• Uri Manor, Sagy Apterman, Gal Ben-Haim, and Dan Prat.
• Internal Medicine "C" Department, Sheba Medical Center, Tel HaShomer 5262000, Israel.
• Mil Med. 2023 Aug 29; 188 (9-10): e2896e2899e2896-e2899.

IntroductionCivilians constitute a significant wartime target, and trauma accounts for most of their injuries. Air raid sirens have long been used to alert civilians of incoming attacks and have since expanded to warn from natural disasters. Sirens are known to cause significant emotional distress and physiological changes. Injuries inflicted from trauma while moving for shelter have yet to be described in the medical literature.MethodsDuring the recent Israel-Gaza conflict of May 2021, most of Israel's population experienced rocket warning sirens. We collected all adult (18<) patients arriving at a major tertiary medical center emergency department (ED), attesting to having suffered their injury while rushing for shelter. Clinical and demographic data were retrieved and analyzed.ResultsA total of 48 patients were identified, with a mean age of 59.6 ± 20.0. Ten (21%) patients were admitted, and their mean length of stay was 4.4 ± 3.7 days. Women had a higher probability of being hospitalized (42.9% vs. 5.9%, P = .04), and those hospitalized tended to be older (68.8 ± 16.4 vs. 54.8 ± 20.8, P = .06). Elderly patients (65<) had a higher risk of injury. Extremity injuries were most common (50%), before head trauma (29%) and torso injuries (25%). Most patients (38/48, 79.2%) were discharged from the ED, and the rest were hospitalized for observation or surgery. One patient died from a head injury.ConclusionsThis study implies that injuries while moving for shelter were a prevalent cause of physical injury to Israeli civilians during the Israel-Gaza 2021 conflict. Warning sirens injuries should be given appropriate attention-from prevention by directed media campaigns to post-conflict reimbursement.© The Association of Military Surgeons of the United States 2022. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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