Emergency response, Israeli style

Emergency response, Israeli style

Magen David Adom expert speaks locally

Presenters and guests at the Teaneck meeting included, from left, the host, Rabbi Daniel Senter, who is an EMS volunteer and former president of the Teaneck Volunteer Ambulance Corps; speaker Guy Caspi of the MDA; Jamie Elkin, an EMS volunteer and instructor; and Dr. Leonard Cole, a former president of the Jewish Federation of Northern New Jersey and an expert on bioterrorism and terror medicine. Courtesy AFMDA

The discussion naturally turned to events in Syria when Guy Caspi, an international expert on mass-casualty preparedness training, spoke in Teaneck last week.

Caspi, an Israeli paramedic, is on a nationwide speaking tour on behalf of the American Friends of Magen David Adom, Israel’s national emergency response system. He began his work with the MDA as a youth volunteer in 1979, and is now its chief multi-casualty incident instructor. He also trains paramedics at Ben-Gurion University of the Negev.

Local AFMDA supporters and Teaneck Volunteer Ambulance Corps members, gathered at the Teaneck home of Rabbi Daniel and Jodi Senter, asked Caspi about how MDA and the Israeli people are responding to threats posed by the instability that Israel’s hostile neighbor is experiencing.

“The situation in Syria is deteriorating fast, and MDA is on higher alert,” Caspi said on the morning after the Teaneck talk. “Besides the 1,700 responses per day [to calls for an ambulance], we are ready all year long for different scenarios. With what is going on in Syria and how it might affect the state of Israel, we are reemphasizing protocols and equipment checks, but before a holiday season this is one of the things we do anyway.”

He said that over the High Holy Day season, beginning with the eve of Rosh Hashanah and stretching to the end of Sukkot, Israelis do a lot of traveling, often resulting in increased traffic accidents. He does not expect the volume to be any different this year, as long as the situation with Syria remains relatively stable.

Syria, however, was not the main topic of Caspi’s presentation in Bergen County, which is a major base of support for MDA. Over the past 10 years, county residents have donated approximately 20 ambulances and two blood mobiles to MDA.

Caspi began with some background on how MDA constantly drills for such scenarios as terror attacks, war, hazardous material spills, and natural disasters.

With 14,000 volunteers and 1,800 fulltime professional staff, MDA is the largest volunteer nongovernmental organization in Israel. It is mandated but not financially supported by the Israeli government. In addition to first response, MDA collects and distributes donated blood to all hospitals and army bases. When a major incident occurs, an algorithm allows MDA to estimate how much blood, and what types, will be needed, even before the first patients arrive.

MDA’s response system differs from the typical American model in several ways, said Caspi, who also spoke to groups including a Denver conference of the International Association of Firefighters, employees at a Chicago trauma center and fire academy, and first responders in New York’s Westchester County. All those groups have shown interest in Israeli methodologies.

“Our first responders are our employees and volunteers on motorcycles or emergency vehicles, not firefighters and EMS [emergency medical services],” said Caspi, who has been on the scene as a paramedic and debriefing officer in most of the multicasualty incidents in Israel over the last 12 years. “Our dispatchers can make the decision to activate our multicasualty protocol on their own; they don’t need to call anybody first.”

He presented some case studies to illustrate the timeline of events – “our chain of command, training and coordination with other responding agencies; our protocol for how to respond to an explosion when there is always the fear of a second device exploding; medical issues of triage; and how we debrief and learn from the incident afterward.”

In a unique live demonstration of the command and control system that allows MDA to see and dispatch all its ambulances using data transmission, Caspi opened a live feed on his laptop so that the Teaneck group could view the action at 4 a.m. in Israel. They could see ambulances racing to respond to calls in Jerusalem and Tel Aviv, as well as the reported nature of each emergency.

Caspi also showed a short video on the Boston marathon attack last April to drive home the point that terror is a threat not only in the Middle East, and to highlight the role of responders who received their training through MDA’s overseas volunteer program.

Gary Perl, AFMDA’s northeast regional director, noted that this program trains American teenagers spending half a year or more in Israel how to be emergency medical technicians or paramedics. “The largest contingent each year is from northern New Jersey,” Perl said. “Every year there are around 30 to 50 of them.”

Not only teens have benefited from MDA expertise.

“Kurt Schwartz, Massachusetts undersecretary for homeland security and emergency management, mentioned that he visited Israel and was trained by our people,” Caspi said. Schwartz came to Israel in December 2011 with other security officials to study best practices, and he has said that what he learned during that trip better prepared him for dealing with the Boston incident.

Event organizer Jan Meyer, an active lay leader with AFMDA and an ambulance driver for the Bogota Volunteer Ambulance Corps, noted that in light of such events as the Boston terror attack, “Maybe it’s time to reevaluate how ambulance and rescue missions are done. Here, we secure the scene and do triage and then transfer the injured. In Israel, they secure the scene faster, if at all, to minimize the time at the scene because of secondary events that can occur. Their focus is to remove patients with great speed. Caspi said they had 37 casualties removed from one recent scene in 12 minutes, much faster than we can do.”

Erik Levis, an AFMDA spokesman, said the main takeaway from Caspi’s presentations was the word “streamlined.”

“Everywhere we’ve gone, EMTs and lay people have been blown away by how streamlined the process in Israel is in terms of organization and efficiency,” Levis said.

“In Bergen County, as in many other places, there are several different fire and police departments that respond to emergencies. When they hear that communication in MDA is so streamlined, they actually stand up and applaud because that is the way it should be. If national, county, state and local authorities take these ideas back to their police and ambulance services to consider the MDA efficiency model, lives could be saved and emergency response time could be cut.”

Meyer added that MDA constantly reevaluates protocols for response, patient care and keeping rescue teams safe. “There is so much we can learn from them, and this was a great opportunity for a leader to open our eyes and ask us to think if we are doing things as well as we can in a changing world.”

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