| Abstrakt: |
Abstract  During the preparations for the world soccer championship in Germany in 2006, a revised concept (Hannover concept) of response to mass casualties was developed. The goal of this concept is the immediate transportation of the severely injured patients to nearby initial care hospitals (ICH) for emergency surgical care. As an essential part of our concept, a medical rescue task force (MRTF) with the equipment for a mobile emergency treatment unit (METU) is implemented into the organization and campus of the ICH. An interdisciplinary task force of doctors of different specialities, nurses, technicians, and the fire department developed and optimized the emergency plan in accordance to the new concept. The existing stock of emergency equipment was reorganized and exact equipment depots during the emergency phase were defined. Transportation and communication routes were established as well as extended infrastructure such as a kindergarten and care for relatives. For example, at the Hannover Medical School, the full switch from routine to emergency organization is defined at a number of more than 100 expected patients. The emergency entrance is shifted to the outpatient hall, where patients are registered and triaged. The triage results in either the immediate assignment to an emergency team (surgeon, anaesthesiologist, nurses) or the referral to the METU for monitoring and stabilization. It takes about 60 min to establish full readiness for mass casualty care. Treatment is provided as "damage control surgery" followed by admission to intensive care or regular wards or transfer to other hospitals. Following the systematic training of the staff, the concept was evaluated in a realistic mass casualty exercise. The majority of emergency patients reached the hospital after a period of about 60 min. This period was sufficient to switch from routine to emergency organization. Due to strict regulations, a chaotic situation was avoided. Proven pathways of daily work allowed the fast and smooth care of a large number of emergency patients. About 3.5 h after beginning of the exercise, the last patient entered the operating room. A temporary shortness of instruments was managed by improvisation. [ABSTRACT FROM AUTHOR] |
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