Issue: May 2018
May 03, 2018
3 min read

Role of orthopaedic and trauma surgeons in mass casualty incidents

Issue: May 2018
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Recent war conflicts and terrorist attacks, happening continuously all over the world, bring to the forefront the key role and responsibility of orthopaedic and trauma practitioners in delivering an immediate and appropriate medical intervention for wounded patients.

The symposium, “Mass Casualty Incidents Within the Orthopaedics & Trauma Community” that is scheduled during our upcoming EFORT 2018 Meeting will present mass casualty experiences of several surgical teams from different locations, going from Barcelona — the congress host city, to the border of Israel with Syria. This session will highlight fundamental emergency principles to be acquired by members of the orthopaedics and traumatology (O&T) community as part of their medical training. Having an anticipated plan for the rapid increase of patients in a hospital, mastering the triage principles or perfecting the damage control procedures are essential requirements to be fulfilled.

Thursday 31 May 2018 | 08:00 to 09:30
Mass Casualty Incidents Within the Orthopaedics & Trauma Community

Moderation: Alexander Lerner (Israel), Ion Carrera Fernandez (Spain)
Terror Attack – View from Barcelona | Jordi Teixidor (Spain)
Terror Attack – View from Brussels | Stefaan Nijs (Belgium)
City Hospital Preparation for Mass Casualty | Steven Velkes (Israel)
DCO and Functional Limb Salvage After Blast Injuries to Limbs | Alexander Lerner (Israel)

The term “mass casualty” refers to a combination of patient numbers and care requirements that challenge or exceed the medical community’s ability to provide adequate patient care using the usual day-to-day materials and facilities. In any community, a mass casualty incident has the potential to quickly run down the resources available for an adapted response. Indeed, the hospital capacity is always dependent on a well-defined comprehensive emergency management plan that should include the worst-case scenario. This type of plan is built to enhance the level of preparation required to respond to exceptional health care needs. The sudden arrival of a surge of patients also presents a logistical challenge to process large number of casualties through the hospital administrative system.

Following last year’s EFORT Terror Attacks session, the need for greater European-wide involvement of the O&T community emerged, and new challenges keep arising for surgeons. The unfortunate terrorist attacks in Barcelona on 17 August 2017 brought this reality to the host city of the EFORT 2018 Congress, reinforcing the necessity of raising the awareness of this topic within the O&T community. A complete update of all the key logistical points to consider for debridement and wound care, through the personal experience of several speakers from different countries, will help improve the treatment and outcomes of patients in these settings. For instance, several resources are essential in the management of the situation and need to be recognized: coaching and training; damage control resuscitation; second analysis of any X-ray exam; continuous monitoring of early and late vascular injuries and the availability of large spaces for admission and triage of patients, among others.


Understanding mass casualty and trauma treatment and management has never been more important. The severity and complexity of such injuries demands access to specialized treatment methods in a short time amount of time and for conditions with restricted resources. While these treatment methods are unique to the management of mass casualty incidents, they are also applicable to industrial, train and natural catastrophic accidents. The treatment methods employed for such high-energy injuries require a distinct approach not used for common, low-energy cases. Therefore, it is necessary for all orthopaedic surgeons to become proficient in these principles.

The shared experiences of colleagues who directly faced exceptional mass casualty incidents will allow a deep analysis of extremely complex situations, which are both unexpected and difficult to cope with because of the resources needed and the psychological burden generated. Presenters of this symposium will therefore share their expertise in treating high-energy injuries, including the humanitarian treatments offered in Israeli hospitals for Syrian casualties. Important principles to follow, medical interventions to prioritize and key points to integrate in the surgeon’s training will emerge from the discussion and emphasis will be placed on the immediate treatment and transportation of injured persons, hospital preparations for the treatment of mass casualties, triage, resuscitation, damage control and functional limb salvage.

The symposium, “Mass Casualty Incidents Within the Orthopaedics & Trauma Community,” is part of the core scientific program of the 19th EFORT Congress and is open to fully registered attendees. Guidelines and fees to sign-up are available on the registration platform. Visit the 2018 congress website on a regular basis.

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