[Emergency and Contingency Team Responsibilities at the Soroka University Medical Center]

The Soroka University Medical Center (SUMC) Emergency Team activity presented here in routine time, periods of transition to emergencies, unto war condition in southern Israel. The SUMC experienced two major events in the Iron Swords War ("Haravot Barzel War"): 1) on the 7th October 2023 violent Hamas attacks against Israelis challenged the SUMC in a mega-mass casualty event (MCE) never seen in Israel; 2) on the 19th June, 2025, an Iranian ballistic missile attack on the surgical building. The SUMC staff treated hundreds of casualties on-site during the first 24 hours, but also dealt with hundreds more going through secondary evacuation to other medical facilities in the country. The SUMC Emergency Headquarters (HQ) worked according to Standards of Procedure (SOP) and specific short Orders of Operations well prepared in advance by the Soroka Emergency Team. Successful handling of such an extraordinary MCE situation required a degree of flexibility of the SUMC management staff and the use of a shared "emergency lexicon". Debriefing principles after all real emergency or training drill events is part of the Soroka Emergency Team duties. After debriefing, lessons are immediately implemented and included in SUMC emergency SOP's - such as the creation of two new emergency treatment areas after the 7.10.2023 MCE.