The Hartford Consensus to improve survivability in mass casualty events: Process to policy

Authors

  • Lenworth Jacobs , MD, MPH, FACS
  • Karyl J. Burns, RN, PhD

DOI:

https://doi.org/10.5055/ajdm.2014.0143

Keywords:

active shooter, mass casualty incidents, hemorrhage control

Abstract

Objective: The Joint Committee to Create a National Policy to Enhance Survivability from Mass Casualty Shooting Events was formed to make recommendations to improve survival from intentional mass casualty incidents. This article describes the development of the Hartford Consensus and the process used to disseminate and implement its findings.
Main outcome: Members of the Committee included individuals from select public safety organizations. The first meeting of the Committee was held on April 2, 2013, and a second meeting was held on July 11, 2013. Attendance at the second meeting was enlarged and included representatives from the Federal Emergency Management Agency and the National Security Staff of the Office of the President. The results of these meetings became known as the Hartford Consensus.
Results: The ideas generated at the meetings produced two documents, one from each meeting. These are referred to as Hartford Consensus I and II. Hartford Consensus I is a concept document and Hartford Consensus II is a call to action that no one should die from uncontrolled bleeding. The recommendations are being incorporated into training programs and have been endorsed by many organizations whose members are involved in the response to mass casualty incidents.
Conclusion: The Joint Committee to Create a National Policy to Enhance Survivability from Mass Casualty Shooting Events was successful in stimulating policy to bring about change. Training and resources including tourniquets and hemostatic dressing are being directed to help ameliorate the unfortunate reality of intentional mass injury.

Author Biographies

Lenworth Jacobs , MD, MPH, FACS

Vice President for Academic Affairs and Chief Academic Officer, Hartford Hospital, Hartford, Connecticut; Professor and Chairman, Department of Traumatology and Emergency Medicine, Professor of Surgery, University of Connecticut School of Medicine, Farmington, Connecticut; Director, Trauma Institute, Hartford Hospital, Hartford, Connecticut.

Karyl J. Burns, RN, PhD

Research Scientist, Hartford Hospital, Hartford, Connecticut; Assistant Professor, Department of Traumatology and Emergency Medicine, University of Connecticut School of Medicine, Hartford Hospital, Hartford, Connecticut.

References

Joint Committee to Create a National Policy to Enhance Survivability from Mass Casualty Shooting Events: Improving survival from active shooter events: The Hartford Consensus. Bull Am Coll Surg. 2013; 98(6): 14-16.

Joint Committee to Create a National Policy to Enhance Survivability from Mass Casualty Shooting Events: Active shooter and intentional mass casualty events: The Hartford Consensus II. Bull Am Coll Surg. 2013; 98(9): 18-22.

US Fire Administration, FEMA: Fire/Emergency Medical Services Department Operational Considerations and Guide for Active Shooter and Mass Casualty Incidents. Available at usfa.fema.gov/downloads/pdf/publications. Accessed September 20, 2013.

Gerston LN: Public Policy Making, Process and Principles. 3rd ed. Armonk, NY: ME Sharpe, 2010: 23.

Winter T, McClam E: Inside Newtown shooter Adam Lanza's 155-bullet shooting spree. MSNBC (03/28/2013). Available at http://www.msnbc.com/msnbc/inside-newtown-gunman-adam-lanzas-155-bullet. Accessed December 30, 2013.

State of Connecticut, Division of Criminal Justice: Danbury's State's Attorney releases additional information on December 14, 2012, incident at Sandy Hook Elementary School. Available at http://www.ct.gov/csao/cwp/view.asp?a=1801&q=521714. Accessed May 6, 2013.

Jacobs LM, Burns KJ, McSwain N, et al.: Initial management of mass-casualty incidents due to firearms: Improving survival. Bull Am Coll Surg. 2013; 98(6): 11-13.

Committee on Trauma of the American College of Surgeons: Blue Book, A Guide to Organization, Objectives, Activities, 2007. Available at http://www.facs.org/trauma/publications/bluebook2007.pdf. Accessed August 20, 2013.

Kragh JF, Walters TJ, Baer DG, et al.: Practical use of emergency tourniquets to stop bleeding in major limb trauma. J Trauma. 2008; 64: S38-S50.

Kragh JF, Walters TJ, Baer DG, et al.: Survival with emergency tourniquet use to stop bleeding in major limb trauma. Ann Surg. 2009; 249: 1-7.

Kotwal RS, Montgomery HR, Kotwal BM, et al.: Eliminating preventable death on the battlefield. Arch Surg. 2011; 146: 1350-1358.

Instructor Guide for Care Under Fire: Tactical Combat Casualty Care. September 2012. Care Under Fire. Available at http://www.yumpu.com/en/document/view/11594359/instructor-guide-for-careunder-fire-120917-1-healthmil. Accessed March 17, 2014.

Eastridge BJ, Mabry RL, Seguin P, et al.: Death on the battlefield (2001-2011): Implications for the future of combat casualty care. J Trauma Acute Care Surg. 2012; 73: S431-S437.

Kotwal RS, Butler FK, Edgar EP, et al.: Saving Lives on the Battlefield: A Joint Trauma System Review of Pre-Hospital Trauma Care in Combined Joint Operating Area – Afghanistan (CJOA-A) Executive Summary. Updated 30 January 2013. Available at https://www.jsomonline.org/TCCC/1301TCCC.pdf. Accessed December 16, 2013.

Kingdon JW: Agendas, Alternatives, and Public Policies. 2nd ed. New York: Addison, Wesley, Longman, Inc., 1995: 166.

Difference Between.com. Difference Between Guideline and Policy. Available at http://www.differencebetween.com/differencebetween-guideline-and-policy/. Accessed November 7, 2013.

Cal Poly: Policy vs. Procedure: A Guideline. Available at http://policy.calpoly.edu/cappolicy.htm. Accessed November 7, 2013.

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Published

01/01/2014

How to Cite

Jacobs , MD, MPH, FACS, L., and K. J. Burns, RN, PhD. “The Hartford Consensus to Improve Survivability in Mass Casualty Events: Process to Policy”. American Journal of Disaster Medicine, vol. 9, no. 1, Jan. 2014, pp. 67-71, doi:10.5055/ajdm.2014.0143.

Issue

Section

Editorial