[Clinical disaster medicine: recommendations of the Surgical Working Group for Military and Emergency Surgery]

In-hospital disaster medicine demands a structured, pragmatic and resource-efficient approach in the surgical treatment of patients under extreme conditions. The Surgical Working Group for Military and Emergency Surgery (CAMIN) of the German Society of General and Visceral Surgery (DGAV) has developed guideline-based recommendations for making decisions, prioritization and management in disaster scenarios. The guidelines address the special challenges of atypical trauma patterns, as can be found in terrorist attacks or situations with mass casualties, such as gunshot or blast injuries. They highlight the use of damage control surgery (DCS), the differentiated application of laparotomy, open abdominal management and the triage of general and oncological procedures. The clinical assessment, focused diagnostics (e.g., extended focussed assessment with sonography in trauma, eFAST) and staged surgical algorithms are at the heart of this concept, aiming to ensure the highest level of patient safety and effectiveness despite critical resource limitations. The overriding principle is: "do the most for the most."