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Quickly Noted: Magen David Adom

February 1, 2010

I got the unique pleasure of attending a lecture by Yonatan Yogodovsky, the International Department Director of Magen David Adom (MDA), sponsored by the American Friends of Magen David Adom and Thomas Jefferson University and Hospitals. The lecture was titled, “Israeli EMS Preparedness and Response to Mass Casualty Events,” and gave an overview of MDA as well as a look at how MDA responds to mass casualty incidents (MCI).

Mr. Yogodovsky is an MDA lifer, as apparently most of his compatriots. Children as young as 16 volunteer to be members of the public, non-state sponsored EMS force. Literally the only thing I could find on the speaker is an interview he gave the BBC after a 2002 suicide bombing.

Unfortunately, I couldn’t take as detailed notes as I’d have liked, but wanted to pass along some of the more unusual (to us here in America) aspects of how their EMS functions, especially during MCIs.

  • MDA functions regionally and nationally. A number of regional call centers handle emergency calls. As those call centers get overwhelmed, the call volume automatically rolls over to the national call center. This is helpful because a large number of calls about a specific incident generally means something bad has happened, and will probably require a larger response effort.
  • MDA does not solely rely on paramedics and EMTs. They command a large volunteer force of people called “first responders.”  Yogodovsky had timing data that showed first responders consistently arriving at emergency scenes before the paramedics or EMTs. Their role is to size up the situation and begin stabilization.
  • Yogodovsky made an interesting point about the first person on the scene. He said that they weren’t allowed to help the folks in the situation. Their job, as first on the scene, is to size up the situation and report back to dispatch about the need for more, or fewer, ambulances; the best route to get at the scene; and any safety issues that MDA staff and volunteers should be aware of (think snipers, secondary devices, etc.). They also become the on-scene commanders until someone higher ranking is dispatched and arrives. Can you imagine the hue and cry if ambulance workers showed up at a site and didn’t immediately start helping someone? In this case, though, it seems to make sense. Yogodovsky noted that once you start helping someone, that becomes your primary concern. Critical intelligence about routes, or the need for and MCI vehicle, etc. isn’t communicated and ultimately slows down the response.
  • So now that there’s some ambulances there, let’s say at a bus bombing, do you think they wait for the bomb squad to clear the area before attending to the victims? Nope. They work alongside the bomb squad. They trust the bomb squad. If a secondary device is found, the bomb squad announces it, and MDA personnel pick up their charges and hightail it out of there. Yogodovsky commented several times that he’s alive solely because of the great work that the bomb squads over there do.
  • Every MDA volunteer and responder is issued a helmet and flak jacket. In an unsafe situation, they don them. They’ve even got bullet-proof ambulances!
  • Yogodovsky noted that they work closely with their neighbors, usually through the Red Crescent Society, even while noting the obvious tensions between Israel and the country’s neighbors.

It was a tremendously interesting lecture and, aside from the grisly video footage shown, was something I would have recorded to show you all. A sincere thank you to the folks at Jefferson and Mr. Yogodovsky.

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