Document Detail


A dynamic mass casualty incident at sea: Lessons learned from the Mavi Marmara.
MedLine Citation:
PMID:  23887562     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Mass casualty incidents (MCIs) represent one of the most difficult prehospital challenges faced by medical personnel. When they occur at sea, this challenge may be further complicated by isolation, distance, vessel structure, number of passengers, and limited evacuation means.
METHODS: We describe our experience and lessons learned from a dynamic MCI in an austere environment at sea.
RESULTS: Following an armed attack on navy operators boarding the MV Mavi Marmara, a vessel heading for Gaza, the Israel Defense Forces' medical teams triaged and cared for 62 casualties, among them 9 soldiers; 9 additional casualties were declared dead at the scene. The injured, including 10 triaged as severely wounded, were all evacuated to Israeli hospitals within several hours of the start of the event. Despite the austere conditions and the severity of injuries, all of the injured passengers were able to return to their home countries, and all soldiers returned to duty. Multiple issues were identified as requiring changes or heightened awareness so as to be better prepared for future events of this special nature.
CONCLUSION: The primary lessons learned related to difficulties in functioning without effective communication, maintaining command and control, coordinating serial evacuation of casualties who were being triaged in parallel, planning for an event with lengthy evacuation times, resolving real-time ethical dilemmas, and preparing our providers mentally. As MCIs tend to be unexpected, preplanning, using preestablished manuals, and drilling for them may prove crucial in such extreme events. Importantly, the lessons learned from this event, with its unique synthesis of multiple contributing factors, remain relevant even in less austere settings.
LEVEL OF EVIDENCE: Care management, level V.
Authors:
Elon Glassberg; Ari M Lipsky; Amir Abramovich; Ilia Sergeev; Ohad Hochman; Nachman Ash
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The journal of trauma and acute care surgery     Volume:  75     ISSN:  2163-0763     ISO Abbreviation:  J Trauma Acute Care Surg     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-07-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101570622     Medline TA:  J Trauma Acute Care Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  292-7     Citation Subset:  AIM; IM    
Affiliation:
From the Medical Corps (E.G., A.M.L., A.A., I.S., O.H., N.A.), Surgeon General's Headquarters, Israel Defense Forces; Department of Medical Administration (O.H.), Hillel Yaffe Medical Center, Hadera; Israel Ministry of Health (N.A.); and Department of Health Administration (N.A.), Ariel University Center of Samaria, Ariel, Israel.
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