SummaryAir transportation missions of seriously ill or injured patients are subdivided into rescue missions and medical evacuation missions. In 1981, for rescue missions, 29 stationed rescue helicopters were available with an operation radius of 50 km. Their task consisted of securing the primary care for vital risk patients as soon as possible. Medical evacuation missions were realized by helicopter, ambulance aircraft, and airliner. Before take-off a medical briefing was held to diminish the transport-trauma. Patients with cardiopulmonary insufficiency are at risk as simultaneous appearance of acceleration, climbing rate, falling cabin pressure and emotional stress may produce serious complications. Additional education of the medical crew is required.
Up to 1980, the important European airports and European airlines increased the number of their flights and passengers. As a result, it has been necessary to develop and launch airplanes with a high passenger capacity (e.g., Boeing 747, Jumbo, with 270 seats; Douglas DC 10 with 265 seats; and the Airbus A 300 with 249 seats). Simultaneously, the airports had to be enlarged or even rebuilt. After this substantial investment, the number of passengers began to decrease. In 1981, the French airline “Air France” expected a deficit of about 65 million DM (29.5 million US dollars), excluding the deficit by Concord. For the first time in 18 years, the Scandinavian airline “SAS” in 1980 had a deficit. The German airline “Lufthansa” expects no profits in 1981. This situation has been caused by rising oil prices, decreasing numbers of passengers, and a general recession. Many airlines have been reducing prices to attract more passengers. In spite of the high investments in new airplanes and modernizing airports, there has been little improvement in the necessary air- and ground-control-systems.In April 1981, the International Associates of Pilots (IFALPA) graded the security of air- and ground-control-systems of German airports as follows: deficient — Frankfurt and Bremen; seriously deficient — Hamburg, Stuttgart and Saarbrücken. According to the security scale of the IFALPA, the most important airports in the Mediterranean area were surveyed and estimated in 1977/78 as follows: deficient — Los Rodeos (Canary Islands), Las Palmas (Canary Islands), Lisbon, Faro, Malaga, Alicante, Madrid, Gerona, Ibiza, Palma de Mallorca, Venice and Roma; and critically deficient — Alghero, Rimini, Naples.
We must be prepared for a survivorship of about 600 to 700 injured passengers in case of an accident involving two jumbo jets as these planes are able to absorb more impact forces than earlier types, and 40%-50% of the passengers may survive.A triage post, an anteroom for resuscitation and anesthesia, and an operating room with 3 tables must be installed within the airport. Mobile operation units are necessary in addition for urgent surgical care on the spot. The optimum time of the operational readiness is approximately half an hour, if “on the spot surgical care” is to be effective.At the triage post several tables are available, each with an experienced surgeon for the rapid medical examination. The time of examination and triage for each victim of the earthquake disaster in El Asnam was three minutes.In an airport disaster, about 10% of survivors might belong to the first category of triage, i.e., have life-threatening injuries. They will require resuscitation and urgent surgical care. Twenty percent might be seriously wounded passengers of the second category, who should be conveyed to hospital as soon as possible. Seventy percent might have minor injuries of the third category and can wait for care and transportation.Many victims may require neurosurgical operations, but this should be carried out by trained experts and not at the airport. Open depressed skull fractures should be treated at the airport by shaving the scalp, irrigating the wound, applying a sterile dressing and instituting antibiotic therapy. Foreign bodies should be left in place until definitive surgery can be undertaken.
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