PERSPECTIVES

Drs. Khoury and Bhandari discussed the challenges and needs of managing trauma in conflict zones, specifically discussing his experience in Tel Aviv. Our discussion uncovered three core themes. These themes and their supporting insights are highlighted below.

1. Injuries recently are different from injuries in the past

The injuries that were seen during domestic attacks in the 2000s consisted of largely blast injuries which occurred from explosions in enclosed areas. More recently the types of injuries seen are penetration injuries due to missiles, as well as blast injuries.

2. Learn from others who have been through similar experiences

When examining your preparedness and creating plans, it is important to look at others who have gone through similar events. With respect to mass casualties in conflict zones, there is emerging literature from Israel and Iraq regarding how to manage these types of situations, and even though the experiences in Israel and Iraq are very different there is still a lot that can be learned. It is always important to continue learning, even in surgeons with experience in mass casualty situations, as advances in techniques and technologies can provide improvements in the management of patients.

3. Performing drills is a key to preparedness

It is incredibly important to perform drills in order to be prepared for situations of mass casualty. Most institutions will have extensive plans for mass casualty situations, but without drills the execution of these plans can be hampered. Running drills through the entire process of a mass casualty situation, from the identification of patients, to using diagnostics and charting systems will help to ensure there are no flaws in the plan. It is also important once a mass casualty situation has occurred to identify errors or faults and learn and adapt in order to improve for the next potential instance.

SENSE-MAKING

In any mass casualty situation, preparedness can make a drastic outcome in saving lives and improving patient outcomes. There are several keys to being prepared for these types of events, including a comprehensive plan, running drills, and learning from your own difficulties as well as the experience of others.