Multiple casualty incidents: the prehospital role of the anesthesiologist in Europe.

The recent increase in incidents involving mass casualties has emphasized the need for a planned and coordinated prehospital emergency medical response, with medical teams on-site to provide advanced trauma life support. The special skills of the anesthesiologist make his/her contribution to prehospital emergency care particularly valuable. The United Kingdom's emergency medical services system is operated paramedically like that in the United States, and is based on rapid evacuation of casualties to hospital emergency medical facilities. In contrast, the French approach is based on the use of its emergency care system SAMU, where both structured dispatching and on-site medical care is provided by physicians, including anesthesiologists. In this article, the lessons learned from multiple casualty incidents in Europe during the past 2 decades are considered from the standpoint of the anesthesiologist.

[1]  P. Carli,et al.  Terrorism in France , 2003, Prehospital and Disaster Medicine.

[2]  C. Grande Textbook of trauma anesthesia and critical care , 1993 .

[3]  Matthew J. Wall,et al.  Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. , 1994 .

[4]  D J Lockey,et al.  London bombings July 2005: the immediate pre-hospital medical response. , 2005, Resuscitation.

[5]  T. Kowalenko,et al.  Improved outcome with hypotensive resuscitation of uncontrolled hemorrhagic shock in a swine model. , 1991, The Journal of trauma.

[6]  F. Burkle Mass casualty management of a large-scale bioterrorist event: an epidemiological approach that shapes triage decisions. , 2002, Emergency medicine clinics of North America.

[7]  J. Ryan,et al.  The London attacks--preparedness: Terrorism and the medical response. , 2005, The New England journal of medicine.

[8]  M A Foulkes,et al.  The role of secondary brain injury in determining outcome from severe head injury. , 1993, The Journal of trauma.

[9]  H Tscherne,et al.  On-scene helicopter transport of patients with multiple injuries--comparison of a German and an American system. , 1992, The Journal of trauma.

[10]  F. Turégano-Fuentes,et al.  11 March 2004: The terrorist bomb explosions in Madrid, Spain – an analysis of the logistics, injuries sustained and clinical management of casualties treated at the closest hospital , 2004, Critical care.

[11]  D. Baker Critical care requirements after mass toxic agent release , 2005, Critical care medicine.

[12]  P. Singer,et al.  Conventional terrorism and critical care , 2005, Critical care medicine.

[13]  Michael J. Hodgson,et al.  CURRENT CONCEPTS blast injuries , 2005 .