On Constant Alert: Lessons To Be Learned From Israel’s Emergency Response To Mass-Casualty Terrorism Incidents

Abstract

In its short modern history, Israel has had to contend with numerous mass-casualty incidents caused by terrorism. As a result, it has developed practical national preparedness policies for responding to such events. Israel's Supreme Health Authority, a committee of the Ministry of Health, coordinates emergency management nationwide. All emergency personnel, health care providers, and medical facilities operate under national policies designed to ensure a swift and coordinated response to any incident, based on an "all hazards" approach that emphasizes core elements commonly encountered in mass-casualty incidents. Israel's emergency management system includes contingency planning, command and control, centrally coordinated response, cooperation, and capacity building. Although every nation is unique, many of the lessons that Israel has learned may be broadly applicable to preparation for mass-casualty incidents in the United States and other countries.

Securing the Emergency Department During Terrorism Incidents: Lessons Learned From the Boston Marathon Bombings

“…Simultaneously and following an established protocol that was developed on previously published literature, ED personnel transferred all patients present in the ED at the time of CMED notification, to inpatient floors. [2][3][4][5][6][7] During these preparations, there were media reports of additional explosions at the John F. Kennedy Presidential Library and Museum. Although these reports were later disproven and the disruption was due to a transformer fire, at the time, the information raised the suspicion for coordinated attacks and brought an additional sense of urgency to the process.…”

“…Social media played a major role in keeping the hospital personnel informed on the situation at the scene of the explosions. 4,30 However, a common complaint by hospital employees was the lack of information regarding the situation within the hospital, particularly after initiating the lockdown.…”

“…Multiple debriefings involving physicians, nurses, and hospital leadership from all departments occurred over the subsequent weeks. 4,32,33 The aforementioned problems and others were identified and analyzed. Potential solutions were designed and in the majority of the cases, implemented (Table 1).…”

Increasing Perceived Emergency Preparedness by Participatory Policy-Making (Think-Tanks)

“…9 Implementation of crisis management policies, including provision of vital services, casualty evacuation, manpower coordination, attention to unique needs of vulnerable populations, and military-civil coordination are an integral component of the preparedness for such events. 5,8,10 Perceptions concerning individual and systemic emergency preparedness are relevant to the capacity to respond to crises. 11,12 Perceived emergency preparedness of the workplace influences the readiness of health care workers to report to duty.…”

Addressing the Mental Health Needs of Victims and Responders to the Boston Marathon Bombings

“…Mass casualty events inflict both physical and psychological damage. Managing acute stress should be a leading component of medical care and not be less important than physical injuries [1,2]. A disaster or terrorist attack affects one's cognitive, emotional, social/behavioral, physiological, and spiritual domains.…”