Terrorism--a new dimension in trauma care

• Published in: Chirurg Vol. 78; no. 10; pp. 902 - 909
• Main Authors: Schwab, R, Güsgen, C, Hentsch, S, Kollig, E
• Format: Journal Article
• Language: German
• Published: Germany 01.10.2007
• Subjects: Barotrauma - surgery; Blast Injuries - etiology; Blast Injuries - mortality; Blast Injuries - surgery; Bombs; Compartment Syndromes - etiology; Compartment Syndromes - mortality; Compartment Syndromes - surgery; Disasters; Fractures, Bone - etiology; Fractures, Bone - mortality; Fractures, Bone - surgery; Hemorrhage - etiology; Hemorrhage - mortality; Hemorrhage - surgery; Hospital Mortality; Humans; Lung - surgery; Lung Injury; Military Personnel; Multiple Trauma - etiology; Multiple Trauma - mortality; Multiple Trauma - surgery; Resuscitation; Soft Tissue Injuries - etiology; Soft Tissue Injuries - mortality; Soft Tissue Injuries - surgery; Terrorism; Triage
• ISSN: 0009-4722
• DOI: 10.1007/s00104-007-1409-2

Bomb attacks on the civilian population are one of the primary instruments of global terrorism. Confronted as we are with the increasingly real threat in Europe too, we now have to be constantly prepared for the mass casualties and new injury patterns in trauma care that are caused by terrorist bombings. This is extraordinarily challenging, on both medical and logistical levels, for the hospitals involved. In this review the basic mechanisms of blast injuries are clarified. In addition, the fundamental principles of triage and the management of multiple trauma are presented; these are oriented on ATLS (advanced trauma life support) and DCS (damage control surgery) guidelines. These treatment concepts, which have proved their worth in both military and civilian environments, involve ongoing triage and constant situational assessment and are the basis of improved treatment results in the care of multiply traumatized victims of terrorist bombings.