Research Interests:
Research Interests: Nursing, Emergency Medicine, Radiology, Neurosurgery, Adolescent, and 19 moreIsrael, Humans, Child, Female, Male, Infant, Ct Scan, Clinical Sciences, Aged, Middle Aged, Teleradiology, Adult, Public health systems and services research, Retrospective Studies, Damage Control, Level, Clinical evaluation, Trauma Centers, and Child preschool
... 14. B. Vastag. “Openness in Biomedical Research Collides with Heightened Security Concerns.” JAMA, 289 (2003), pp. 686–690. 15. T. Clancy, Executive Orders (New York: GP Putnam, 1996). 16. M. Oren. “Bioterrorism.” Harefuah, 141... more
... 14. B. Vastag. “Openness in Biomedical Research Collides with Heightened Security Concerns.” JAMA, 289 (2003), pp. 686–690. 15. T. Clancy, Executive Orders (New York: GP Putnam, 1996). 16. M. Oren. “Bioterrorism.” Harefuah, 141 (2002), pp. 13–15. 17. ...
Research Interests:
The world now faces the dreadful possibility of biological weapons attacks by terrorists. Healthcare systems would have to cope with such emergencies should all preemptive measures fail. Information gained from the Global Mercury exercise... more
The world now faces the dreadful possibility of biological weapons attacks by terrorists. Healthcare systems would have to cope with such emergencies should all preemptive measures fail. Information gained from the Global Mercury exercise and the SARS outbreak has shown that containing an outbreak at the start is more effective than reacting to it once it has spread and that containment should be treated both nationally and internationally. On the national level this entails developing rapid and effective methods to detect and identify infected cases, and implementing isolation and control measures to lower the risk of further transmission of the disease while assuring the safety of medical teams and laboratory workers. Strategic contingency plans should incorporate well-defined procedures for hospitalization and isolation of patients, providing regional backup of medical personnel and equipment and maintaining close cooperation between the various bodies in the healthcare system. Q...
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The terror attacks of the September 11, 2001 in the U.S.A followed by the proliferation of anthrax using mail in some US cities and abroad, demonstrated the complex, devastating and harmful nature of terror activity. The use of weapons of... more
The terror attacks of the September 11, 2001 in the U.S.A followed by the proliferation of anthrax using mail in some US cities and abroad, demonstrated the complex, devastating and harmful nature of terror activity. The use of weapons of mass destruction (WMD) in terrorist activities is a reality as is the use of biological weapons (BW) in bioterrorism. Cyberterrorism is another form of non-conventional terrorism. The health care system throughout all its different components and layers--public health, primary care, hospitals, first responders etc., must be prepared. The complete network must have a comprehensive contingency plan for any possible BW scenario. The health care system must cope successfully with the challenge of early diagnosis of extraordinary illness or outbreak of disease, having the ability to define any bioterror event and to conduct appropriate risk assessments. It is of great importance to prepare in advance a comprehensive coordinated plan with all other gover...
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ABSTRACT In the last decade, terror has become an increasingly global problem. More people have become radicalized, the know-how to use weapons of mass destruction (WMD) is easily accessible by Internet and electronic media, and... more
ABSTRACT In the last decade, terror has become an increasingly global problem. More people have become radicalized, the know-how to use weapons of mass destruction (WMD) is easily accessible by Internet and electronic media, and precursors and basic ingredients are easily purchased. Terrorists are innovative and we now face a new era of nonconventional terrorism: chemical, biological, radiological, nuclear (CBRN), as well as cyber terrorism. The deliberate use of (WMD–CBRN) by hostile states or terrorists and of naturally emerging infectious diseases that have a potential to cause illness on a massive scale could pose a national security threat.1 Resulting panic and economic damage could paralyze a country.
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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... more
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.
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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... more
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...
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Mass-casualty incidents (MCIs) can occur outside of major metropolitan areas. In such circumstances, the nearest hospital seldom is a Level-1 Trauma Center. Moreover, emergency medical services (EMS) capabilities in such areas tend to be... more
Mass-casualty incidents (MCIs) can occur outside of major metropolitan areas. In such circumstances, the nearest hospital seldom is a Level-1 Trauma Center. Moreover, emergency medical services (EMS) capabilities in such areas tend to be limited, which may compromise prehospital care and evacuation speed. The objective of this study was to extract lessons learned from the medical response to a terrorist event that occurred in the marketplace of a small Israeli town on 26 October 2005. The lessons pertain to the management of primary and secondary evacuation and the operational practices by the only hospital in the town, which is designated as a Level-2 Trauma Center. Data were collected during the event by Home Front Command Medical Department personnel. After the event, formal and informal debriefings were conducted with EMS personnel, the hospitals involved, and the Ministry of Health. The medical response components, interactions (mainly primary triage and secondary distribution)...
Research Interests: Terrorism, Adolescent, Israel, Emergency Medical Services, Humans, and 7 moreTriage, Female, Male, Explosions, Aged, Middle Aged, and Adult
Proper management of mass-casualty incidents (MCIs) relies on triage as a critical component of the disaster plan. [corrected] The objective of this study was to assess the precision of triage in mass-casualty incidents. The precision of... more
Proper management of mass-casualty incidents (MCIs) relies on triage as a critical component of the disaster plan. [corrected] The objective of this study was to assess the precision of triage in mass-casualty incidents. The precision of decisions made by two experienced triage officers was examined in two large MCIs. These decisions were compared to the real severity of injury as defined by the Israeli Defence Forces (IDF) classification of severity of injuries and the Injury Severity Score (ISS). Two experienced trauma physicians triaged a total of 94 casualties into 77 mild, seven moderate, and 10 severe casualties. Based on the IDF criteria, there were 74 mild, five moderate, and 15 severe casualties. Based on ISS scoring, there were 78 mild (ISS <9), five moderate (9 < or = ISS < 16), and 11 severe (ISS <16) casualties. Of 15 severely injured victims defined by the IDF classification of injury severity, the triage officers identified only seven (47%). Primary triage...
Research Interests:
The threat of a disease outbreak resulting from biologic warfare has been of concern for the Israeli health system for many years. In order to be prepared for such an event the health system has formulated doctrines for various biologic... more
The threat of a disease outbreak resulting from biologic warfare has been of concern for the Israeli health system for many years. In order to be prepared for such an event the health system has formulated doctrines for various biologic agents and defined the logistic elements for the procurement of drugs. During the last 4 years, and especially after the West Nile fever epidemic in 2000, efforts to prepare the healthcare system and the relevant organizations were accelerated. The Director-General of the Ministry of Health nominated a Supreme Steering Committee to fill in the gaps and upgrade the preparedness of the health system for an unusual disease outbreak. This committee and its seven subcommittees established appropriate guidelines, communication routes among different organizations, and training programs for medical personnel. The anthrax outbreak in the United States found the healthcare system in the hub of the preparation process, and all modes of action were intensified....