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The accident at the Ramstein base air show August 28,  1988 – KAMEDO-report 57

The Kamedo-reports are published by the Swedish Disaster Medicine Study Organisation (Kamedo), at the National Board of Health and Welfare. Observers study the medical, psychological, organisational and social aspects of disasters. The results, with a focus on experiences gained, are presented in the reports.

This report is entirely in Swedish. Only summary in English.

Summary

Three fighter jets of the Italian airforce precision team Frecci Tricolori collided Sunday August 28, 1988 at an air show at the US airforce base in Ramstein. One plane hurtled into the crowd and exploded into flames. Around 40 of the spectators died during the first minutes and several hundreds were injured.
After the immediate panic escape away thousands of people tried to return to the site of the accident, which made the rescue operation more difficult. Vehicles for fire fighting managed with the help of rotating blue light and blowing horns to reach the fire, which, when all the gas had burned out, could be easily fought. A few minutes later ambulances and helicopters arrived. Because of all the noise radio- and telecommunication could not be used.
The four "first aid" stations were not equipped for an accident of this size. They had only and a few litres of fluid. Injured, people instead spontaneously brought to three other spots for sorting and medical help before transport to hospitals.
The US military personnel used the principle to evacuate the patients as fast as possible to hospital with only minor treatment at the site of the accident. No infusions were given before the arrival to hospital. Most of the activity was rather improvised and no one had a true picture of the actual situation. The injured were brought to several hospitals. In Landstuhl, close to Ramstein, there was well equipped American military hospital, which took care of 120 patients from the accident. 60 from these, all German citizens, were the same day and night transferred to other hospitals. More than 40 patients could after treatment leave the military hospital the same day.
Because of the great number of injured coming to the hospital it was necessary with advanced surgery already in the emergency department (tracheostomy, amputations).
In Landstuhl there is also a civilian hospital with 406 beds. The hospital received 70 patients, who were sorted in the ambulance hall. Seriously injured were taken care of by an anaesthesiologist and a nurse. 50 of the totally 70 patients, brought to the hospital had to stay. From these were, later on, ten with severe burns transported to Ludwigshafen.
In Ludwigshafen there is a hospital specialized for the treatment of trauma cases, with competence in orthopedic, traumatology, intensive care, plastic surgery, burns treatment and rehabilitation of paraplegic patients. Totally this hospital received 30 patients with burns of which 28 already arrived within the first five hours after the accident. Four patients died during the first hour.
In Kaiserslautern there is a civilian hospital with special competence in, i.e. traumatology and thorax surgery. Altogether 98 patients from the accident were brought to the hospital. From these 42 had to stay.
Injured people from the accident were also brought to other hospitals in surrounding towns. Besides, several burn clinics in Western Germany had prepared to receive patients from Ramstein but did not get any, at least not during the first days, because the patients were preferably brought to hospitals in the vicinity of Ramstein.
On the 29 of August a medical team was transported from San Antonio in Texas to Ramstein to evacuate four patients with severe burns to Brooke Army Medical Centre in San Antonio.
The death toll from the accident rose during the following two months to 69. Of the injured, 50 percent had burn injuries, 25 percent predominantly other injuries.
In this report the identification work and some psychological problems connected with the accident are also shortly described.

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