Israeli ED experience during the Gulf War

Area of Science:

• Emergency Medicine
• Psychiatry
• Public Health

Background:

• The Gulf War involved missile attacks on civilian areas, necessitating emergency medical responses.
• Understanding the health impacts of such attacks is crucial for disaster preparedness.

Purpose of the Study:

• To report on the types of casualties presenting to an emergency department (ED) following missile attacks.
• To analyze the direct health consequences of missile attacks on a civilian population.

Main Methods:

• Data collected over an 8-hour period after each nationwide alert during the Gulf War.
• Inclusion criteria: patients presenting to the ED with symptoms or injuries directly related to missile attacks in the Tel Aviv area.
• Categorization of patient conditions including psychological reactions, injection errors, physical trauma, and other medical issues.

Main Results:

• 103 patients presented with symptoms directly related to missile attacks.
• 70 patients experienced acute psychological reactions (e.g., anxiety).
• 19 patients had false autoinjections of atropine.
• 9 patients sustained physical injuries from the explosion; others had smoke inhalation or myocardial infarction.
• The majority of patients suffered from anxiety or false atropine injections, not severe physical trauma.

Conclusions:

• Missile attacks during the Gulf War led to a relatively small number of serious physical injuries.
• The primary health concerns observed in the emergency department were acute psychological reactions and medication errors.
• Preparedness for mass casualty events should address psychological support and medication safety alongside physical trauma care.