Raiter Y, Farfel A, Lehavi O, Goren O B, Shamiss A, Priel Z, Koren I, Davidson B, Schwartz D, Goldberg A, Bar-Dayan Y
Home Front Command Medical Department, Israel.
Emerg Med J. 2008 Apr;25(4):225-9. doi: 10.1136/emj.2007.052399.
Terrorist attacks in Israel cause mass events with varying numbers of casualties. A study was undertaken to analyse the medical response to an event which occurred on 17 April 2006 near the central bus station, Tel Aviv, Israel. Lessons are drawn concerning the management of the event, primary triage, evacuation priorities and the rate and characteristics of casualty arrival at the nearby hospitals.
Data were collected both during and after the event in formal debriefings. Their analysis refers to medical response components, interactions and main outcomes. The event is described according to the DISAST-CIR methodology (Disastrous Incidents Systematic AnalysiS Through--Components, Interactions and Results).
91 casualties were reported in this event; 85 were evacuated from the scene including 3 already dead on arrival, 9 severely injured, 14 moderately injured and 59 mildly injured. Six were declared dead at the scene. Emergency medical service (EMS) vehicle accumulation was rapid. The casualties were distributed between five hospitals (three level 1 and two level 2 trauma centres). The first evacuated casualty arrived at the hospital within 20 min of the explosion and the last urgent victim was evacuated from the scene after 1 h 14 min. Evacuation occurred in two phases: the first, lasting 1 h 20 min, in which most of the patients with evident trauma were evacuated and the second, lasting 8 h 15 min, in which most patients presented with tinnitus and symptoms of somatisation. The most common injuries were upper and lower limb injuries, diagnosed in 37% of the total injuries, and stress-related disturbances (anxiety, tinnitus, somatisation) diagnosed in 41%.
Rapid accumulation of EMS vehicles, effective primary triage between urgent and non-urgent casualties and primary distribution between five hospitals enabled rapid conclusion of the event, both at the scene and at the receiving hospitals.
以色列的恐怖袭击造成了不同伤亡人数的大规模事件。开展了一项研究，以分析对2006年4月17日发生在以色列特拉维夫中央汽车站附近的一起事件的医疗应对情况。总结了有关该事件管理、初步分诊、疏散优先级以及伤员抵达附近医院的速度和特征的经验教训。
在事件期间和之后的正式汇报中收集数据。其分析涉及医疗应对的组成部分、相互作用和主要结果。该事件按照DISAST-CIR方法（通过组成部分、相互作用和结果对灾难性事件进行系统分析）进行描述。
该事件报告了91名伤员；85人从现场疏散，其中包括3名抵达时已死亡、9名重伤、14名中度受伤和59名轻伤。6人在现场被宣布死亡。紧急医疗服务（EMS）车辆迅速聚集。伤员被分配到五家医院（三家一级和两家二级创伤中心）。第一名疏散的伤员在爆炸后20分钟内抵达医院，最后一名紧急伤员在1小时14分钟后从现场疏散。疏散分两个阶段进行：第一阶段持续1小时20分钟，在此期间大多数有明显创伤的患者被疏散；第二阶段持续8小时15分钟，在此期间大多数患者出现耳鸣和躯体化症状。最常见的损伤是上肢和下肢损伤，占总损伤的37%，与压力相关的障碍（焦虑、耳鸣、躯体化）占41%。
EMS车辆的迅速聚集、对紧急和非紧急伤员进行有效的初步分诊以及在五家医院之间进行初步分配，使得该事件在现场和接收医院都能迅速结束。
