title: Preparedness of German Paramedics and Emergency Physicians for a Mass Casualty Incident: A National Survey.
abstract: OBJECTIVE
  Paramedics and physicians are important components of our emergency medical system. To date, no survey has been carried out assessing physicians and paramedics regarding their preparedness for a mass casualty incident (MCI) resulting from a terrorist attack in Germany. The aim of this study was to assess the current state of preparedness of emergency physicians and paramedics for an MCI.
  
  
  METHODS
  Using an online questionnaire, we interviewed 1,707 emergency physicians and paramedics in Germany. The replies were analyzed statistically with the one-way analysis of variance (ANOVA) test and the Tukey-Kramer multiple comparisons test.
  
  
  RESULTS
  In all, 95% of the emergency physicians and paramedics knew their area of responsibility in the case of an MCI. However, 45% of them were unaware of injury patterns and treatment strategies in patients following nuclear, chemical or biological contamination. Of the interviewed emergency physicians and paramedics, 97% asked for further specific training for MCI/terrorism attacks.
  
  
  CONCLUSIONS
  Emergency physicians and paramedics are still insufficiently prepared for nuclear, chemical, and biological as well as conventional terrorism attacks. The emergency training of emergency physicians and paramedics must be modified to accommodate the increased risk of catastrophes and terrorist attacks.
authors.affiliation: Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Bonn, Germany. ph.fischer@gmx.de.|Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. ph.fischer@gmx.de.
authors.forename: Philipp
authors.initials: P
authors.lastname: Fischer
authors.affiliation: Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Bonn, Germany.
authors.forename: Karoush
authors.initials: K
authors.lastname: Kabir
authors.affiliation: Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Bonn, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Weber
authors.affiliation: Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Bonn, Germany.
authors.forename: Dieter C
authors.initials: DC
authors.lastname: Wirtz
authors.affiliation: Center of Musculoskeletal Surgery, Charité-University Medicine Berlin, Berlin, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Bail
authors.affiliation: Department of Accident and Reconstructive Surgery, University Hospital Giessen and Marburg, Marburg, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Ruchholtz
authors.affiliation: Trauma Services, Department of Surgery, Rabin Medical Center, Petach Tikva, Israel.
authors.forename: Mickey
authors.initials: M
authors.lastname: Stein
authors.affiliation: Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Bonn, Germany.
authors.forename: Christof
authors.initials: C
authors.lastname: Burger
keywords: Emergency training; Mass casualty incident; Paramedics; Physicians; Preparedness