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April 22, 2013 8:29 pm

In responding to Terror Attack, Boston Doctors Benefitted Greatly from Israeli Training

avatar by Zach Pontz

Though condemning the Boston Marathon bombings in which 3 people were killed and more than 100 wounded, Iran also criticized U.S. drone attacks in the Middle East. Some online Jihadis expressed happiness over the Boston attack. Photo: Wikimedia Commons via Aaron Tang.

Several Boston hospitals have been thrust into the spotlight with recent events in that city, and along with them so too have the medical staffs. Everyone wants to know how they have so successfully responded to a crisis of such proportions. The answer to some extent is this: Israel. recently interviewed Dr. Alasdair Conn, Chief of the Department of Emergency Medicine at Massachusetts General. He described how Israeli doctors played a prime role in the successful medical response following last week’s terror attack.

Collaboration began after 9/11 when staff at Massachusetts General realized they wouldn’t be prepared for an attack of that magnitude closer to home.

“We could manage to treat patients from a multiple car crash – with three or four or five patients – pretty well,” recalls Dr. Alasdair Conn, Chief of the Department of Emergency Medicine, “but what would happen if we had many more patients, simultaneously and with very little warning?”

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Dr. Conn and his colleagues looked to Israel for advice, and turned to Dr. Pinchas Halpern, Chief of the Emergency Department at Tel Aviv Medical Center. A world-renowned expert on trauma care, Dr. Halpern had helped make Tel Aviv’s Sourasky Medical Center one of the world’s leaders in emergency medicine.

Halpern came over in 2005, when Israel was experiencing a wave of terror attacks. For the doctors at Massachusetts General, the visit would prove tremendously important 8 years later. “To this day I remember a comment,” Dr. Conn recalls. “One of the Israelis said that here in the United States we have a terrorist event every few years, but ‘unfortunately, in Israel,’ he said, ‘we have a situation where a bomb is put on a bus once every three weeks. We have no notice, and we get 50 or 60 or 70 casualties with no warning.'”

Logistics was a focal point of the training process. Israeli doctors taught their American colleagues lessons they’d learned in organizing responses to large-scale disasters. “Only a small part of dealing with such an event is medical, much of it is logistical,” Tel Aviv’s Dr. Halpern explained.

He and his colleagues developed a unique triage system, moving casualties indoors as soon as possible and streamlining processes to make it more rapid. “We did away with a lot of the structure that was in the textbook that was never really tested,” Dr. Halpern said. They developed protocols like doing extra CT scanning to detect small pieces of shrapnel from bombs designed to cause maximum damage.

Israeli trauma doctors had learned to alter their lab testing procedures, to streamline the way they identified victims after terror attacks, and to not discharge blast victims right away, because often their injuries don’t show symptoms until later. Mass. General’s Dr. Paul Biddinger noted that “we improved our plans for triage, site security, reassessment and inter-specialty coordination” after consulting with the Israelis.

Another lesson the Israelis learned was to call up large numbers of staff as soon as the hospital hears of a terrorist attacks in case they are needed. This proved particularly beneficial last week.

“As soon as we heard about the blasts we didn’t let any anesthesiologists or general or trauma surgeons or pediatricians leave the hospital,” said ER head Dr. Alasdair Conn. “We learned that from the Israelis. I remember walking through the emergency department two hours after the bomb victims arrived. Many of the acute patients had already been moved, and it looked like there were more staff than patients in the ER. If there had been a third or a fourth bomb that day – we could have managed.”

Over 30 blast victims arrived at the hospital following last Monday’s attack. Each victim had their own dedicated team attending to them.

“We’re not smarter than other doctors,” Dr. Halpern told “But we have two things going for us. One, unfortunately, is the high level of terrorism Israel faces. The other factor is Israel’s advanced medical system. In general, countries with lots of terrorism have a lower level of academic research and writing; countries with sophisticated medical systems have lower levels of terrorism. Israel combines both.”

Noting that Israelis had been first on the scene at disasters across the globe, Dr. Halpern said, “We can help, so we feel we have a moral obligation. We respond very quickly and efficiently. We think out of the box, not dogmatically, and we are often first on the scene… There’s a very strong sense to apply the skills we’ve gained morally. I choose to live in Israel in the face of much adversity, and I believe it is incumbent upon us as Jews and Israelis to help whomever we can.”

“When we were preparing for mass casualties we realized the Israelis had the expertise in this type of situation,” Dr. Conn said, “and we turned to them. This week it really paid off.”

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