Evaluation completed for the disaster exercise LIV-25

Held in April this year at NÄL (Norra Älvsborgs Länssjukhus), the exercise was the third and most extensive disaster medicine total defense exercise so far within the Västra Götaland Region. It gathered around 400 participants from the healthcare system, the Police Authority, the Rescue Services, and the Swedish Armed Forces. The purpose was to test the entire chain of medical response under realistic conditions, with the goal of strengthening the ability to manage mass casualty incidents during serious emergencies, crises, or war.

“Collaboration with military units generally worked well, with efficient transfers to civilian healthcare. However, structural differences and unclear communication pathways were noted both at the handover points and in the emergency department. These factors highlight the importance of establishing frameworks and coordination between civilian and military actors to avoid delays in the chain of care,” the report states.

LIV-25 marked by strong commitment and high professionalism

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The Center for Disaster Medicine (CKM) at the University of Gothenburg participated as evaluator and authored the final report for Exercise LIV-25 on behalf of the Västra Götaland Region.

The results show a high level of medical expertise, strong willingness to cooperate, and good ability to prioritize under pressure. At the same time, several areas for improvement were identified – including leadership and command, endurance, and communication. These lessons will now be used to strengthen preparedness for future crises and disasters.

Jonas Zimmerman, researcher at CKM and one of the evaluation leaders for LIV-25, describes the work:

– An exercise like this demands an enormous effort, both from us in the management team and from all participants. Planning has been underway for several years, and it is very satisfying to now present the report. We can see that the healthcare system is highly skilled at managing traumatic injuries and that we can indeed cooperate across organizational boundaries – even though experience in working together with the Armed Forces and some other actors is still limited.

Necessary to test capacity over longer periods

At the same time, he points out that the exercise revealed several areas that now need to be further developed – particularly regarding collaboration and leadership within healthcare.

– Who should make decisions about medical direction, when should those decisions be made, and how do we adjust them as conditions change? Exercise LIV-25 lasted only a few hours, but in the future, it would be both interesting and necessary to test the system’s capacity over a longer period – which would likely reflect real-world stress scenarios more accurately, concludes Jonas Zimmerman.

Text: Susanne Lj Westergren