The Health System Readiness for MCI in a Remote City with Limited Health Services

Summary: Eilat is the southernmost tourist city in Israel, with a population of about 65,000. The Iron Swords War brought 65,000 displaced people to the town. The local hospital has 67 beds, no trauma unit, three operating rooms, and a few specialist doctors. The referring hospital is about 100 km away, and the nearest airport is 20 minutes away. Given the worsening threat of an MCI in the city and taking into account the hospital’s limitations, the Ministry of Health’s hospitalization desk, in cooperation with the rescue forces and the army, drew up an action plan: • Increasing the number of personnel, including orthopedists, surgeons, pediatric surgeons, anesthesiologists, intensive care specialists, traumatologists, Emergency Physicians, and nurses as a backup team. • Converting the hospital into a triage facility, performing life-saving procedures, delaying treatment, and determining the priority order for secondary evacuation. • Training was conducted for both the hospital and its backup staff. There were many MCI exercises, including sudden drills, cooperating with the army, and the rescue forces. In the hospital, there was a significant knowledge gap regarding the operation of the RN and familiarity with the RN’s manual. Officials did not know their defined mission, and the hospital headquarters did not demonstrate command and control during the incident. The hospital did not compile a situational picture that allowed decision-making and casualty evacuation as required. The hospital headquarters did not demonstrate command and control during the incident. A lack of trained medical professionals from the trauma profession was observed. Recommendations: • The hospital permanently placed skilled personnel from the trauma professions throughout the war. Conducting joint training to enhance the skills of hospital personnel in triage. • Daily practice of all staff for MCIs.