatz
Joe Cuthbertson
Luca Ragazzoni
Evangelos Sdongos
Itamar Ashkenazi
Roberto Faccincani
Publication date
13-12-2022
Publisher
Springer Berlin Heidelberg
Keyword
Triage
Published in
European Journal of Trauma and Emergency Surgery / Issue 2/2023
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-022-02198-1

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