Algorithmus für das initiale klinische Management bei einem Massenanfall von Verletzten

Mass casualty incidents (MCI) are a special challenge for all those involved. While strategies, such as mSTaRT have successfully been implemented to manage the prehospital phase, the in-hospital care of the patients is lagging behind. In particular exceptional incidents, such as terrorist attacks or gun rampage killings involving civilian victims necessitate specific preparation. By presenting our algorithm for the initial clinical management of MCIs, we would like to increase awareness on the importance of such concepts as well as providing other hospitals with a scheme, which is easily adaptable to local circumstances. Components of the algorithm are the triage of patients arriving at hospital, allocation of available facilities, initial emergency measures and imaging until a decision on the further treatment of patients can be made. All the recommendations given are based on up-to-date evidence extracted from official guidelines and recent publications. Well-known and broadly accepted methods, such as the ABCDE approach for trauma patients according to ATLS® have been incorporated. Nevertheless, implementation of our algorithm should only be regarded as another step towards providing best possible care in cases of MCI. It needs to interlock smoothly with prehospital patient management and both parts need to be practiced and evaluated together.