The October 7, 2023, Attack on Israel Indicates a Change in Trauma Patterns of Terror Victims, due to the Use of Thermobaric Weapons

Introduction The terror attack on October 7, 2023, in southern Israel resulted in approximately 1,200 civilians and security personnel killed. Of the civilians murdered, approximately 200 men, women, and children were murdered inside their homes, while the remaining casualties were murdered in an open field at a music festival, in their cars, or in the streets of local cities. Materials and Methods Currently, official data have not yet been published regarding the types of injuries suffered by Israeli civilians during the terror attack. However, the massive damage found in buildings infiltrated by the terrorists, weapons found on neutralized terrorists, and the findings of the pathologists tasked with examining and identifying the casualties, as well as preliminary clinical evidence, suggested that many died from hand-held explosive devices or rocket-propelled grenades containing a "thermobaric"-type warhead. Results The use of thermobaric weapons has also been reported from the Russia-Ukraine war, suggesting that these weapons are becoming more common in their use. Thermobaric injuries differ from typical battlefield injuries due to their specific blast characteristics. Considering that thermobaric weapons are relatively cheap to manufacture and highly efficient, it can be assumed that their unique injury patterns will become more common in future battlefields. Conclusions This paper reports on a possible change in the nature of terror and battlefield injuries and alerts emergency organizations and military forces worldwide to prepare for the need of treating more blast injuries, burns, smoke inhalation, and asphyxiation.