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Primary Triage, Evacuation Priorities, and Rapid Primary Distribution between Adjacent Hospitals—Lessons Learned from a Suicide Bomber Attack in Downtown Tel-Aviv

Published online by Cambridge University Press:  28 June 2012

Moshe Pinkert ,
Ofer Lehavi ,
Odeda Benin Goren ,
Yaron Raiter ,
Ari Shamis ,
Zvi Priel ,
Dagan Schwartz ,
Avishay Goldberg ,
Yehezkel Levi  and
Yaron Bar-Dayan
Moshe Pinkert
Affiliation:
Home Front Command Medical Department
Ofer Lehavi
Affiliation:
Sorasky Medical Center Tel Aviv, Israel
Odeda Benin Goren
Affiliation:
Sorasky Medical Center Tel Aviv, Israel
Yaron Raiter
Affiliation:
Home Front Command Medical Department
Ari Shamis
Affiliation:
Director, Sheba General Medical Center, Tel-Hashomer, Israel
Zvi Priel
Affiliation:
Deputy Director, Edith Wolfson Hospital, Tel-Aviv, Israel
Dagan Schwartz
Affiliation:
Faculty of Health Sciences, Ben Gurion University, Beer-Sheva, Israel Israeli EMS, Magen David Adom, Medical Division
Avishay Goldberg
Affiliation:
Faculty of Health Sciences, Ben Gurion University, Beer-Sheva, Israel
Yehezkel Levi
Affiliation:
Israeli Defense Force Medical Corps, Surgeon General Headquarters
Yaron Bar-Dayan*
Affiliation:
Home Front Command Medical Department Faculty of Health Sciences, Ben Gurion University, Beer-Sheva, Israel
*
16 Dolev St. Neve Savion Or-Yehuda, Israel E-mail: bardayan@netvision.net.il
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Abstract

Introduction:

Terrorist attacks have occurred in Tel-Aviv that have caused mass-casualties.The objective of this study was to draw lessons from the medical response to an event that occurred on 19 January 2006, near the central bus station, Tel-Aviv, Israel. The lessons pertain to the management of primary triage, evacuation priorities, and rapid primary distribution between adjacent hospitals and the operational mode of the participating hospitals during the event.

Methods:

Data were collected in formal debriefings both during and after the event. Data were analyzed to learn about medical response components, interactions, and main outcomes. The event is described according to Disastrous Incidents Systematic AnalysiS Through—Components, Interactions and Results (DISAST-CIR) methodology.

Results:

A total of 38 wounded were evacuated from the scene, including one severely injured, two moderately injured, and 35 mildly injured. The severe casualty was the first to be evacuated 14 minutes after the explosion. All of the casualties were evacuated from the scene within 29 minutes. Patients were distributed between three adjacent hospitals including one non-Level-1 Trauma Center that received mild casualties. Twenty were evacuated to the nearby, Level-1 Sourasky Medical Center, including the only severely injured patient. Nine mildly injured patients were evacuated to the Sheba Medical Center and nine to Wolfson Hospital, a non-Level-1 Trauma Center hospital. All the receiving hospitals were operated according to the mass-casualty incident doctrine.

Conclusions:

When a mass-casualty incident occurs in the vicinity of more than one hospital, primary triage, evacuation priority decision-making, and rapid distribution of casualties between all of the adjacent hospitals enables efficient and effective containment of the event.

Keywords

distributionevacuationmasscasualty incidentprimary triageprioritiesterrorism
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 23 , Issue 4 , August 2008 , pp. 337 - 341
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2008

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