{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:19:12Z","timestamp":1760149152388,"version":"build-2065373602"},"reference-count":25,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2023,7,8]],"date-time":"2023-07-08T00:00:00Z","timestamp":1688774400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>On 17 April 2019, a coach with tourists from Germany crashed in Madeira, requiring repatriation by the German Air Force. The Advanced Trauma Life Support (ATLS) concept was the central component of patient care. Data in Madeira were collected through a structured interview. The analysis of the Aeromedical Evacuation was based on intensive care transport records. In Germany, all available medical data sheets were reviewed for data collection. Quality of life (HRQoL) was evaluated by the 12-item Short Form Health Survey (SF-12). Twenty-eight prehospital patients were transported to the Level III Trauma Center in Funchal (Madeira). Five operative procedures were performed. Fifteen patients were eligible for Aeromedical Evacuation (AE). In the second hospital phase in Germany, in total 82 radiological images and 9 operations were performed. Hospital stay lasted 11 days (median, IQR 10\u201318). Median follow-up (14 of 15 patients) was 16 months (IQR 16\u201321). Eighty percent (8 out of 10) showed an increased risk for post-traumatic stress disorder (PTSD). Six key findings were identified in this study: divergent injury classification, impact of AE mission on health status, lack of communication, need of PTSD prophylaxis, patient identification, and media coverage. Those findings may improve AE missions in the future, e.g., when required after armed conflicts.<\/jats:p>","DOI":"10.3390\/jcm12144556","type":"journal-article","created":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T00:54:23Z","timestamp":1688950463000},"page":"4556","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Performing Advanced Trauma Life Support (ATLS) across Borders: Midterm Follow-Up of the Aeromedical Evacuation after Civilian Bus Accident at Madeira"],"prefix":"10.3390","volume":"12","author":[{"given":"Sebastian","family":"Imach","sequence":"first","affiliation":[{"name":"Department of Trauma and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), University Witten\/Herdecke, 51109 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Deschler","sequence":"additional","affiliation":[{"name":"Special Air Mission Wing, Federal Ministry of Defence, 51147 Cologne, Germany"},{"name":"Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Bundeswehr Central Hospital, 56072 Koblenz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5605-1040","authenticated-orcid":false,"given":"Stefan","family":"Sammito","sequence":"additional","affiliation":[{"name":"Experimental Aerospace Medicine Research, German Air Force Centre of Aerospace Medicine, 51147 Cologne, Germany"},{"name":"Department of Occupational Medicine, Medical Faculty, Otto von Guericke University, 39106 Magdeburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel","family":"Reis","sequence":"additional","affiliation":[{"name":"Department of Surgery, Servi\u00e7o Regional de Sa\u00fade da Madeira, 6180 Funchal, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylta","family":"Michaelis","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), University Witten\/Herdecke, 51109 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beneditk","family":"Marche","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), University Witten\/Herdecke, 51109 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Paffrath","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, Hospital of the Augustinerinnen, 50678 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bertil","family":"Bouillon","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), University Witten\/Herdecke, 51109 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thorsten","family":"Tjardes","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), University Witten\/Herdecke, 51109 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1097\/01.CCM.0000163269.42524.50","article-title":"The long-distance tertiary air transfer and care of tsunami victims: Injury pattern and microbiological and psychological aspects","volume":"33","author":"Maegele","year":"2005","journal-title":"Crit. Care Med."},{"key":"ref_2","first-page":"441","article-title":"Intensivtransportprotokoll","volume":"3","author":"Moecke","year":"2000","journal-title":"Notf. Rett."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1026\/0084-5345.31.1.22","article-title":"Entwicklung eines Screeninginstrumentes zur Identifizierung von Risikopatienten f\u00fcr die Entwicklung einer Posttraumatischen Belastungsst\u00f6rung (PTB) nach einem Verkehrsunfall","volume":"31","author":"Stieglitz","year":"2002","journal-title":"Z. Klin. Psychol. Psychother."},{"key":"ref_4","first-page":"241","article-title":"Examination of quality criteria of the Freiburger Screening Fragebogen to identify patients at risk for the development of a post-traumatic stress disorder in the group of severely injured accident patients","volume":"3","author":"Schneider","year":"2011","journal-title":"Z. Psychiatr. Psychol. Psychother."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1026\/0012-1924\/a000205","article-title":"Normierung des SF-12 Version 2.0 zur Messung der gesundheitsbezogenen Lebensqualit\u00e4t in einer deutschen bev\u00f6lkerungsrepr\u00e4sentativen Stichprobe","volume":"64","author":"Wirtz","year":"2018","journal-title":"Diagnostica"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1007\/s00068-019-01270-7","article-title":"Polytrauma outcome: Implementation of health-related quality of life assessment into the German Trauma Registry","volume":"47","author":"Kamp","year":"2019","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1002\/jts.22189","article-title":"Somatic Experiencing for Posttraumatic Stress Disorder: A Randomized Controlled Outcome Study","volume":"30","author":"Brom","year":"2017","journal-title":"J. Trauma. Stress"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1331108","DOI":"10.1080\/20008198.2017.1331108","article-title":"A randomized controlled trial of brief Somatic Experiencing for chronic low back pain and comorbid post-traumatic stress disorder symptoms","volume":"8","author":"Andersen","year":"2017","journal-title":"Eur. J. Psychotraumatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2061","DOI":"10.1007\/s00268-015-3063-z","article-title":"Level of Evidence Analysis for the Latest German National Guideline on Treatment of Patients with Severe and Multiple Injuries and ATLS","volume":"39","author":"Mutschler","year":"2015","journal-title":"World J. Surg."},{"key":"ref_10","unstructured":"Henry, S. (Bulletin of the American College of Surgeons, 2018). ATLS 10th edition offers new insights into managing trauma patients, Bulletin of the American College of Surgeons."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2273","DOI":"10.1007\/s00268-014-2587-y","article-title":"Impact of ATLS Training on Preventable and Potentially Preventable Deaths","volume":"38","author":"Navarro","year":"2014","journal-title":"World J. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1016\/S0140-6736(09)60232-4","article-title":"Effect of whole-body CT during trauma resuscitation on survival: A retrospective, multicentre study","volume":"373","author":"Lefering","year":"2009","journal-title":"Lancet"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2184","DOI":"10.1007\/s00586-013-2738-0","article-title":"AO spine injury classification system: A revision proposal for the thoracic and lumbar spine","volume":"22","author":"Reinhold","year":"2013","journal-title":"Eur. Spine J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1007\/s00586-015-3765-9","article-title":"Reliability analysis of the AOSpine thoracolumbar spine injury classification system by a worldwide group of na\u00efve spinal surgeons","volume":"25","author":"Kepler","year":"2016","journal-title":"Eur. Spine J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1148\/radiol.2018180492","article-title":"Whole-Body CT in Patients with Multiple Traumas: Factors Leading to Missed Injury","volume":"289","author":"Banaste","year":"2018","journal-title":"Radiology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1097\/01.ta.0000226154.38852.e6","article-title":"Spiral Computed Tomography for the Initial Evaluation of Spine Trauma: A New Standard of Care?","volume":"61","author":"Antevil","year":"2006","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.injury.2011.05.019","article-title":"Incidence and predictors of missed injuries in trauma patients in the initial hot report of whole-body CT scan","volume":"43","author":"Eurin","year":"2012","journal-title":"Injury"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"859","DOI":"10.2214\/AJR.05.0145","article-title":"Chance-Type Fractures of the Thoracolumbar Spine: Imaging Analysis in 53 Patients","volume":"187","author":"Bernstein","year":"2006","journal-title":"Am. J. Roentgenol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"S61","DOI":"10.1097\/TA.0b013e318065ad9d","article-title":"Geriatric Spine Fractures: An Emerging Healthcare Crisis","volume":"62","author":"Chapman","year":"2007","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1055\/a-1208-4806","article-title":"Innereurop\u00e4ische Aeromedical-Evacuation-Transporte im Rahmen von COVID-19","volume":"36","author":"Sammito","year":"2020","journal-title":"Notarzt"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1007\/s00068-018-0969-9","article-title":"Patterns of injury and outcomes in the elderly patient with rib fractures: A multicenter observational study","volume":"45","author":"Kwakernaak","year":"2019","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_22","first-page":"433","article-title":"Early Short-Term Inpatient Psychotherapeutic Treatment versus Continued Outpatient Psychotherapy on Psychosocial Outcome: A Randomized Controlled Trial in Trauma Patients","volume":"70","author":"Tecic","year":"2011","journal-title":"J. Trauma Inj. Infect. Crit. Care"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1001\/jama.2015.8370","article-title":"Psychotherapy for Military-Related PTSDA Review of Randomized Clinical Trials","volume":"314","author":"Steenkamp","year":"2015","journal-title":"JAMA"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1007\/s00406-012-0289-8","article-title":"Posttraumatic stress disorder (PTSD) in the German Armed Forces: A retrospective study in inpatients of a German army hospital","volume":"262","author":"Bandelow","year":"2012","journal-title":"Eur. Arch. Psychiatry Clin. Neurosci."},{"key":"ref_25","unstructured":"World Health Organisation (2023, July 01). Mass Casualty Management Systems: Strategies and Guidelines for Building Health Sector Capacity. Available online: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/43804\/9789241596053_eng.pdf."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/14\/4556\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:08:44Z","timestamp":1760126924000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/14\/4556"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,8]]},"references-count":25,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["jcm12144556"],"URL":"https:\/\/doi.org\/10.3390\/jcm12144556","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2023,7,8]]}}}