Emergency medical services in Israel
Encyclopedia
Emergency medical services in Israel are provided by the Magen David Adom
(MDA) organization, supplemented in some areas by Hatzalah, and the Palestinian Red Crescent Society.
While the MDA currently has approximately 1,200 medics, paramedics and emergency physicians on staff, it still relies heavily on over 12,000 volunteers who serve in both operational and administrative capacities. The organization operates 95 stations with a fleet of over 700 ambulances. The majority of the fleet consists of Basic Life Support
(BLS) ambulances. These are supplemented by Advanced Life Support
(ALS) ambulances, mobile intensive care unit
s (MICU) and a variety of first responders. First responders sometimes include the United Hatzalah organization. In an unusual feature, armored ambulances are not uncommon nationwide. The system is highly dependent on volunteers, many of whom are from outside of Israel. As a recognized national aid society, according to the Geneva Conventions
MDA may become an auxiliary arm of the Israeli Defence Force during wartime. Young people holding dual citizenship, often from the U.S., are permitted to fulfill their national service
obligations by serving in MDA, instead of in the regular military.
Most major stations also include special units for responding to mass-casualty incidents like natural disasters or terrorist attacks. The system, for the most part, conforms to the Franco-German (as opposed to the Anglo-American) model of EMS care, and the presence of physicians at high-acuity emergencies is not uncommon. In addition, emergency ambulance service is supplemented by a variety of private carriers who are tasked with interfacility transfers only.
Air ambulance service was provided by Israeli Air Force
MEDEVAC
helicopters, however, in 2008 civil HEMS was introduced by a private company called Lahak Aviation Ltd, utilizing four German
-made MBB Bo 105s staffed with MDA paramedics. Lahak deployed them throughout the country in order to improve response times in peripheral areas. Previous attempts to integrate independent helicopter service in the 1970s were unsuccessful due to high cost. Non-emergency and repatriation air ambulance service is normally provided by a variety of private charter carriers such as Arrow Aviation in Israel.
Most of the fleet is made up of regular size vans staffed by "medics" (Hovesh) and "advanced medics" (Hovesh Bacir) as well as teenage and international volunteers (often qualified as first responders) and advanced life support ambulances, staffed by paramedics; mobile intensive care units, staffed by paramedics and physicians, respond only to the most medically serious cases. The vehicles compare in general terms with American or European ambulances, however compliance with either the KKK 1822 or CEN 1789
standard is not compulsory. In addition, first responders will often proceed to calls in their own vehicles, and could be anything from a private car to a motor scooter.
) and those at the Hovesh Bacir level are permitted to start IVs. Paramedics may be trained over a period of 15 months, with nine months of didactic and hospital clinical time, and a six month preceptorship with a qualified paramedic on a mobile intensive care unit ambulance. Increasingly, however, paramedics are choosing another option; obtaining a three year B.Sc. in Emergency Medicine as part of their paramedic training.
In an unusual move aimed at raising revenue to offset operating costs, MDA has begun to market its expertise at emergency care and system organization on an international level. They have achieved some success in this endeavour, assisting the nation of Chile
with the development of a national EMS system.
) and decision-support software that are comparable with U.S. and European systems. The national emergency number for an ambulance in Israel is 101. This number is answered by MDA around the clock.
Magen David Adom
The Magen David Adom is Israel's national emergency medical, disaster, ambulance and blood bank service. The name means "Red Star of David"...
(MDA) organization, supplemented in some areas by Hatzalah, and the Palestinian Red Crescent Society.
Land Ambulance
Basic life support
Basic life support is the level of medical care which is used for patients with life-threatening illnesses or injuries until the patient can be given full medical care at a hospital. It can be provided by trained medical personnel, including emergency medical technicians, paramedics, and by...
(BLS) ambulances. These are supplemented by Advanced Life Support
Advanced Life Support
Advanced Life Support is a set of life-saving protocols and skills that extend Basic Life Support to further support the circulation and provide an open airway and adequate ventilation .-Components of ALS:These include:...
(ALS) ambulances, mobile intensive care unit
Mobile Intensive Care Ambulance
Australian Mobile Intensive Care Ambulances are well-equipped ambulances staffed by highly trained paramedics dispatched to emergency situations where patients require a higher level of care than a regular ambulance can provide.- MICA Paramedics :...
s (MICU) and a variety of first responders. First responders sometimes include the United Hatzalah organization. In an unusual feature, armored ambulances are not uncommon nationwide. The system is highly dependent on volunteers, many of whom are from outside of Israel. As a recognized national aid society, according to the Geneva Conventions
Geneva Conventions
The Geneva Conventions comprise four treaties, and three additional protocols, that establish the standards of international law for the humanitarian treatment of the victims of war...
MDA may become an auxiliary arm of the Israeli Defence Force during wartime. Young people holding dual citizenship, often from the U.S., are permitted to fulfill their national service
National service
National service is a common name for mandatory government service programmes . The term became common British usage during and for some years following the Second World War. Many young people spent one or more years in such programmes...
obligations by serving in MDA, instead of in the regular military.
Most major stations also include special units for responding to mass-casualty incidents like natural disasters or terrorist attacks. The system, for the most part, conforms to the Franco-German (as opposed to the Anglo-American) model of EMS care, and the presence of physicians at high-acuity emergencies is not uncommon. In addition, emergency ambulance service is supplemented by a variety of private carriers who are tasked with interfacility transfers only.
Air Ambulance
Israeli Air Force
The Israeli Air Force is the air force of the State of Israel and the aerial arm of the Israel Defense Forces. It was founded on May 28, 1948, shortly after the Israeli Declaration of Independence...
MEDEVAC
MEDEVAC
Medical evacuation, often termed Medevac or Medivac, is the timely and efficient movement and en route care provided by medical personnel to the wounded being evacuated from the battlefield or to injured patients being evacuated from the scene of an accident to receiving medical facilities using...
helicopters, however, in 2008 civil HEMS was introduced by a private company called Lahak Aviation Ltd, utilizing four German
Germany
Germany , officially the Federal Republic of Germany , is a federal parliamentary republic in Europe. The country consists of 16 states while the capital and largest city is Berlin. Germany covers an area of 357,021 km2 and has a largely temperate seasonal climate...
-made MBB Bo 105s staffed with MDA paramedics. Lahak deployed them throughout the country in order to improve response times in peripheral areas. Previous attempts to integrate independent helicopter service in the 1970s were unsuccessful due to high cost. Non-emergency and repatriation air ambulance service is normally provided by a variety of private charter carriers such as Arrow Aviation in Israel.
Vehicles
CEN 1789
CEN 1789:2007 is the European Union standard for ambulances and medical transportation vehicles. This European standard specifies requirements for the design, testing, performance and equipping of road ambulances used for the transport and care of patients...
standard is not compulsory. In addition, first responders will often proceed to calls in their own vehicles, and could be anything from a private car to a motor scooter.
Training and staffing
As previously stated, the MDA uses a broad range of staff from First Responders to Physicians, an both volunteers and paid staff. First responders typically receive about one week of training to prepare them for their roles. Paid employees are required to be certified at the Hovesh level, which requires an additional three weeks of training. The next step is the Hovesh Bacir which requires a further two weeks of training. Those certified at the Hovesh level are permitted to use automatic external defibrillators (AEDAED
AED may refer to:* Anhidrotic ectodermal dysplasia, a genetic disorder* Automated external defibrillator, a portable electronic device that diagnoses and can correct arrhythmia of the heart....
) and those at the Hovesh Bacir level are permitted to start IVs. Paramedics may be trained over a period of 15 months, with nine months of didactic and hospital clinical time, and a six month preceptorship with a qualified paramedic on a mobile intensive care unit ambulance. Increasingly, however, paramedics are choosing another option; obtaining a three year B.Sc. in Emergency Medicine as part of their paramedic training.
In an unusual move aimed at raising revenue to offset operating costs, MDA has begun to market its expertise at emergency care and system organization on an international level. They have achieved some success in this endeavour, assisting the nation of Chile
Chile
Chile ,officially the Republic of Chile , is a country in South America occupying a long, narrow coastal strip between the Andes mountains to the east and the Pacific Ocean to the west. It borders Peru to the north, Bolivia to the northeast, Argentina to the east, and the Drake Passage in the far...
with the development of a national EMS system.
Dispatch
Ambulances are dispatched from regional dispatch centres, except during wars or other emergencies when service is provided from a national dispatch centre. This centre uses dispatch technologies such as Automatic Vehicle Locating (AVLAVL
AVL may refer to:*Acadèmia Valenciana de la Llengua *Approved Vendor List*The United Nations Audiovisual Library of International Law*Aroostook Valley Railroad...
) and decision-support software that are comparable with U.S. and European systems. The national emergency number for an ambulance in Israel is 101. This number is answered by MDA around the clock.