Department for Trauma Surgery and Orthopaedics, Reconstructive and Septic Surgery, Sportstraumatology, German Armed Forces Hospital Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany.
Department for Trauma Surgery, Krankenhaus der Augustinerinnen Cologne, Jacobstr. 27-31, 50678, Cologne, Germany.
Eur J Trauma Emerg Surg. 2020 Aug;46(4):673-682. doi: 10.1007/s00068-020-01390-5. Epub 2020 Jul 29.
Mass-casualty incidents are always a particular challenge not only for healthcare providers and other emergency service responders at the scene but also for receiving hospitals. Terrorism-related mass-casualty incidents can result in a wide variety of different scenarios so that hospitals and their personnel must prepare for far more complex and demanding requirements.
In this article, we describe and discuss in-hospital aspects of mass-casualty terrorist incidents and focus on the special medical and in particular surgical care that is required in this setting.
The overview presented here is based on the Terror and Disaster Surgical Care (TDSC) course. The TDSC course was mainly developed from a comprehensive and structured analysis of the literature, single expert opinions, and expert consensus conferences. The objective of this course is to train clinical decision-makers in how to manage major incidents.
The management of a mass-casualty terrorist incident and the care of victims present multiple and unique challenges to hospitals. This applies in particular to the number and distribution of patients arriving at the hospital, injury patterns, infrastructural aspects, and personnel resources. Particular attention must be given to the surgical approach to caring for these patients, e.g., early total care, damage control surgery, or tactical abbreviated surgical care.
Mass-casualty terrorist incidents are different from other mass-casualty events in many respects that require special attention. The provision of appropriate public services requires in particular that the preparation and training of personnel as well as the organisation of the in-hospital response be tailored to the incident.
大规模伤亡事件不仅对现场的医疗保健提供者和其他应急服务响应者构成特殊挑战，对接收医院也是如此。与恐怖主义有关的大规模伤亡事件可能导致各种不同的情况，因此医院及其人员必须为更加复杂和苛刻的要求做好准备。
本文描述并讨论了大规模伤亡恐怖事件的院内方面，并重点关注了这种情况下所需的特殊医疗，特别是外科护理。
这里呈现的概述基于恐怖和灾难外科护理（TDSC）课程。TDSC 课程主要是通过对文献的全面和结构化分析、单一专家意见和专家共识会议来开发的。该课程的目的是培训临床决策者如何应对重大事件。
大规模伤亡恐怖事件的管理和对受害者的护理对医院构成了多重且独特的挑战。这尤其适用于到达医院的患者数量和分布、伤害模式、基础设施方面和人员资源。必须特别注意对这些患者进行外科护理的方法，例如早期全面护理、损伤控制性手术或战术性简化外科护理。
大规模伤亡恐怖事件在许多方面与其他大规模伤亡事件不同，需要特别关注。提供适当的公共服务特别要求根据事件情况对人员的准备和培训以及院内应对的组织进行调整。
