TY - JOUR
T1 - A four-step approach for establishment of a national medical response to mega-terrorism
AU - Leiba, Adi
AU - Blumenfeld, Amir
AU - Hourvitz, Ariel
AU - Weiss, Gali
AU - Peres, Michal
AU - Schwartz, Dagan
AU - Goldberg, Avishay
AU - Levi, Yehezkel
AU - Bar-Dayan, Yaron
N1 - Funding Information:
A detailed scenario oudining a mega-event caused by a terrorist attack was designed by a committee of experts from the Israeli Home Front Command (HFC) medical department, the Medical Corps Trauma Branch, and the Ministry of Health. This scenario consisted of 500 casualties (including deaths) occurring in an urban setting. The attack was presumed to consist of multiple, simultaneous detonations in closed-space areas.
PY - 2006/1/1
Y1 - 2006/1/1
N2 - 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.
AB - 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.
KW - evacuation
KW - mass-casualty incident
KW - mega-terrorism
KW - terrorism
UR - http://www.scopus.com/inward/record.url?scp=33947578324&partnerID=8YFLogxK
U2 - 10.1017/S1049023X00004167
DO - 10.1017/S1049023X00004167
M3 - Article
AN - SCOPUS:33947578324
SN - 1049-023X
VL - 21
SP - 436
EP - 440
JO - Prehospital and Disaster Medicine
JF - Prehospital and Disaster Medicine
IS - 6
ER -