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Although evacuations of hospitals are considered rare events, they might be more frequent than often thought. Recent research revealed 158 evacuations of hospitals in the USA within 17 years (mean 9.3/year). Leading causes for evacuations might be natural disasters, technical issues or man-made threats like bomb or active shooter events. Evacuations of hospitals are resource-intensive and might be time-critical. Logistical and coordination challenges for efficient deployment of rescue personnel and material must be met. Management of these situations requires efficient leadership and coordination between hospital employees and rescue organizations such as fire departments or emergency medical services. Therefore, a robust concept for evacuation of hospitals is needed. Our publication describes hospital evacuations and appropriate concepts in Germany., Competing Interests: Erklärung zu finanziellen Interessen Forschungsförderung erhalten: nein; Honorar/geldwerten Vorteil für Referententätigkeit erhalten: nein; Bezahlter Berater/interner Schulungsreferent/Gehaltsempfänger: nein; Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an Firma (Nicht‐Sponsor der Veranstaltung): nein; Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an Firma (Sponsor der Veranstaltung): nein Erklärung zu nichtfinanziellen Interessen Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Background: Two key positions have been defined for the in-house management of patients in the context of a terrorism-related mass casualty incident (Terror-MASCAL). The senior triage coordinator (LArS) categorizes the injured according to injury severity using algorithms. The central operational and medical coordinator (ZONK) disposes and prioritizes the injured for treatment measures, considering the injury severity and the available treatment capacities. The dynamics and complexity of a Terror-MASCAL combined with the high number of patients requires comprehensible documentation., Material and Methods: The evaluation of an incident exercise of a Terror-MASCAL revealed deficits in its documentation. Based on the deficits identified, requirements have been defined. The article presents the management and documentation aids of a German national trauma center., Results: The hospital with its currently available resources is abstractly represented via the Trauma Tactics Board (TTB). Patients with their individual injuries are represented by identification cards on the TTB. The ZONK can prioritize and dispose further treatment based on the information about the available resources and the patient-specific injury pattern. The patient registry continues to document the patient's other medical findings. Important external and internal information is noted in an event register. The entire documentation process on the TTB is documented by camera., Conclusion: Documentation aids are required to fulfil the core tasks of the ZONK. By using the documentation aids, a hospital can prepare for a Terror-MASCAL within a short time. Lack of daily practical application of the documentation aids should be compensated for by regular practice and interdisciplinary exchange of experience., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Explosion injuries are not restricted to war-like military conflicts or terrorist attacks. The emergency physician may also encounter such injuries in the private or industrial fields, injuries caused by fireworks or gas explosions. In such cases the injury patterns are especially complex and may consist of blunt and penetrating injuries as well as thermal damage. Emergency medical personnel must be prepared to cope with explosion trauma not only in individual cases but also in major casualty incidents (MCI). This necessitates a sound knowledge about the mechanisms and processes of an explosion as well as the particular pathophysiological relationships of explosion injuries in order to be able to initiate the best possible, guideline-conform trauma therapy., (© Georg Thieme Verlag Stuttgart · New York.)