Telemedicine in trauma and disasters--from war to earthquake: are we ready?

Every year many disasters cause thousands of injuries, deaths, refugees. Earthquakes and war often cause severe injuries (burns; amputations; Crush-Syndrome; gunshots; landmines; nuclear, biological or chemical warfare / hazardous material; infectious diseases; pediatric specialties). Referring to big earthquakes in the last few years up to 20.000 thousand people were killed (India 2001). 310.000 deaths were caused by war in 2001. The Mass Casualty Incident is characterized by the disbalance between victims and the normal community emergency response. Because of this a lot of different institutions and organizations are involved in coping with the disaster. This produces an extensive demand of qualified Command, Control and Communication (C3). Furthermore a lot of data has to be collected during the treatment and the injuries need special medical treatment. The use of health telematics in disaster response helps to cope with the scenario. Modern technologies provide support for building up medical aid although the normal infrastructure is destroyed. To cope with disaster scenarios there are some telematic tools which can be used: computer based Command and Control System, telemedical support, and data-resources-network/Medical Intelligence. The International Center for Telemedicine at the University of Regensburg Medical Center provides support for Health Care Professionals as a competence center for telemedicine. For the eastern part of Bavaria it develops a telemedical network with many components: The mobile emergency care system NOAH (Notfall-Organisations- und Arbeits-Hilfe) supports the Emergency Medical Service. Local Health Networks and the Clinical Network of Eastern Bavaria connect physicians and hospitals with the Regensburg Medical Center. With an online-education tool participants from all over the country can take part in trainings and courses.