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Hartford Consensus III focuses on first responders



The Joint Committee to Create a National Policy to Enhance Survivability from Intentional Mass-Casualty and Active Shooter Events, founded by the American College of Surgeons (ACS), held its third Hartford Consensus meeting April 14, 2015, in Hartford, CT. Chaired by ACS Regent Lenworth M. Jacobs, Jr., MD, MPH, FACS, professor of surgery; director, Trauma Institute; and vice-president of academic affairs, Hartford Hospital, the meeting focused on implementation of strategies for effective hemorrhage control.

The full Hartford Consensus III report will be published in the July issue of the Bulletin. Briefly, however, the Hartford Consensus III centers on strategies for preparing individuals at the scene of a mass-casualty event to serve as immediate responders using the group’s THREAT system. THREAT involves the following:

Threat suppression

Hemorrhage control

Rapid Extrication to safety

Assessment by medical providers

Transport to definitive care

The Hartford Consensus calls for a seamless, integrated response from the following groups:

• Immediate responders: Individuals present at the incident

• Professional first responders: Law enforcement, emergency medical service personnel, firefighters, and rescue workers

• Trauma professionals: Hospitalists; emergency department physicians, nurses, and technicians; and trauma surgeons

Empowering immediate responders

An emphasis of the Hartford Consensus III is on empowering the public to provide lifesaving, first-line care. The Hartford Consensus III also calls for educating individuals and communities about the use of effective external hemorrhage control techniques and for ensuring access to bleeding control bags in public places in the same way that automatic external defibrillators are now accessible to the public. For example, the document calls for extending Good Samaritan protections to individuals who use tourniquets and lifesaving devices to control the bleeding of victims at mass-casualty events.

A number of ACS Fellows in addition to Dr. Jacobs participated in the Hartford Consensus III.

ACS Fellow participants in Hartford Consensus III

.5 Richard Carmona, MD, MPH, FACS, 17th U.S. Surgeon General
Alasdair K. T. Conn, MD, FACS, FRCSC, chief emeritus, department of emergency medicine, Massachusetts General Hospital, Boston
Alexander Eastman, MD, MPH, FACS, Major Cities Police Chiefs Association; chief of trauma, Parkland Memorial Hospital, University of Texas Southwestern Medical Center, Houston
Lenworth M. Jacobs, Jr., MD, MPH, FACS, professor of surgery; director, Trauma Institute; and vice-president of academic affairs, Hartford Hospital
John Holcomb, MD, FACS, chief, division of acute care surgery, University of Texas Health Science Center at Houston
Norman McSwain, MD, FACS, medical director, prehospital trauma life support, Tulane University, New Orleans, LA
Peter Rhee, MD, MPH, FACS, professor of surgery, department of surgery, University of Arizona, Tucson
Ronald Stewart, MD, FACS, Chair, ACS Committee on Trauma; chair, department of surgery, University of Texas Health Science Center at San Antonio
ACS President Andrew L. Warshaw, MD, FACS, FRCSEd(Hon), surgeon-in-chief emeritus, Massachusetts General Hospital, and the W. Gerald Austen Distinguished Professor of Surgery, Harvard Medical School, Boston
Leonard Weireter, MD, FACS, Vice-Chair, ACS Committee on Trauma; Arthur and Marie Kirk Family Professor of Surgery, Eastern Virginia Medical School, Norfolk
Jonathan Woodson, MD, FACS, Assistant Secretary of Defense for Health Affairs, U.S. Department of Defense, Washington, DC

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