Koslowski L
Chirurgische Universitätsklinik Tübingen.
HNO. 1993 Mar;41(3):153-61.
German law requires that any physician at a place of accident is obliged to help according to his training and ability. As an emergency doctor on duty he works in a warrantee position. In cases with multiple accident victims triage may be necessary, corresponding to the priority of medical care. In criminal procedures against a physician due to omitted help, there is no probative charge against the accused. On the other hand, civil law sets up an objective standard: attention as required in communication. In giving initial medical assistance for unconscious patients or injured children, rules of "authorized management without commission" become valid. Basic first aid measures involve: securing, saving and rescue. Life-threatening situations such as severe bleeding, airway obstruction and cardiac arrest must be dealt with immediately. Following this, such measures as proper positioning, clearing of the respiratory tract, removal of dental prostheses, evaluation of multiple injuries, avoidance of hypothermia and initiating infusions are mandatory. The orientating examination of the accident victim is described, as is the "ABCD Rule" for treating respiratory insufficiency or circulatory arrest and shock, using heart massage and artificial respiration. Finally, medical first aid is described for special injuries, such as cerebral or thoracic trauma, fractures and burns. The psychological situation affecting the physician at the place of an accident is characterized.
德国法律规定，在事故发生地的任何医生都有义务根据其培训和能力提供帮助。作为值班急诊医生，他处于受担保的地位。在有多名事故受害者的情况下，可能需要进行分诊，这与医疗护理的优先级相对应。在针对因未提供帮助而对医生提起的刑事诉讼中，对被告没有指控证据。另一方面，民法设定了一个客观标准：沟通中所需的注意义务。在为昏迷患者或受伤儿童提供初步医疗救助时，“无委托的授权管理”规则生效。基本的急救措施包括：固定、挽救和救援。必须立即处理严重出血、气道阻塞和心脏骤停等危及生命的情况。在此之后，正确的体位摆放、清理呼吸道、摘除假牙、评估多处损伤、避免体温过低以及开始输液等措施是必须的。文中描述了对事故受害者的定向检查，以及使用心脏按摩和人工呼吸治疗呼吸功能不全、循环骤停和休克的“ABCD规则”。最后，文中描述了针对特殊损伤，如脑外伤或胸外伤、骨折和烧伤的医疗急救。文中还描述了事故现场影响医生的心理状况。
