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Lessons identified from the 2017 Manchester and London terrorism incidents. Part two: the reception and definitive care (hospital) phases
  1. Paul Hunt1,2
  1. 1 Emergency Department, South Tees Hospitals NHS Foundation Trust, James Cook University Hospital, Middlesbrough, UK
  2. 2 ADMEM, Royal Centre for Defence Medicine, Birmingham, UK
  1. Correspondence to Paul Hunt, Emergency Department, South Tees Hospitals NHS Foundation Trust, James Cook University Hospital, Middlesbrough TS4 3BW, UK; paul.hunt1{at}


The provision of medical care during the reception and definitive care phases of a terrorist incident will likely take place in designated receiving hospitals such as Major Trauma Centres. There is a need for an enhanced capability in such units to receive, initially manage and hold casualties with more serious injuries. Also, even less severely injured casualties may require significant time and clinical input such as risk management in potential bloodborne viruses.

The distribution of casualties from the incident scene requires advance consideration of the injury pattern and regional network organisation of specialist services, such as maxillofacial, neurosurgery or severe burns care. Paediatric centres are also more sparsely distributed and often only in large city networks which represents a significant challenge for planners and responders in other regions. An effective response relies on a coordinated multidisciplinary approach including emergency and front-of-house teams, surgical, medical and clinical support services.

  • major incidents
  • terrorism
  • EPRR
  • reception phase
  • definitive care phase

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  • Contributors As per previous submission.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.