The Crowd Crush at Mount Meron: Emergency Medical Services Response to a Silent Mass Casualty Incident

Abstract On April 30, 2021, a total of 45 died and 112 were injured in a crowd crush at a religious festival on Mount Meron, Israel. Unlike a bomb blast, building collapse, mass shooting, or stampede, the incident lacked a dramatic, noticeable trigger and may be termed a “silent mass casualty incident (MCI).” This may have resulted in a slight delay in response. Magen David Adom (MDA)—Israel’s National Emergency Medical Services Organization—was the main prehospital response to the MCI. MDA’s intense planning, organization of medical infrastructure, and on-site MCI drill before the event allowed for the rapid, coordinated treatment and evacuation of casualties by ambulance and helicopter. The use of volunteers facilitated an effective response to the event. A “rolling reinforcement” system of ambulances helped treat and transport those at the scene while placing staff at stations throughout the country to serve routine emergency calls.