Three Activations, One Plan: Evolving Emergency Preparedness Through Recurrent Sudden-Onset Disasters in Beirut, Lebanon

AI Summary

Iterative debriefing after each activation produced progressively revised emergency preparedness plans, improving institutional readiness for recurrent sudden onset mass casualty incidents.
Despite revisions, persistent and new vulnerabilities remained: unassigned trainees in red zone, premature code deactivation, surgical resident resource constraints.
Absence of a regional interfacility transfer network limited patient redistribution capacity; establishing coordinated transfer systems is essential for multi-wave disaster response.

AI Summary

Disaster Med Public Health Prep. 2026 Jun 8;20:e114. doi: 10.1017/dmp.2026.10385.

This report describes the hospital's emergency preparedness plan (EPP) response and examines challenges encountered across 3 sequential mass casualty incidents at the same institution: the Beirut Port Explosion (2020), the Pager Explosion (2024), and the April 2026 airstrikes.

The April 8 response exposed persistent and newly identified vulnerabilities: unassigned trainees accumulating in the red zone, premature code deactivation prior to a second casualty wave, surgical resident resource constraints, and the absence of a regional interfacility transfer network.

Basic summary

Disaster Med Public Health Prep. 2026 Jun 8;20:e114. doi: 10.1017/dmp.2026.10385.

ABSTRACT

On April 8, 2026, a series of large-scale airstrikes struck Lebanon, killing at least 254 people and injuring 1,165 others. The Lebanese American University Medical Center-Rizk Hospital, located in central Beirut, received 2 distinct waves of casualties totaling 42 patients: 28 red, 9 green, and 5 deceased. This report describes the hospital’s emergency preparedness plan (EPP) response and examines challenges encountered across 3 sequential mass casualty incidents at the same institution: the Beirut Port Explosion (2020), the Pager Explosion (2024), and the April 2026 airstrikes. Each prior activation was formally debriefed, and its lessons incorporated into successive EPP revisions. The April 8 response exposed persistent and newly identified vulnerabilities: unassigned trainees accumulating in the red zone, premature code deactivation prior to a second casualty wave, surgical resident resource constraints, and the absence of a regional interfacility transfer network. Iterative debriefing and plan revision can produce an evolving EPP.

PMID:42253224 | DOI:10.1017/dmp.2026.10385

Document this CPD