The German emergency and disaster medicine and management system-history and present

Abstract

As well for optimized emergency management in individual cases as for optimized mass medicine in disaster management, the principle of the medical doctors approaching the patient directly and timely, even close to the site of the incident, is a long-standing marker for quality of care and patient survival in Germany. Professional rescue and emergency forces, including medical services, are the "Golden Standard" of emergency management systems. Regulative laws, proper organization of resources, equipment, training and adequate delivery of medical measures are key factors in systematic approaches to manage emergencies and disasters alike and thus save lives. During disasters command, communication, coordination and cooperation are essential to cope with extreme situations, even more so in a globalized world. In this article, we describe the major historical milestones, the current state of the German system in emergency and disaster management and its integration into the broader European approach.

Keywords: Disaster medicine; Emergency medical systems; Germany; Public health.

Fig. 1

Modern depiction of the original rescue chain by Ahnefeld in German, taken from the Ministry of the Interior of Rhineland-Westphalia. Translation from left to right: secure your own and others safety, life-saving immediate measures, emergency call, first aid, rescue services, hospital admission.

Fig. 2

Depiction of crucial times within the rescue chain (Hecker, Domres 2017).

Fig. 3

Helicopter bases throughout Germany by the various accredited providers (source ADAC Germany).

Fig. 4

Pictures RTW and equipment (Source: German Red Cross).

Fig. 5

Pictures of NEF and equipment (Source: German Red Cross).

Fig. 6

Shock room level 1 trauma center.

Fig. 7

Number of accidents (years 2000–2014) with injured people on German roads (red-dotted line) and fatalities because of accidents directly or in the process (red line with yellow dots). Data are expressed as thousand. Source: German National Statistical Agency.

Fig. 8

Political and Disaster Management Standard Operating Procedures as defined by the German State (Source German Civil Defense Agency, Bundesamt für Bevölkerungschutz und Katastrophenhilfe).

Fig. 9

Standard operational structure of a MTF (Source: BBK).

Fig. 10

Standard operational structure of a MTF (2) (Source: BBK).

Fig. 11

Deployment of MTF across Germany (source: BBK).

Fig. 12

European civil protection mechanism.