A four-step approach for establishment of a national medical response to mega-terrorism

Adi Leiba, Amir Blumenfeld, Ariel Hourvitz, Gali Weiss, Michal Peres, Dagan Schwartz, Avishay Goldberg, Yehezkel Levi, Yaron Bar-Dayan

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


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.

Original languageEnglish
Pages (from-to)436-440
Number of pages5
JournalPrehospital and Disaster Medicine
Issue number6
StatePublished - 1 Jan 2006


  • evacuation
  • mass-casualty incident
  • mega-terrorism
  • terrorism

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency


Dive into the research topics of 'A four-step approach for establishment of a national medical response to mega-terrorism'. Together they form a unique fingerprint.

Cite this