Minutes Matter: Inside the IDF’s Medical Operations in Gaza

There are few battlefields in the world more chaotic than Gaza, where civilian buildings and infrastructure have been designed for one purpose: to wage war against Israeli soldiers through ambushes, sniper fire, and explosive devices.One of the most difficult and complex urban battlefields in modern history, Gaza often became a nightmare for Israeli troops moving from building to building in search of Hamas and Palestinian Islamic Jihad terrorists.Nearly a thousand soldiers have been killed in battle since October 7, and several thousand more were wounded. One of the most critical units in the Israel Defense Forces proved to be the Medical Corps, which worked to save lives on the battlefield as soldiers were often severely injured.With more than 6,000 medical evacuations from battlefields, the head of the Medical Services in the IDF’s Southern Command told The New York Sun that the army has made “amazing advancements” compared with previous wars.Colonel (res.) Dr. A., speaking on condition of anonymity, said the average time from when a soldier is wounded until he or she reaches a hospital in Israel has been reduced from 64 minutes to roughly 45 minutes.The Medical Corps, he said, has focused on preparing and educating soldiers so they know exactly how to assist paramedics in the field when an evacuation is required.“We teach all the soldiers in the IDF how to stop bleeding, which is the primary cause of death in the battlefield. Each soldier also knows how to apply a tourniquet,” Dr. A. said, referring to a life-saving strap that can be tied around limbs to stop bleeding on the spot.“The second part of the treatment is to return the blood to the injured soldier. Before October 7, only Unit 669, the Israeli Air Force’s tactical rescue unit, used to give blood on the spot. But now every regiment has the ability to give blood minutes after an injury,” he added.That change means infantry units now keep blood in containers at all times on the battlefield, or as close to it as possible.“Just imagine the logistics behind it during war. Every regiment has its own refrigerators and its own supply,” Dr. A. said.The practice of carrying blood at all times was implemented during the first weeks of the war.“We had to put refrigerators inside armored vehicles. You need the right cables and if you turn off the vehicle, the refrigerator doesn’t work, so we need to keep the temperature. It took two to three weeks to solve all those problems. But now it works smoothly,” he said.When a situation unfolds in which one or more soldiers must be evacuated, the paramedic’s first task is to determine what, if any, emergency treatment must be administered immediately.On-the-spot treatment is carried out only in “extreme situations,” such as when a paramedic must establish an airway and cut the soldier’s throat to insert a ventilation tube.“But most treatments are done on the way to the helipad or an ambulance at the border, so that we’re not wasting time. We actually grab the injured soldier, take him into an armored vehicle and start driving towards the border,” Dr. A. said.As the wounded soldier is transported by ambulance or helicopter, a physician or paramedic enters the most critical medical information into an iPad, which is then handed off to the next medical team.Like nearly everything that happens during the roughly 45 minutes between injury and arrival at a hospital, the process comes down to optimizing time.In cases of mass casualties, units rely on one another to evacuate and treat as many wounded soldiers as possible simultaneously.“So it’s our role in the central command to try to make sure that the incoming help happens very orderly and not in a mess. We know exactly where each force is located,” Dr. A. said.Although the fighting in Gaza has subsided for now, Dr. A.’s unit continues to extract lessons from the battlefield.“Each of our physicians or paramedics has a GoPro on his helmet, and we are basically learning from each incident. We do a hot debriefing the same night or the next day, and we go over the treatment. What was good and what was bad. We take all the conclusions and spread them down all the way to the last paramedic or medic,” he said.At the height of the war, more than 750 medical professionals were deployed in the Southern Command’s Medical Corps. Roughly 10 percent of them were women.

Minutes Matter: Inside the IDF’s Medical Operations in Gaza

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