The evacuation hospital in civilian disasters.

In a mass casualty situation the hospital nearest to the disaster scene is usually overwhelmed by the injured. We propose a solution whereby a civilian hospital in times of crisis can become an evacuation hospital (EH) to meet the immediate needs of the casualties. An EH is a hospital located as near as possible to the disaster area, whose function is to serve as a forward treating facility. All the wounded should be brought first to the EH, where they are sorted, resuscitated and stabilized for transportation, after which they are evacuated. Only the critically wounded undergo surgery at the EH; the lightly wounded remain in the EH, and all other wounded are distributed among the general hospitals for rapid definitive treatment. This principle was first applied in a civilian medical system. The Rokach (Hadassah) Hospital in Tel Aviv served as an EH in admitting 40 casualties following a nearby terrorist attack. Seventeen seriously and moderately wounded patients were resuscitated and evacuated to hospitals in the vicinity. All arrived in stable condition. Seventeen lightly wounded were detained in the EH and 4 underwent life-saving surgery there.