ArticleBMC emergency medicine2024
Evaluating emergency response at a hospital near the Gaza border within 24 h of increased conflict.
Article in BMC emergency medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 8 citations in OpenAlex.
- Managing health systems under armed conflict: a scoping review of international evidence and a document review of Iranian experiences.Global health action · 2026Article
- Impact of prolonged armed conflict on the patterns of emergency department visits.BMC emergency medicine · 2026Article
- Developing a hospital response plan for mass casualties in traumatic incidents: A study protocol.Journal of education and health promotion · 2026Article
- Battlefield Neck Injuries: Contemporary Insights From the Israeli National Trauma Registry.Journal of the American College of Emergency Physicians open · 2025Article
- Healthcare providers' insights on pediatric care quality in Gaza hospitals: integrating evidence-based practices and illness management, health information systems, and referral efficiency.Frontiers in pediatrics · 2025Article
- Characteristics and survival of hospitalized combat casualties during two major conflicts between Israel and Hamas: 2023 versus 2014.BMC emergency medicine · 2024Article
- Emotional resilience and sense of danger among doctors in hospitals during periods of heightened tensions and warfare in Israel.Israel journal of health policy research · 2024Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFrontline hospitals near active hostilities face unique challenges in delivering emergency care amid threats to infrastructure and personnel safety. Existing literature focuses on individual aspects like mass casualty protocols or medical neutrality, with limited analysis of operating acute services directly under fire.
objectivesTo describe the experience of a hospital situated meters from hostilities and analyze strategies implemented for triage, expanding surge capacity, and maintaining continuity of care during attacks with limited medical staff availability due to hazardous conditions. A focus will be placed on assessing how the hospital functioned and adapted care delivery models in the event of staffing limitations preventing all teams from arriving on site.
methodsA retrospective case study was conducted of patient records from Barzilai University Medical Center at Ashkelon (BUMCA) Medical Center in Israel within the first 24 h after escalated conflict began on October 7, 2023. Data on 232 admissions were analyzed regarding demographics, treatment protocols, time to disposition, and mortality. Missile alert data correlated patient surges to attacks. Statistical and geospatial analyses were performed.
resultsPatients predominantly male soldiers exhibited blast/multisystem trauma. Patient surges at the hospital were found to be correlated with the detection of incoming missile attacks from Gaza within 60 min of launch. While 131 (56%) patients were discharged and 55 (24%) transferred within 24 h, probabilities of survival declined over time reflecting injury severity limitations. 31 deaths occurred from severe presentation.
conclusionInsights gleaned provide a compelling case study on managing mass casualties at the true frontlines. By disseminating BUMCA's trauma response experience, strategies can strengthen frontline hospital protocols optimizing emergency care delivery during hazardous armed conflicts through dynamic surge capacity expansion, early intervention prioritization, and infrastructure/personnel protection measures informed by risks.
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