Mass casualty incident after the Taba terrorist attack: an organisational and medical challenge

Abstract

Two suicide bombings in and around Taba, Egypt, on 7 October 2004 created a complex medical and organisational situation. Since most victims were Israeli tourists, the National Emergency and Disaster Management Division handled their evacuation and treatment. This paper describes the event chronologically, as well as the organisational and management challenges confronted and applied solutions. Forty-nine emergency personnel and physicians were flown early to the disaster area to reinforce scarce local medical resources. Two hundred casualties were recorded: 32 dead and 168 injured. Eilat hospital was transformed into a triage facility. Thirty-two seriously injured patients were flown to two remote trauma centres in central Israel. Management of mass casualty incidents is difficult when local resources are inadequate. An effective response should include: rapid transportation of experienced trauma teams to the disaster zone; conversion of local medical amenities into a triage centre; and rapid evacuation of the seriously injured to higher level medical facilities.

Organizing for the Big One: A Review of Case Studies and a Research Agenda for Multi‐Agency Disaster Response

“…In addition to ineffective information sharing and resource deployment, actions driven by motives of impression management also tend to hamper the development of trust (Garnett et al, 2007). Trust, importantly, has been shown to increase the willingness to share information and to initiate cooperation (Dawes et al, 2004;Karp, Sebbag, Peiser, Dukhno, Ovnat, Levy, Hyam, Blumenfeld, Kluger, Simon & Shaked, 2007;Saab, Tapia, Maitland, Maldonado & Tchouakeu, 2013). Through this mechanism, the presence of just a few organizations following impression management logics has the potential to disrupt the effectiveness of the larger operation.…”

Evaluation of a CT triage protocol for mass casualty incidents: results from two large-scale exercises

“…As reported in analyses of past mass casualty incidents, the admission rate is neither constant nor linear [17,18]. The first peak of casualties admitted usually consists of walking wounded and noncritical victims who seek care in the hospitals located nearest to the site of the incident.…”

Review of On-Scene Management of Mass-Casualty Attacks

“…According to Kluger [84], definitive care by well-trained physicians in wellequipped facilities has a higher impact on patient outcome than care on scene. Setting up field hospitals and sending mobile teams from hospitals to provide advanced treatment on scene is an alternative when there is not enough prehospital staff, when casualties are trapped, when appropriate hospitals are far away, or where limited transport facilities cause a delay in evacuation [53,68,82,105]. There have also been instances were physicians have been beneficial on the scene by enabling extrication and transfer to hospital, sometimes through field amputations [55,58,61].…”

“…Helicopters and fixed-wing aircrafts have been essential to deploy staff and equipment to the site or primary receiving hospitals [44,93,105,112], as well as use for primary or secondary evacuation and distribution of injured [93,105,112]. Improvements in air evacuation have significantly upgraded the ability of the EMS to rapidly evacuate MCA casualties in distant areas to tertiary care facilities, but effective use of air-medical evacuation requires planning, coordination, and training [112].…”

“…The principle of an evacuation hospital (or "triage hospital") has been recommended when the needs of the patients greatly outweigh the capabilities of the receiving hospital or when the expected number of patients amount to a continued patient flow. This sets the hospital to a mode of treating and discharging mild casualties while stabilizing, and secondarily evacuating, patients that require admission [93,105].…”