• Thomas Wurmb, Axel Franke, Nora Schorscher, Barbara Kowalzik, Matthias Helm, Renate Bohnen, Jutta Helmerichs, Ulrich Grueneisen, Detlef Cwojdzinski, Georg Jung, Gesa Lücking, and Martin Weber.
• Department of Anaesthesia and Critical Care, Emergency and Disaster Relief Medicine, Head of the Subsection Emergency and Disaster Relief Medicine, University Hospital of Wurzburg, Oberdürrbacherstrasse 6, 97080, Wurzburg, Germany. Wurmb_t@ukw.de.
• Eur J Trauma Emerg Surg. 2020 Aug 1; 46 (4): 725-730.

PurposeRescue missions during terrorist attacks are extremely challenging for all rescue forces (police as well as non-police forces) involved. To improve the quality and safety of the rescue missions during an active killing event, it is obligatory to adapt common rescue mission goals and strategies.MethodsAfter the recent attacks in Europe, the Federal Office of Civil Protection and Disaster Assistance started an evaluation process on behalf of the Federal Ministry of the Interior and the Federal Ministry of Health. This was done to identify weaknesses, lessons learned and to formulate new adapted guidelines.ResultsThe presented bullet point recommendations summarise the basic and most important results of the ongoing evaluation process for the Federal Republic of Germany. The safety of all the rescue forces and survival of the greatest possible number of casualties are the priority goals. Furthermore, the preservation and re-establishment of the socio-political integrity are the overarching goals of the management of active killing events. Strategic incident priorities are to stop the killing and to save as much lives as possible. The early identification and prioritised transportation of casualties with life-threatening non-controllable bleeding are major tasks and the shortest possible on-scene time is an important requirement with respect to safety issues.ConclusionWith respect to hazard prevention tactics within Germany, we attributed the highest priority impact to the bullet points. The focus of the process has now shifted to intense work about possible solutions for the identified deficits and implementation strategies of such solutions during mass killing incidents.

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