• Dan Bieler, Axel Franke, Markus Blätzinger, Marzellus Hofmann, Johannes Sturm, Benedikt Friemert, Gerhard Achatz, and The Deployment, Disaster, Tactical Surgery Working Group of the German Trauma Society.
• Department of Trauma Surgery and Orthopaedics, Reconstructive and Hand Surgery, Burn Medicine, German Armed Forces Central Hospital Koblenz, Rübenacher Strasse 170, 56072, Koblenz, Germany. dr.dan.bieler@t-online.de.
• Eur J Trauma Emerg Surg. 2020 Aug 1; 46 (4): 709-716.

BackgroundMass-casualty terrorist incidents are a medical and organisational challenge for every hospital. The Terror and Disaster Surgical Care (TDSC®) course was developed because such incidents are associated with special injury patterns, escalating situations, and surges of casualties and haemodynamically unstable patients requiring treatment and can overwhelm the resources of hospitals.Materials And MethodsThe course currently lasts two-and-a -half days and is designed for 18-21 experienced surgeons, anaesthetists and clinical emergency physicians (who form groups of three for the tabletop simulation game). From 2017 to 2019, a total of 20 courses with 437 participants were conducted. The data in this study were collected from these 437 participants.ResultsMost of the participants were male (82%); 64% of participants specialised in a major field of surgery (general surgery, visceral surgery, vascular surgery, trauma surgery and orthopaedics). At the time of the course, most participants (86%) were department heads, senior physicians or specialists. The tabletop simulation game, which was specifically developed for the course, as well as the presentations were rated good to very good. The result of the overall course evaluation, which included aspects such as organisation, professionalism, content and teaching, was on average 1.34 and thus very good.DiscussionThe TDSC course complements already established courses and provides training in tactical surgical care after hospital admission. The TDSC course integrates and builds on elements of individualised trauma care such as the primary survey and the extended focused assessment with sonography in trauma (eFAST). This underlines again that it complements and does not replace other course formats. We can conclude that the presentations and the tabletop simulation game were well suited to the target group and that the participants were able to increase their knowledge of this complex subject.

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