title: Medical and logistical challenges of trauma care in a 12-day cave rescue: A case report.
abstract: OBJECTIVE
  To describe the case of a patient with a severe head injury at a depth of about 1000 m from the cave entrance in Bavaria, Germany, who received pre-hospital trauma care for 12 days until evacuation.
  
  
  RESULTS
  Search and rescue (SAR) operation involved 728 rescuers, 202 working directly in the cave (for a total of 9239 h) and 7 physicians from five countries. At 6-month follow-up, the patient had recovered completely and resumed his job.
  
  
  CONCLUSIONS
  This case highlights several pitfalls of trauma care in complex SAR operations, which often rely on expert knowledge and are not yet evidence-based practice.
authors.affiliation: Intensivmedizin Krankenhaus Barmherzige Brüder, München, Germany.
authors.forename: Thomas-Michael
authors.initials: TM
authors.lastname: Schneider
authors.affiliation: Emergency Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy; CNSAS Italian Mountain and Cave Rescue Service, Milano, Italy.
authors.forename: Rino
authors.initials: R
authors.lastname: Bregani
authors.affiliation: Mountain Rescue Association of Slovenia, Kranj, Slovenia.
authors.forename: Rok
authors.initials: R
authors.lastname: Stopar
authors.affiliation: ÖHR Austrian Cave Rescue Service, Salzburg, Austria.
authors.forename: Jacob
authors.initials: J
authors.lastname: Krammer
authors.affiliation: ÖHR Austrian Cave Rescue Service, Salzburg, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Göksu
authors.affiliation: Bergwacht Bayern Bavarian Mountain Rescue, Bad Tölz, Germany.
authors.forename: Natalie
authors.initials: N
authors.lastname: Müller
authors.affiliation: Bergwacht Bayern Bavarian Mountain Rescue, Bad Tölz, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Petermeyer
authors.affiliation: Bergwacht Bayern Bavarian Mountain Rescue, Bad Tölz, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Schiffer
authors.affiliation: CNSAS Italian Mountain and Cave Rescue Service, Milano, Italy; EURAC Institute of Mountain Emergency Medicine, Bolzano, Italy. Electronic address: giacomo.strapazzon@eurac.edu.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Strapazzon
mesh_terms: D000062:Accidents, Occupational; D017732:Air Ambulances; D059552:Caves; D006259:Craniocerebral Trauma / Q000628:therapy*; D004632:Emergency Medical Services; D055317:Evidence-Based Practice; D006801:Humans; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D018635:Rescue Work; D062707:Return to Work
keywords: Caving; Emergency medical services; Head trauma; Mountain medicine; Search and rescue; Trauma care