/
/

Train accident in Germany 1998 – KAMEDO-report 79

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

The worst train accident in Germany since WWII occurred on 3 June 1998. A high-speed express train, the Inter City Express 884, carrying 300 passengers drove into a bridge abutment at 200 kph near the German city of Eschede. The accident claimed the lives of 101 people and injured 108.
Of the injured, 87 had to be transported to the hospital. In 27 cases, transport was by helicopter and in 60 cases by over-the-road ambulance. Eighty-five doctors were involved in the rescue effort and the injured were distributed amongst 23 hospitals. During the first 24 hours, 1,889 people were involved in the emergency response effort. There were 354 vehicles and 39 helicopters at the scene. The massive emergency response meant that all the injured could be given skilled and speedy aid.
The accident happened on a weekday during the spring in an easily accessible area, which allowed swift implementation of emergency services. The primary problems that arose were command of the large number of aid workers, inadequate coordination of medical response, and the lack of a formal organization to provide psychosocial assistance.

The observers’ conclusions

High-speed express trains have evolved into a very common mode of travel in Europe. As the trains are driven at very high speeds, the standards imposed on materials for both rail lines and trains are stringent. When such a train is involved in an accident, the damage energy is high and the estimated damage outcome likewise much higher than for ordinary accidents. Consequently, the disaster response organizations in these regions should adapt their resources according to these potential incident scenarios.
The accident in Eschede was caused by a purely material defect that was difficult to prove. The human factor had little significance here, in contrast to many other major incidents.
Modern computer technology can facilitate rapid notification of all agencies when a major incident occurs. The lack of this technology can, however, be adequately compensated for by meticulously prepared disaster declaration plans in which command center operators know precisely how they are supposed to act in the event of a major incident.
Medical transports via helicopter are valuable when distances are long and terrain is inaccessible. Most medical transports, however, are accomplished just as swiftly by ambulance, and the vehicles that can accommodate several injured persons are frequently utilized.
Medical aid on the scene was performed by a large number of medical teams consisting only of doctors. Many were used to situations of this kind, which is a prerequisite for efficient performance. In Sweden, on the other hand, there are specially trained nurses who can perform essentially all medical interventions done on the scene.
If there are too many doctors working at the scene or at the rendezvous point, there is always a risk that too much will be done before the injured are dispatched to the hospital. In Eschede, 80 percent of the most severely injured had been transported to a hospital within two hours of the accident. For many of the injured, this certainly entailed a substantially longer time at the scene than the 10 minutes prescribed in Swedish trauma medicine training. Conditions may be unique in a real disaster situation, but it is always important to get the injured on the way to the hospital quickly.
Transport of the injured to the hospital is often difficult to direct when there are many medical transports. Better coordination amongst the medical teams in Eschede would probably have resulted in better distribution of the most severely injured amongst the hospitals. A central command doctor at the scene of the disaster or management of medical transports via a command center are other solutions to this problem. The English alternative described in the report from Paddington Station, where the ambulance service managed the distribution of the injured to different hospitals, is likewise a possibility.
Patients were received and admitted at the various hospitals without significant problems. When the incident was declared a disaster, the hospitals were quickly able to call in enough personnel and arrange enough beds, even at the smaller hospitals that do not usually take care of this category of patients.
Volunteer efforts are often difficult to manage during major incidents because no one knows how many volunteers there are or what skills they may have. As a rule, volunteers are rarely needed for the rescue effort or at the hospitals. The German volunteer organization “Techniches Hilfswerk” works well, however. The emergency services organizations are familiar with Techniches Hilfswerk and the latter has limited its contributions to assisting with the logistical problems that arise during a time-consuming aid effort.
Disaster preparedness plans should include procedures for taking care of the dead in a dignified and respectful fashion. For instance, bodies should be identified as rapidly as possible; an adequate number of caskets should be available; and transports should be carried out in a correct manner.
One of the most important lessons that the German disaster organization learned from the train accident was that psychosocial care for victims and their families must be thoroughly reviewed. There was no joint press spokesman dedicated to those issues.

Read the full Summary

Contact

Susannah Sigurdsson
+46 (0)75 247 30 00