Lessons Learned Regarding Personal Protective Gear Use in Operation Protective Edge in the Gaza Strip

Personal protective gear offers a means of prevention and protection from otherwise severe and often fatal injuries to the head, trunk and other areas. In operation Protective Edge, the Israel Defense Forces (IDF) medical corps treated 704 casualties, of which 65 died. Ballistic helmets, personal body gear and protective eye goggles were provided to the combatants, and the injuries sustained were analyzed and compared with the use of personal protective gear. We conducted a retrospective study, studying mechanism of injury, anatomic injury sites, injury severity and use of helmets and protective gear, in both the wounded and the fatalities. The predominant mechanism of injury was penetration (65%). When compared with penetration, shrapnel injury was more prevalent among the wounded than the deceased (49.2% compared to 33.33%), whereas penetrating gunshot wounds were more prevalent among the deceased than among the wounded (10.4% versus 39.7%). Thoracic injuries were more prevalent among the deceased than the wounded (8.5% compared to 22.5%). The rate of head and neck injuries were similar in the deceased and wounded (24.8% in the wounded compared to 25.2% in the deceased). In summary, the use of personal protective gear in the battlefield is of paramount importance, and efforts should focus on increasing the bulletproof surface area of the trunk. Also, as treatment of traumatic brain injuries is not progressing, continued efforts towards the development of bulletproof helmets should be sustained.