Zusammenfassung
Durch die terroristischen Anschläge in Paris, Brüssel, Ansbach, München, Berlin, zuletzt Manchester und London ist eine mögliche terroristische Attacke als Bedrohung für unsere Gesellschaft und als Herausforderung für die medizinischen Versorgungsstrukturen in Deutschland greifbar und möglich geworden. Ohne Ängste zu schüren, gilt es, für die Thematik zu sensibilisieren und mit den Besonderheiten der typischen Verletzungen und den Prioritäten der Einsatztaktik und prä- und innerklinischen medizinischen Versorgung vertraut zu machen. Es gilt die Funktionsfähigkeit vorhandener Strukturen zur Versorgung eines Massenanfalls von Verletzten bezüglich der neuen gesellschaftlichen Bedrohung durch terroristische Ereignisse zu prüfen und ggf. zu verbessern. Ziel dieser Arbeit ist es, Herausforderungen in der präklinischen Versorgung von nach einem terroristischen Anschlag typischen Verletzten von der Auffangstelle über die Übergabe am Sichtungspunkt der Klinik aus chirurgischer Sicht darzustellen. Es werden die medizinischen und organisatorischen Aspekte der Erstversorgung in einer Klinik beschrieben und, sofern vorhanden, Lösungs- und Handlungsoptionen aufgezeigt.
Abstract
Due to the recent terrorist attacks in Paris, Brussels, Ansbach, Munich, Berlin and more recently Manchester and London, terrorism is realized as a present threat to our society and social life, as well as a challenge for the health care system. Without fueling anxiety, there is a need for sensitization to this subject and to familiarize all concerned with the special kind of terrorist attack-related injuries, the operational priorities and tactics and the individual basic principles of preclinical and hospital care. There is a need to adapt the known established medical structure for a conventional mass casualty situation to the special requirements that are raised by this new kind of terrorist threat to our social life. It is the aim of this article, from a surgical point of view, to depict the tactics and challenges of preclinical care of the special kind of terrorist attack-related injuries from the site of the incident, via the advanced medical post or casualty collecting point, to the triage point at the hospital. The special needs of medical care and organizational aspects of the primary treatment in the hospital are highlighted and possible decisional options and different approaches are discussed.
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A. Franke, D. Bieler, B. Friemert, E. Kollig und S. Flohe geben an, dass kein Interessenkonflikt besteht. B. Friemert und A. Franke sind Vorsitzende der AG Einsatz‑, Katastrophen- und Taktische Chirurgie (EKTC) der DGU®. A. Franke, D. Bieler und S. Flohe sind Mitglieder der Sektion Notfall‑, Intensivmedizin und Schwerstverletztenversorgung (NIS) der DGU®. A. Franke, D. Bieler und B. Friemert sind Mitglieder der AG Chirurgische Arbeitsgemeinschaft Militär- und Notfallchirurgie (CAMIN) der DGAV® und der EKTC der DGU®.
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D. Bieler und A. Franke haben zu gleichen Teilen bei der Erstellung dieses Beitrages mitgewirkt.
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Franke, A., Bieler, D., Friemert, B. et al. Prä- und innerklinisches Management bei MANV und Terroranschlag. Chirurg 88, 830–840 (2017). https://doi.org/10.1007/s00104-017-0489-x
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DOI: https://doi.org/10.1007/s00104-017-0489-x