Mass casualties and damage control orthopedics

Abstract

In general, a mass casualty is defi ned as any incident in which the existing medical service in terms of personnel resources and equipment is overwhelmed by the number and severity of injured patients generated at one time. Accordingly, the routine course of preclinical and clinical healthcare services could not be maintained. Based on this defi nition a wide range of events with different variations of severity and diversity of injuries are covered: major accidents (e.g., road traffi c, railroads, aircraft) with a large number of injured persons, especially when taking place in rural areas; military situations with explosion and gunshot injuries served by small combat hospitals with marginal medical staff; natural disasters in medical immature systems such as the earthquake in Haiti (2010) with multiple crush injuries; disaster situations in medical well-provided, but dense populated areas with substantial destruction of infrastructure like the earthquake and tsunami in Japan (2011); and casualties of terroristic origin such as the bombing attacks in Madrid (2004) and London (2005) with a mass of injured patients suffering from blast and blunt trauma. Depending on the amount of injured patients, the Advanced Trauma Life Support (ATLS®) concept distinguishes between incidents with multiple casualties (multiple casualty incidents) and mass casualty victims (mass casualty events).