A Review of the Landscape: Challenges and gaps in trauma response to civilian high threat mass casualty incidents.

The ultimate goal of the emergency response and trauma system is to reduce potentially preventable death from trauma. Tremendous advances in trauma care emerged from the past fifteen years of United States’ combat engagements around the globe. Unfortunately, combat and insurgency tactics have also metastasized to the civilian world, resulting in increasingly complex and dynamic acts of intentional mass violence. These high threat Active Violent Incidents (AVIs) pose significant preparedness, response and clinical care challenges to the civilian healthcare systems. Currently, there are several operational and policy gaps that limit the successful preparedness and response to AVIs and dynamic MCIs in the United States. Director, Operational and Disaster Medicine, Associate Professor, Emergency Medicine, Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC, 1000 Blythe Blvd, Medical Education Building (MEB) 3, Charlotte, NC 28203, David.callaway@carolinashealthcare.org, (704) 355-3968 Conflicts of Interest and Source of Funding: Dr. David Callaway is a former voting member and current subject matter expert for the Committee on Tactical Combat Casualty Care, he is the Chair Emeritus of the Committee for Tactical Emergency Casualty Care, and he serves as the Co-Chair of the American College of Emergency Physicians High Threat Emergency Casualty Care Task Force. Dr. Callaway reports receiving an honoraria from Velico Medical. © 2018 Lippincott Williams & Wilkins, Inc.

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