Digital Patient Distribution and Dynamic Capacity Management During a Vehicle-Ramming Mass-Casualty Incident in Munich, Germany.

Abstract

Objectives: Urban mass-casualty incidents (MCIs) caused by deliberate violence pose a high risk of hospital overload and secondary system failure. Digital coordination platforms have been proposed as tools to enhance system resilience, yet real-world evaluations remain limited. To describe and evaluate the use of a web-based digital patient distribution system during the February 13, 2025 vehicle-ramming attack in Munich, Germany.

Methods: We conducted a retrospective operational analysis using anonymized data from the Integrierter Versorgungsnachweis (IVENA) Massenanfall von Verletzten, mass-casualty incident (MANV) coordination module, integrated into the regional hospital capacity management system. Key outcomes included timelines of system activation, patient distribution, hospital capacity feedback, and continuity of routine emergency care.

Results: The incident resulted in 39 casualties, including two fatalities. Early activation of the digital MANV module enabled real-time situational awareness and demand-oriented allocation of patients. All critically injured patients were distributed across multiple hospitals within 19 min of the first transport. Hospitals dynamically adjusted reported capacities throughout the incident, allowing routine emergency operations to continue largely unaffected. No single hospital experienced critical overload.

Conclusions: Digital patient distribution supported rapid, adaptive coordination during a high-impact urban MCI and contributed to prevention of hospital overload. Integration of such systems into routine operations, combined with standardized preparation and training, may enhance disaster risk reduction and resilience of urban emergency medical systems.