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A Four-Step Approach for Establishment of a National Medical Response to Mega-Terrorism

Part of: Prehospital and Disaster Medicine Counterterrorism Collection

Published online by Cambridge University Press:  28 June 2012

Adi Leiba ,
Amir Blumenfeld ,
Ariel Hourvitz ,
Gali Weiss ,
Michal Peres ,
Dagan Schwartz ,
Avishay Goldberg ,
Yehezkel Levi  and
Yaron Bar-Dayan
Adi Leiba
Affiliation:
Home Front Command Medical Department, Israel
Amir Blumenfeld
Affiliation:
Israeli Medical Corps, Surgeon General Headquarters, Trauma Branch, Israel
Ariel Hourvitz
Affiliation:
Home Front Command Medical Department, Israel
Gali Weiss
Affiliation:
Home Front Command Medical Department, Israel
Michal Peres
Affiliation:
Home Front Command Medical Department, Israel
Dagan Schwartz
Affiliation:
Israeli Emergency Medical Service (Israeli Shield of David), Israel
Avishay Goldberg
Affiliation:
Faculty of Health Sciences, Department of Emergency Medicine, Ben Gurion University, Beer-Sheva, Israel
Yehezkel Levi
Affiliation:
Israeli Medical Corps, Surgeon General Headquarters, Trauma Branch, Israel
Yaron Bar-Dayan*
Affiliation:
Home Front Command Medical Department, Israel
*
Col. Dr. Y. Bar-Dayan MD, MHA Chief Medical Officer, IDF Home Front Command, 16 Dolev St. Neve Savion, Or-Yeshiva, Israel E-mail: bardayan@netvision.net.il
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Abstract

A simplified, four-step approach was used to establish a medical management and response plan to mega-terrorism in Israel. The basic steps of this approach are: (1) analysis of a scenario based on past incidents; (2) description of relevant capabilities of the medical system; (3) analysis of gaps between the scenario and the expected response; and (4) development of anoperational framework.

Analyses of both the scenario and medical abilities led to the recommendation of an evidence-based contingency plan for mega-terrorism. An important lesson learned from the analyses is that a shortage in medical first responders would require the administration of advanced life support (ALS) by paramedics at the scene, along with simultaneous, rapid evacuation of urgent casualties to nearby hospitals by medics practicing basic life support (BLS). Ambulances and helicopters should triage casualties from inner to outer circle hospitals secondarily, preferentially Level-1 trauma centers.

In conclusion, this fourstep approach based on scenario analysis, mapping of medical capabilities, detection of bottlenecks, and establishment of a unique operational framework, can help other medical systems develop a response plan to megaterrorist attacks.

Keywords

evacuationmass-casualty incidentmega-terrorismterrorism
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 21 , Issue 6 , December 2006 , pp. 436 - 440
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2006

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