Mintz Y, Shapira SC, Pikarsky AJ, et al. The experience of one institution dealing with terror: the El Aqsa Intifada riots (original) (raw)
Related papers
The experience of one institution dealing with terror: the El Aqsa Intifada riots
The Israel Medical Association journal : IMAJ, 2002
During a period of 13 months--1 October 2000 to 31 October 2001--586 terror assault casualties were treated in the trauma unit and emergency department of Hadassah University Hospital (Ein Kerem campus); 27% (n = 158) were hospitalized and the rest were discharged within 24 hours. To analyze the special requirements of a large number of victims who received treatment during a short period. Data were attained from the main admitting office and the trauma registry records. Factors analyzed included age, gender, mechanism of injury, anatomic site of injury, Injury Severity Score, and length of stay. Males comprised 81% of the hospitalized patients. The majority of the injuries (70%) were due to gunshot wounds and 31% of the hospitalized patients were severely injured (ISS > or = 16). Twelve patients died, yielding a mortality rate of 7.5%. The nature of the injuries was more complex and severe than trauma of other etiologies, as noted by the mean length of stay (10.2 vs. 7.2 days), ...
Pattern of Injury and Outcome of Victims in Ahvaz Terrorist Attack
Trauma monthly, 2021
Background: Responses for medical emergencies can be different during most terrorist attacks in which civilians and military personnel might be killed or wounded. Objectives: The present study aimed to reflect on injury patterns and the outcome of victims in terrorist attacks. Methods: A retrospective research design study was conducted on the data obtained from terrorist attacks in the city of Ahvaz, Iran, on September 22, 2018. In this deadly incident, 92 military and civilian victims had been transferred to hospitals within the first 24 hours. To this end, the data including age, gender, causes, site of injuries, outcomes, and the Injury Severity Score (ISS) values were analyzed. Data were acquired from the Iranian Legal Medicine Organization, the Iranian Emergency Department, as well as health care facilities. Results: The findings revealed that, out of 92 victims of Ahvaz terrorist attack, 85 cases (92.4%) were men. The mean age of these individuals was about 28.68±11.22 years...
Trauma Care and Case Fatality during a Period of Frequent, Violent Terror Attacks and Thereafter
World Journal of …, 2012
Background From September 1999 through January 2004 during the second Intifada (al-Aqsa), there were frequent terror attacks in Jerusalem. We assessed the effects on case fatality of introducing a specialized, intensified approach to trauma care at the Hebrew University-Hadassah Hospital Shock Trauma Unit (HHSTU) and other level I Israeli trauma units. This approach included close senior supervision of prehospital triage, transport, and all surgical procedures and longer hospital stays despite high patientstaff ratios and low hospital budgets. Care for lower income patients also was subsidized. Methods We tracked case fatality rates (CFRs) initially during a period of terror attacks (1999)(2000)(2001)(2002)(2003) in 8,127 patients (190 deaths) at HHSTU in subgroups categorized by age, injury circumstances, and injury severity scores (ISSs). Our comparisons were four other Israeli level I trauma centers (n = 2,000 patients), and 51 level I U.S. trauma centers (n = 265,902 patients; 15,237 deaths). Detailed HHSTU follow-up continued to 2010. Results Five-year HHSTU CFR (2.62 %) was less than half that in 51 U.S. centers (5.73 %). CFR progressively decreased; in contrast to a rising trend in the US for all age groups, injury types, and ISS groupings, including gunshot wounds (GSW). Patients with ISS [ 25 accounted for 170 (89 %) of the 190 deaths in HHSTU. Forty-one lives were saved notionally based on U.S. CFRs within this group. However, far more lives were saved from reductions in low
Prehospital and disaster medicine
A mass-casualty incident (MCI) can occur in the periphery of a densely populated area, away from a metropolitan area. In such circumstances, the medical management of the casualties is expected to be difficult because the nearest hospital and the emergency medical services (EMS), only can offer limited resources. When coping with these types of events (i.e., limited medical capability in the nearby medical facilities), a quick response time and rational triage can have a great impact on the outcome of the victims. The objective of this study was to identify the lessons learned from the medical response to a terrorist attack that occurred on 05 December 2005, in Netanya, a small Israeli city. Data were collected during and after the event from formal debriefings and from patient files. The data were processed using descriptive statistics and compared to those from previous events. The event is described according to Disastrous Incidents Systematic Analysis Through Components, Interac...
Annals of Surgery, 2004
Context: An increase of terror-related activities may necessitate treatment of mass casualty incidents, requiring a broadening of existing skills and knowledge of various injury mechanisms. Objective: To characterize and compare injuries from gunshot and explosion caused by terrorist acts. Methods: A retrospective cohort study of patients recorded in the Israeli National Trauma Registry (ITR), all due to terror-related injuries, between October 1, 2000, to June 30, 2002. The ITR records all casualty admissions to hospitals, in-hospital deaths, and transfers at 9 of the 23 trauma centers in Israel. All 6 level I trauma centers and 3 of the largest regional trauma centers in the country are included. The registry includes the majority of severe terror-related injuries. Injury diagnoses, severity scores, hospital resource utilization parameters, length of stay (LOS), survival, and disposition. Results: A total of 1155 terror-related injuries: 54% by explosion, 36% gunshot wounds (GSW), and 10% by other means. This paper focused on the 2 larger patient subsets: 1033 patients injured by terror-related explosion or GSW. Seventy-one percent of the patients were male, 84% in the GSW group and 63% in the explosion group. More than half (53%) of the patients were 15 to 29 years old, 59% in the GSW group and 48% in the explosion group. GSW patients suffered higher proportions of open wounds (63% versus 53%) and fractures (42% versus 31%). Multiple body-regions injured in a single patient occurred in 62% of explosion victims versus 47% in GSW patients. GSW patients had double the proportion of moderate injuries than explosion victims. Explosion victims have a larger From the
Assessment of Injuries Following Terrorist Attacks: A Narrative Review
Trauma monthly, 2020
Background: In the few past decades, the world has experienced numerous terrorist attacks. Objectives: We sought to review the mechanisms and patterns of injuries in terrorist attacks; the main goal being better management of victims of these attacks. Methods: In current narrative review; electronic databases (PubMed, Wiley, EMBASE, ISI Web of Knowledge, and Scopus) were searched seeking relevant publications between 2000-2018. The keywords used when searching for articles included: violence, terrorism, disasters, trauma, trauma centers, war, mass casualties, wounds, and injuries. Searching, screening, and assessment of records were done separately by two authors; disagreements were resolved by discussion with a third reviewer. Results: Nine studies were found to be eligible for inclusion in this study. The most common device-related terrorist attacks were explosives and bombs. More than half of the victims suffered minor injured and could be treated promptly. The most common causes...
Prehospital and disaster medicine
Based on the experience of managing > 20 such events during the last decade, the authors' understanding of a mass-casualty incident is that it is an event in which there may be many victims, but only a few that actually suffer from life-threatening injuries. To make an impact on survival, one must identify those who are severely wounded as quickly as possible and offer those patients optimal care. Experienced trauma physicians are the most important resource available to achieve this objective, and they should be allocated to the treatment of seriously injured victims instead of more traditional management roles such as triage and incident manager.
Injury, 2009
Terror attacks against civilian populations in urban settings have become much more common in recent years. Many countries in Europe, the Americas, Middle East and Asia have experienced such events and remain at risk of future attacks. Some countries such as Israel, United Kingdom, Turkey and Spain have been subjected to repeated attacks over many years. In Israel, a site of frequent terror attacks over the past decade, hundreds of civilians have lost their lives and thousands of others were wounded, as a consequence of these actions. We would like to learn from our experience in order to improve future management and outcome of such events.
Patterns of injury in hospitalized terrorist victims
American Journal of Emergency Medicine, 2003
Acts of terror increase the demand for acute care. This article describes the pattern of injury of terror victims hospitalized at 9 acute-care hospitals in Israel during a 15-month period of terrorism. To characterize patients hospitalized as a result of terror injuries, we compared terror casualties with other injuries regarding severity, outcome, and service utilization. Using data from the National Trauma Registry, characteristics of casualties are portrayed. During the study period, 23,048 patients were recorded, 561 of them (2.4%) were injured through terrorist acts. Seventy percent were younger than 29 years. Seventy-five percent were males. Thirteen percent of terror victims compared with 3% with other traumatic injuries, arrived by helicopter. Injury mechanism consisted mainly of explosions (n ؍ 269, 48%) and gunshot injuries (n ؍ 266, 47%). One third of the population experienced severe trauma (Injury Severity Score > 16). One hundred-forty-two patients (26%) needed to be admitted to the intensive-care unit. Inpatient mortality was 6% (n ؍ 35). Fifty-five percent of the injuries (n ؍ 306) included open wounds and 31% (n ؍ 172) involved internal injuries; 39% (n ؍ 221) sustained fractures. Half of the patients had a procedure in the operating room (n ؍ 298). Duration of hospitalization was longer than 2 weeks for nearly 20% of the population. Injuries from terrorist acts are severe and impose a burden on the healthcare system. Further studies of the special injury pattern associated with terror are necessary to enhance secondary management and tertiary prevention when occurring. (Am J Emerg Med 2003;21:258-262.