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Published on: October 4, 2018
Acute response to the October 7th hostage release: rapid development and evaluation of the novel ReSPOND protocol
Naama de la Fontaine1,2, Tamar Silberg3,4, Jörg M Fegert5
1The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Derech Sheba 2, Ramat Gan, 5262656, Israel. naama.delafontaine@yale.edu.
Insights
A new protocol, Hostage-ReSPOND, was developed for caring for hostages after release. It proved feasible and effective in addressing complex needs, highlighting a gap in trauma care literature for mass casualty events.
Area of Science:
- Trauma-informed care
- Public health response
- Emergency medicine
Background:
- The October 7th Hamas attack presented unique challenges for hostage reception due to limited existing protocols and information.
- Variability in hostage demographics and captivity conditions complicated initial care efforts.
Purpose of the Study:
- To develop, implement, and evaluate the Hostage-ReSPOND protocol for immediate post-captivity care.
- To provide comprehensive, trauma-informed care for released hostages, including children and families.
Main Methods:
- A multidisciplinary team conducted a literature review to create the ReSPOND protocol.
- The protocol emphasizes team readiness, specialized care, personalized needs, safety, and discharge coordination.
- Live simulations and video debriefings were used for team training.
Main Results:
- A dedicated facility managed 29 hostages aged 3.9-80 years, with 28% under 18.
- The Hostage-ReSPOND protocol effectively addressed diverse needs by prioritizing psychosocial interventions.
- Assessing immediate and long-term mental health needs for returnees presented significant challenges.
Conclusions:
- This study introduces a novel protocol for released hostages, filling a critical gap in trauma response literature.
- The findings offer valuable insights for public health organizations managing mass traumatization events.
- Further research is needed to address the long-term mental health assessment of hostages.
Background:
The decision to allocate hospitals for the initial reception of hostages abducted on the October 7th Hamas attack introduced an array of unprecedented challenges. These challenges stemmed from a paucity of existing literature and protocols, lack of information regarding captivity conditions, and variability in hostage characteristics and circumstances.
Objective:
To describe the rapid development, implementation and evaluation of the Hostage-ReSPOND protocol, a comprehensive trauma-informed procedure for the care of hostages, including young children, their caregivers and families, immediately following their release from prolonged captivity.
Methods:
A multidisciplinary expert focus group conducted a comprehensive literature review to develop the ReSPOND protocol, consisting of: Readiness of teams via multifaceted trainings, utilizing live simulations and video debriefings; Specialized professional teams experienced in providing holistic trauma-informed care; Personalized care tailored to individualized and developmentally-informed needs; Optimal safety rooted in creating a secure environment and trauma-informed response to young children, adolescents, caregivers and families; and Navigating Discharge, through coordination with community-based care systems.
Results:
A designated facility at the Children's hospital was carefully prepared for receiving 29 hostages, aged 3.9-80 years, 28% under the age of 18. Implementation of the ReSPOND protocol, which prioritized holistic psychosocial interventions above urgent medical care, proved feasible and effective in managing the diverse and complex needs of returnees as per provider report. Finally, systemic assessment of returnee's immediate and long-term mental health needs proved highly challenging.
Conclusions:
There is currently no literature addressing the response to released hostages, especially those involving infants, young children and families within a children's hospital facility. This study has the potential to fill a crucial gap in knowledge by introducing a novel protocol which could offer valuable insights for public health organizations tasked with providing acute care to diverse individuals and families experiencing extreme, multi-layered mass traumatization.
