Massenanfall von Verletzten – Besonderheiten von „bedrohlichen Lagen“

Hossfeld, Bjoern; Wurmb, Thomas; Josse, Florent; Helm, Matthias

doi:10.1055/s-0042-120229

Cited by 24 publications

(17 citation statements)

References 24 publications

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“…Modern concepts of "tactical medicine" are based on military experience and assign specific lifesaving tasks with specialized equipment (e.g., tourniquets, hemostyptics, etc.) to medical rescue [8]. The EMS principally provide emergency care in those areas in which the police originally averted danger to life and limb.…”

Section: Classification Of Ems Tasks In Civil Protection (External and Internal Threats)mentioning

confidence: 99%

Architecture of emergency medical services in Germany

Lechleuthner

2019

Notfall Rettungsmed

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Architecture of emergency medical services in GermanyPart I: Integration into the public protection system Introduction and problem statementEmergency medical services (EMS) in Germany are regulated according to the EMS state law and are seen as part of civil protection system as well as of services for the public [3].The development of EMS from simply an ambulance service to a, according to experts, complete third pillar of emergency medical services in Germany (beside the other two pillars: outpatient and inpatient care) began in post-war Germany in the 1950s-1970s. Ambulance services were basically simply small vehicles, some with two stretchers. The drivers working as the emergency personnel only had, if at all, a few hours of limited training in first aid, which qualified them as "suitable personnel. " Nevertheless, even then, the ambulance service personnel's task was twofold. On the one hand, they transported sick people in the course of transport orders (socalled arranged ambulance service), and on the other hand, there were trips to accidents or emergencies (so-called non-arranged ambulance service, today's emergency ambulance service). Thus, with respect to EMS, the ambulance service was only responsible for transporting patients and those who were injured, it This is the English version of the article Architektur des Rettungsdienstes in Deutschland. Teil I: Einordnung in das System der operativen Gefahrenabwehr Notfall Rettungsmed (2019) 22:136-146. The German version can be found under

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Section: Classification Of Ems Tasks In Civil Protection (External and Internal Threats)mentioning

confidence: 99%

Architecture of emergency medical services in Germany

Lechleuthner

2019

Notfall Rettungsmed

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“…"second hit"), 4 die Verwendung von Kriegswaffen und die 4 die durch diese Waffen verursachten Verletzungen eine entscheidende Rolle [4]. Wie schon in anderen Auswerteprozessen beschrieben [5] wurde für das präklinische Management lebensbedrohlicher Einsatzlagen folgende Strategie festgelegt: 4 beende oder kontrolliere die Bedrohung, 4 finde die roten Patienten und 4 "clear up the scene immediately".…”

Section: Festlegung Einer Strategie Zur Erreichung Der Zieleunclassified

“…Diese Patienten müssen im Rahmen einer Vorsichtung der Sichtungskatego-rie SK I Rot zugeordnet werden. Da die Art der Gewaltanwendung im Rahmen von Terroranschlägen zumeist penetrierende Verletzungen verursacht, wird es maßgeblich Patienten mit kritischen Blutungen geben, die schnellstmöglich zur chirurgischen Therapie in Krankenhäuser gebracht werden müssen [5][6][7][8][9][10]. Gleiches gilt letztlich aber auch für schwere stumpfe Verletzungen, wie man sie nach einem Überrolltrauma findet.…”

Section: Finde Die Lebensbedrohlich Verletzten Patienten (Sichtungskaunclassified

“…"Clear up the scene immediately". Diese Strategie hat zwei wesentliche Aspekte: Zum einen wird der Imperativ erfüllt, lebensbedrohlich blutende Patienten schnellstmöglich in ein Krankenhaus zu bringen, zum anderen ist der beste Eigenschutz für Einsatzkräfte und Schutz derBetroffenendie kürzestmögliche Verweildauer am Einsatzort [5].…”

Section: Finde Die Lebensbedrohlich Verletzten Patienten (Sichtungskaunclassified

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Bewältigung von besonderen Bedrohungslagen

Wurmb

Kowalzik

Rebuck

et al. 2018

Notfall Rettungsmed

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Bewältigung von besonderen Bedrohungslagen Ergebnisse des bundesweiten Auswerteprozesses am Bundesamt für Bevölkerungsschutz und Katastrophenhilfe-Teil 1: Präklinisches Management Die Bewältigung terroristischer Anschläge, Amoktaten oder anderer Bedrohungslagen stellt alle Einsatzkräfte (die der polizeilichen und die der nichtpolizeilichen Gefahrenabwehr) vor extreme Herausforderungen. Nach den Anschlägen in Frankreich und Belgien in den Jahren 2015 und 2016 wurden auch in Deutschland mehrere Terroranschläge und ein folgenschwerer Amoklauf verübt.

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“…Terrorism-related and shooter incidents present enormous challenges not only for emergency service responders at the scene but also for nearby hospitals, which may be confronted with unusual patterns of injury and large numbers of patients [ 1 – 3 ].…”

Section: Introductionmentioning

confidence: 99%

Terrorist incidents: strategic treatment objectives, tactical diagnostic procedures and the estimated need of blood and clotting products

Franke

Bieler

Friemert³

et al. 2020

Eur J Trauma Emerg Surg

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Background Terrorism-related incidents that are associated with mass casualties (mass-casualty terrorist incidents) are a medical and organisational challenge for every hospital because of the special injury patterns involved, the time of the incident, the development of the situation, the initial lack of information, the number of injured, and the number of uninjured survivors who self-refer to a hospital. Methods The Terror and Disaster Surgical Care (TDSC®)-Course was developed in order to address mass-casualty terrorist incidents and to provide surgeons with the specialist medical and surgical knowledge and skills required for these special situations. The focus of the TDSC® course is on how to provide surgical care and how to deploy scarce resources in a particular tactical situation in such a way that the number of survivors is maximised. Results The effective management of such a tactical situation must be based on priorities and first and foremost requires the standardised sorting and categorisation of the injured at the hospital. The aim of triage, or the sorting of the injured, is to immediately identify patients with life-threatening injuries in environments with strained resources. The medical management of mass-casualty terrorist incidents requires tactical abbreviated surgical care (TASC) teams that have the skills needed to perform a primary survey and to provide care for casualties who need immediate surgery (triage category 1-T1). Initial fluid therapy should be restrictive (permissive hypotension) unless contraindicated. Clotting products are replaced in a standardised manner on the basis of patient requirements, which are calculated using rapidly available surrogates (blood gas analysis). Blood products can be administered or kept available depending on risks and triage categories. The highest priority should be given to the identification and management of haemodynamically unstable patients who require immediate surgery for injuries associated with bleeding into body cavities (T1 + +). Conclusion The recommendations and approaches described here should be considered as proposals for hospitals to develop standards or modify well-established standards that enable them to prepare themselves successfully for situations (e.g. masscasualty terrorist or shooter incidents) in which their resources are temporarily overwhelmed.

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Massenanfall von Verletzten – Besonderheiten von „bedrohlichen Lagen“

Cited by 24 publications

References 24 publications

Architecture of emergency medical services in Germany

Architecture of emergency medical services in Germany

Bewältigung von besonderen Bedrohungslagen

Terrorist incidents: strategic treatment objectives, tactical diagnostic procedures and the estimated need of blood and clotting products

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