Berzon Baruch, West Debra, Jacobs Eliana, Nerlander Maximilian, Salameh Shaden, Talor Eran, Slutsky Tzachi, Rieck Jonathan, Alpert Evan Avraham
Shamir Assaf Harofeh Emergency Medicine Department, Shamir Medical Center, Be'er Yaakov, Israel; Magen David Adom, Tel Aviv, Israel.
Samson Assuta Ashdod University Hospital, Ashdod, Israel.
J Emerg Med. 2025 Oct;77:130-139. doi: 10.1016/j.jemermed.2025.07.032. Epub 2025 Jul 29.
On October 7, 2023, approximately 2,500 Hamas terrorists infiltrated southern Israel from Gaza. Over 1,200 people were killed and 1600 were injured in the largest mass casualty incident (MCI) in Israel's history. Emergency departments (EDs) throughout the country were overwhelmed with patients and working under missile fire. Injuries included high-velocity gunshot wounds, blast injuries, and burns.
The objective of this article is to outline the lessons learned from the response of EDs in Israel to a large, multi-front MCI, in Israel known as a mega MCI, with a specific focus on the clinical care provided to patients in accordance with Israel's National Hospital Disaster Preparedness Plan mandates.
This is a retrospective descriptive analysis of the implementation of Israel's National Hospital Preparedness Plan to the events of October 7, 2023. The working group that performed this analysis are Israeli and international emergency physicians who are involved in disaster preparedness at either their hospital or on a national level. The study is based on institutional after-action reviews. Any data presented is from the Israel Ministry of Health.
A total of 1632 victims from October 7 were seen at 19 EDs throughout the country from the morning of the mega MCI until midnight. The EDs of the Soroka Medical Center, and the Barzilai Medical Center saw the most patients- 624 and 323 respectively. Israel's National Committee for Mass Casualty Incidents (NCMCI) sets comprehensive guidelines and supervises yearly mandatory comprehensive hospital-wide exercises related to MCIs. Based on this, the EDs were able to easily call in additional staff and critical patients were treated using a multidisciplinary approach. Additional patient care areas were opened. There were instances of compromised patient care due to large numbers of arriving patients. Also, there was a need for more secondary transfers.
Being the largest MCI in Israel's history, October 7 tested the performance of the 19 EDs involved. Overall, staffing was sufficient and additional patient care areas were successfully opened. However, there were issues of compromised care and the need for increased numbers of secondary transfers. These lessons are important for the future management of MCIs in Israel and worldwide.
2023年10月7日，约2500名哈马斯恐怖分子从加沙地带潜入以色列南部。这起以色列历史上最大规模的重大伤亡事件（MCI）造成1200多人死亡，1600人受伤。全国各地的急诊科人满为患，医护人员在导弹袭击的威胁下工作。伤者包括高速枪伤、爆炸伤和烧伤。
本文旨在概述以色列急诊科应对大规模、多战线重大伤亡事件（以色列称为超级重大伤亡事件）所吸取的经验教训，特别关注根据以色列国家医院灾难准备计划的要求为患者提供的临床护理。
这是一项对以色列国家医院准备计划在2023年10月7日事件中的实施情况进行的回顾性描述性分析。进行此项分析的工作组由以色列和国际急诊医生组成，他们在各自医院或国家层面参与灾难准备工作。该研究基于机构事后评估。所呈现的任何数据均来自以色列卫生部。
从超级重大伤亡事件发生当天上午到午夜，全国19家急诊科共接待了2023年10月7日事件的1632名受害者。索罗卡医疗中心和巴齐莱医疗中心的急诊科接待的患者最多，分别为624人和323人。以色列重大伤亡事件国家委员会（NCMCI）制定了全面的指导方针，并监督每年与重大伤亡事件相关的全院强制性综合演练。基于此，急诊科能够轻松召集额外的工作人员，并采用多学科方法治疗重症患者。还开设了更多的患者护理区域。由于大量患者涌入，出现了患者护理受到影响的情况。此外，还需要更多的二次转运。
作为以色列历史上最大规模的重大伤亡事件，10月7日考验了所涉19家急诊科的表现。总体而言，人员配备充足，成功开设了更多的患者护理区域。然而，存在护理受到影响的问题，并且需要增加二次转运的数量。这些经验教训对以色列及全球未来重大伤亡事件的管理具有重要意义。
