In an attack, most of the victims die from hemorrhage . There are between three and five minutes to cut it. And when every second counts, it could not be that in Spain there was not yet a specific manual to standardize the response to a terrorist action with multiple victims . This is what Susana Simón, a doctor specializing in emergencies and SEM care from Althaia, thought.
As coordinator and author of the ‘Manual of Incidents of Multiple Victims and Catastrophes’ and coordinator of the university course of the same name at the UVic-UCC, she saw that situations of terrorist aggression would deserve a whole book and set off. She contacted the civic nursing work group of the Spanish Society of Emergency and Emergency Medicine (SEMES), which immediately joined the project.
For the Fundación Universitaria del Bages, which through the Ediciones FUB experts collection had already published the previous manual and which offers the course Incidents of Multiple Victims of the UVic-UCC, it was another step in a field of expertise that it has cultivated for years.
The Master in Outpatient Emergencies taught by UManresa is a training with 23 years of experience, first as a postgraduate. To square the circle, the Iberian Press group came into play, to which ‘Regió7’ belongs , which sponsors the edition of the manual.
To the question of how it had been possible to get here without a manual to guide the actions of the emergency services and of all those involved in the event of an attack, the answer is that the awareness of indiscriminate attacks against the civilian population linked to jihadist terrorism is Recent and more recent is still the outbreak of unpredictable and bloody small-format performances .
In the face of incidents with multiple intentional victims, there are reference protocols such as the Hartford Consensus, which adapted to the Spanish reality is the Victoria Consensus , but which had to be deepened. The response to this need has been the ‘Manual of intentional multiple casualty incidents’, which was presented this Thursday in the FUB auditorium.
The work, coordinated by Jesús M. Hernández, Luis Martín, Aina Pagès and Susana Simón, is the result of the work of a score of authors with long experience in different areas of emergency intervention.
The book was presented by the general director of the FUB, Valentín Martínez; Susana Simón, co-coordinator of the Manual; Jordi Molet, CEO of Edicions Intercomarcals, company of the Iberian Press group sponsor of the edition; Daniel Martínez, a member of the emergency team who arrived with the first ambulance on Las Ramblas after the 17A attack; and Eva Valiño, from SEMES and one of the authors who have participated in the preparation of the manual.
The manual is based on the need to adapt international consensus regarding health intervention and emergencies in case of attacks to the reality of a decentralized health model in autonomous communities, through the Victoria Document .
The coordinators of the publication understand that these types of incidents “are already a real threat existing in our environment, and this forces us to propose a change in the care paradigm and response planning” under coordinated procedures and agreed upon by all the people who intervene to save as many lives as possible.
A choral work that analyzes all the links
The specificity of the ‘Manual of multiple intentional victims incidents’ lies in providing a practical vision giving clear guidelines from the beginning of the health chain to the last link, which would be the hospitals. The manuals that existed until now were not useful because a terrorist incident has different characteristics .
A terrorist attack situation requires a dynamic and not static security, since it is necessary to anticipate how to work in an environment that is still insecure. The injuries are also different, since they go out of the ordinary in the day to day. In addition, potential biological, chemical or nuclear hazards are added.
The manual is divided into 15 chapters in which an introduction to the global threat is made and reference is made to the different international consensus on health care in the event of an attack. The publication also analyzes who intervenes in a situation of these characteristics, both the people who arrive immediately and the professionals. The manual refers to specific procedures and actions.
A book with a field to travel
The ‘Manual of incidents of multiple intentional victims’ teaches what to do in the event of an attack, both against a pedestrian and private security workers , teachers , special intervention groups throughout the Spanish State and health workers .
The objective is that it enter as a textbook in state institutions for all students of the Army training centers and security forces and bodies.
The Victoria Consensus, which is the adaptation of the Hartford Document, has been adopted as a framework document by the Ibero-American Committee for Tactical and Operational Medicine. It is a consensus of experts that allowed in-depth tasks. The manual is precisely one of its derivatives.