Case study of the terrorist bombing in Tel Aviv market – putting all the eggs in one basket might save lives

Objectives: On 1 November 2004 a suicide bomber detonated himself in Tel Aviv, in a crowded open market space, resulting in 3 dead victims and 34 casualties. This event in a central urban area was handled quickly by experienced emergency medical service (EMS) teams. We analysed evacuation destinations of urgent casualties in order to learn whether severe casualties should all be evacuated to the closest trauma centre. Alternatively, they might be distributed to all nearby hospitals, both trauma and non‐trauma centres. A third possibility is directing urgent casualties only to trauma centres, dividing them between the close trauma centre and a ‘second cycle’ distant level A trauma centre. Methods: Data were collected from formal debriefings carried out after the event in the Ministry of Health, in the Israeli Defense Forces Medical Corps (IDF MCs) and in the Home Front Command (HFC). Other debriefings, in which we took part, were those of the EMS and participating hospitals. We analysed these data to learn...