[Trauma management under military conditions. A German field hospital in Afghanistan in comparison with the National Trauma Registry].
BACKGROUND
The German armed forces run a role-III field hospital in Kabul, Afghanistan. Emergency room (ER) management is of utmost importance as a link between pre- and in-hospital treatment.


METHODS
Prospective data were acquired of all patients admitted to the ER over a 3-month period. The quality of ER management was tested using established audit filters and comparing the results with those of the National Trauma Registry.


RESULTS
A total of 353 patients were admitted to the ER (48.4% trauma cases). Fifty-nine patients were major trauma cases, and the proportion of combat-related injury was 33.2%. In comparison to the National Trauma Registry, significant differences were observed regarding age (25.2 vs 41.7 years, P<0.0001) and injury severity (NISS 18.8 vs 28.8, P<0.0001). The demands on the quality of ER management have increased. Using the audit filters of the National Trauma Registry, significant differences were observed regarding ER management.


CONCLUSIONS
In a military setting, medical treatment of major trauma victims is influenced by multiple adverse factors significantly affecting the quality of trauma management.
Helm
M
M
Abteilung für Anästhesiologie und Intensivmedizin, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89070, Ulm. matthias.helm@extern.uni-ulm.de
Kulla
M
M
Birkenmaier
H
H
Lefering
R
R
Lampl
L
L
D000293:Adolescent; D000328:Adult; D000346:Afghanistan; D000368:Aged; D002648:Child; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D005858:Germany; D015600:Glasgow Coma Scale; D017052:Hospital Mortality; D006772:Hospitals, Military / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data; D009104:Multiple Trauma / Q000401:mortality / Q000601:surgery*; D010348:Patient Care Team / Q000592:standards; D011785:Quality Assurance, Health Care / Q000592:standards; D012042:Registries; D012151:Resuscitation / Q000592:standards; D012774:Shock, Traumatic / Q000401:mortality / Q000601:surgery; D014218:Triage / Q000592:standards*; D014600:Utilization Review / Q000706:statistics & numerical data