[Trauma management under military conditions. A German field hospital in Afghanistan in comparison with the National Trauma Registry].

BACKGROUND: The German armed forces run a role-III field hospital in Kabul, Afghanistan. Emergency room (ER) management is of utmost importance as a link between pre- and in-hospital treatment. PATIENTS AND METHODS: Prospective data were acquired of all patients admitted to the ER over a 3-month period. The quality of ER management was tested using established audit filters and comparing the results with those of the National Trauma Registry.
RESULTS: A total of 353 patients were admitted to the ER (48.4% trauma cases). Fifty-nine patients were major trauma cases, and the proportion of combat-related injury was 33.2%. In comparison to the National Trauma Registry, significant differences were observed regarding age (25.2 vs 41.7 years, P<0.0001) and injury severity (NISS 18.8 vs 28.8, P<0.0001). The demands on the quality of ER management have increased. Using the audit filters of the National Trauma Registry, significant differences were observed regarding ER management.
CONCLUSION: In a military setting, medical treatment of major trauma victims is influenced by multiple adverse factors significantly affecting the quality of trauma management.