Counter-Terrorism Emergency Planning, Resilience and Response Research Division (CTEPRRU)

The Counter-Terrorism Emergency Planning, Resilience and Response Research Unit (CTEPRR) is a specialised research division (RD) within Counter-Terrorism Medicine Europe, in association with the European Society for Emergency Medicine (EUSEM) Disaster Medicine Section and KU Leuven (KUL).

Background

The Counter Terrorism Emergency Planning Resilience and Response (CTEPRR) division advances evidence-based operational frameworks, clinical protocols, and structural resilience across acute European healthcare systems facing asymmetric and high-impact security threats, hybrid warfare, terrorism, or non-terror acts of extreme violence. By bridging academic research, emergency medicine practice, emergency planning, resilience and disaster planning, CTEPRR aims to minimise casualties, optimise immediate medical response times, and establish standardised preparedness metrics for hospitals and acute healthcare services across Europe.

Core objectives

1. Standardise hospital preparedness metrics and standard operating procedures

   Establish operational and clinical benchmarks for healthcare facilities responding to blast, ballistic, CBRN, active shooter, and high-impact security events.

2. Cross-border research, interoperability, mutual aid & knowledge transfer

   Aggregate data on surge capacity, inter-hospital transfers, emergency department closures, and mutual aid protocols across European healthcare settings.

3. Enhance institutional preparedness and resilience

   Develop scalable training frameworks to stress-test hospital lockdown procedures, invacuation/evacuation strategies, decontamination, and supply chain security.

4. Policy and interoperability advocacy

   Formulate actionable, evidence-based recommendations to inform European health security policies and streamline civil-military and law enforcement cooperation.

Flagship Initiative: European Survey on Hospital Preparedness Against Terrorist Attacks

The division's launch initiative is a pan-European survey assessing hospital readiness across all 27 EU member states. Targeted at emergency department directors, trauma centre managers, and disaster and emergency planning coordinators, hospital leadership across EU and partner states, and local resilience forums in acute healthcare settings, the assessment evaluates six core operational domains:

• Surge capacity & triage protocols

  • Rapid bed expansion, emergency recovery bays, trauma capability, and secondary triage under high-volume stress.

• Clinical specialisation & CBRN readiness, including toxicology capabilities

  • Staff training in penetrating trauma, blast mechanics, toxicology capabilities, decontamination, and antidote stockpiles.

• Infrastructure & security Integration

  • Physical facility lockdown capabilities, access controls, staff safety protocols, and resilient communication networks.

• Supply chain & resources

  • Management of pharmaceutical stockpiles, blood products, PPE, and self-sufficiency limits during prolonged crises.

• Psychological first aid and post-event recovery

  • Immediate and long-term psychological first aid and occupational health support for frontline medical personnel.

• Communication and interoperability

  •  Standardised joint protocols with law enforcement, civil defence, fire services, and military units.

Key deliverables

1. Pan-European baseline report: A published dataset identifying systemic vulnerabilities and regional best practices across Europe.

2. Standardised SOPs & guidance documents: Evidence-based operational cards and action plans adapted for local healthcare systems.

3. European preparedness index: A standardised framework for hospitals to self-assess and benchmark emergency response capabilities.

Academic & Governance Framework

• CTM-E serves as the host platform, leading operational strategy, data protection, and network distribution through CTM-E regional networks.

• EUSEM Disaster Medicine Section manages professional network engagement, clinical validation, and emergency medicine specialist involvement.

• KU Leuven (KUL) provides academic rigour, ethical oversight, statistical data analysis, and support for scientific publication.