Reduction in critical mortality in urban mass casualty incidents: analysis of triage, surge, and resource use after the London bombings on July 7, 2005[1]
Summary
A retrospective analysis of the London 7 July 2005 bombings — the UK's largest mass-casualty event since WWII — examined the London-wide prehospital response and one academic trauma centre's in-hospital response. Of 775 casualties and 56 deaths (53 at scene), 20 patients were critically injured; critical mortality was low at 15% and not due to resource shortage. Over-triage was reduced where advanced prehospital teams performed initial scene triage. The receiving centre saw a peak surge of 18 seriously injured patients per hour, reached resuscitation capacity within 15 minutes, and used 264 units of blood products in 15 hours.
So what
Shows that repeated effective triage and a hospital-wide "damage control" posture — minimal investigations, rapid transfer to definitive care — preserve surge capacity and lower critical mortality; advanced prehospital triage teams cut over-triage.
Key findings
- 775 casualties, 56 deaths (53 at scene), 20 critically injured; critical mortality 15%.
- Advanced prehospital scene triage reduced over-triage.
- Peak surge 18 serious patients/hour; resuscitation capacity reached in 15 minutes; 264 blood units in 15 h.
Read the paper
- Publisher (DOI) ↗may be paywalled
- PubMed ↗abstract · free