United Hatzalah: Creating a National Flashmob of EMS Lifesavers Through Education

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By Raphael Poch, International Media Spokesman, United Hatzalah
Published in Ambulance Today, Issue 3, Volume 13, Ahead of the Curve, Education and Technology Special, Autumn 2019

One key element in creating what is likely the fastest EMS response time in the world (a national average of less than 3 minutes) was developing what has been termed a national flashmob of EMS first responders, comprised of fully trained EMTs, paramedics, and physicians who immediately drop whatever it is they are doing at a given moment specifically to respond to emergencies within their local vicinity. In order to achieve this national network of volunteers that numbers around 6,000 men and women from all communities, cultures, and religions in Israel, United Hatzalah needs to expand its operation from simply responding to medical emergencies to also include focus on continual training.

United Hatzalah is a national EMS organization serving Israel, fully staffed by volunteers, which provides all of its services completely free of charge. The organisation teaches between 35-40 fully accredited EMT training courses that are recognised and supervised by the country’s Ministry of Health. Each course is comprised of between 25-40 people and is based in speci c regions where the need for additional responders is greatest. “We have a dedicated education department that not only attends to the needs of the instructors and students whilst dealing with the logistical challenges of these courses that are offered across the country, but they also assess where a new course is needed based upon population density, the average number of emergencies in the given area and how many responders are already in that area,” explains President and Founder of United Hatzalah Eli Beer. “The system is incredibly effective. If for example, we see a rise in medical emergencies in a city in the north, say Nahariya, then we will work with our chapter head in that region and open a new training course to increase the number of volunteers we have there. The more volunteers we have, the faster our response time will be.”

A search and rescue training drill for collapsed buildings

Graduates of the EMT courses given by United Hatzalah hold the level of EMT-b and respond to all types of medical emergencies around the country.

Each volunteer responds to medical emergencies in their close proximity in order to arrive at the scene within less than three minutes. The more volunteers that the organisation has, the more widely its lifesaving network will expand and the faster it will have a fully trained first responder in the door whenever and wherever a medical emergency occurs. The volunteers either use their own private vehicles or one of the organisation’s iconic ambucyles or ambulances.

But the basic courses are just the beginning of United Hatzalah’s educational component. As the official training partner in Israel of the American Heart Association and the US- based National Registry of Emergency Medical Technicians (NREMT), United Hatzalah is Israel’s only organisation that can train volunteers to be licensed both in Israel and in the United States. United Hatzalah offers training classes that are certified by both the AHA and the NREMT respectively and has a medical department that continuously oversees the level and quality of training. Each volunteer that wishes to become a first responder in Israel must undergo no less than three rigorous tests administered by seasoned paramedics (EMT-p) whose responsibility it is to ensure that the volunteer has not only a mastery of the information learned and its practical application but also the expertise to manage a scene by themselves, even if that scene is an MCI (mass casualty incident).

A general training exercise for United Hatzalah. Photo courtesy Shira Hershkop

Proper triage and scene management protocols are taught to every first responder as part of the EMT training course. “With a response time as fast as ours, our volunteers often find themselves at the scene of a medical emergency long before an ambulance arrives,” explained Chief Paramedic Avi Marcus. “These scenes can be anything from assisting an elderly patient who is suffering from weakness, to suicides, a major motor vehicle accident and even terror attacks. Our volunteers need to know how to respond to any medical emergency in the appropriate fashion befitting that scene.”

A water rescue training exercise in Tiberias.
Photo courtesy of Shira Hershkop

Together with the head of the medical department, Alon Basker, Marcus is in charge of making sure that each and every one of the 6,000 responders also fulfil their requirements of participating in an annual retraining course. “To be a licensed EMT in Israel, each responder needs to undergo an annual training course that focuses on a number of specific items that the organisation feels need an extra level of attention. We generally focus on techniques that are not commonly used in the field by all first responders. This year we covered some newly developed techniques of wound packing, paying closer attention to the number of questions asked when taking an oral history so as not to belabour the patient, and familiarising the responders with the techniques of applying the Asherman chest seal bandage, an item that was just brought back into the standard protocol of application on open chest wounds in Israel. By focusing on the less used aspects of the tools and techniques an EMT uses, we build the volunteer’s exposure to them so that they can more comfortably use them in the field, should they ever come across a situation in which they are required.”

A water rescue training exercise in Tiberias.
Photo courtesy Shira Hershkop

Other elements that are unique to United Hatzalah’s EMS training program include cultural sensitivity courses that educate responders about how to properly treat patients from other cultures or religions while taking into account their religious sensitivities. This course often bridges the gap between Muslim and Jewish students who often participate in courses together. Another unique element of the course is the addition of a special psychological first aid (PFA) training class given by one of the members of the organisation’s Psychotrauma and Crisis Response Unit that teaches EMTs how to identify patients or other first responders who are suffering from shock or emotional stress reactions at a traumatic scene.

Defensive Ambucycle Training

In the past 12 months, United Hatzalah has graduated 35 training classes, and more than 1,000 new volunteers have joined the national network of first response volunteers. The goal of the organisation is to train enough responders across Israel so that the national average response time goes down to 90 seconds.

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