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Wednesday, December 15, 2010

Life and Death

Its been quite some time since the last time I posted on here, and this is mostly due to a recent death in my family that was very close. I have seen many people die this year, more than usual. In fact, this year has been the worst year for deaths since 2007 when I lost my grandfather, and two close friends who were much too young. This year, while the deaths have not all been close to home, I have seen many of my friends suffering with the loss of family members, friends, and relatives, mainly from cancer. It just goes to show that life is short and unpredictable and that you need to live life to the fullest. I know that after this year's experience, my goal will be to talk to my patients even more than I do now. Especially the ones that know that the trip with me will probably be their last. Holding a hand or two, offering comforting words, maybe a laugh or two. It was hard seeing my family member towards the end, but one thing that comforted me was that he felt "ok" with things. He had sold his stocks, made sure that his life insurance was in order, and closed any deals that were left unattended. He said to me that towards the end, things don't seem as crazy, you kind of look forward to death just so it can be all over. Of course, he hoped for a cure or some miracle, but sometimes there are just things we can't do. It took only three weeks for my uncle to pass away, he wasn't old, he wasn't young, but I certainly never expected to be at his funeral at this point in his or my life. It took three weeks from the time of his diagnosis to his untimely death, a period of time that has been very hard for my family, but, as I said earlier in the post, this is why we all need to take the time away from work, away from the stresses of life, and spend time with our families, friends, loved ones, and/or pets and live our lives to the fullest.

I think Dr. Sidney Friedman from M*A*S*H put it best when he said:

"You know, I told you people something a long time ago, and it's just as pertinent today as it was then. Ladies and gentlemen, take my advice - pull down your pants and slide on the ice."

Tuesday, November 9, 2010

Peer Advising

When I was a freshman in college, I was given a peer adviser, whose job it was to check in one me throughout the year and help with class selection/advice. So, why not apply this to my campus EMS squad? The way this would work is by having probationary members paired up with senior members who run the calls. Each week the advisee and adviser meet to discuss the probationary member's progress on calls, address questions the new member may have, and to assess how best to help the new member continue to improve. This would enhance our quality of care exponentially. Just imagine, new members and old members exchanging knowledge on issues and learning from each other. The probationary members would feel more confident and our senior members could increase teamwork on scenes, feeling confident in the probationary member's skills and knowledge base.

My goals for my EMS squad are to create a higher quality of care for our patients, make better EMTs/FRs, increase teamwork on scenes, and instill a sense of accomplishment and pride in what we do. This is just one way.

Tuesday, November 2, 2010

Get out there and VOTE!

This past weekend, I went with a group of 57 students from my school to Washington, DC for the Rally to Restore Sanity. We left at 11pm on Friday and got to DC at 7am Saturday, by 8am the Mall was filled. The final numbers on attendance was somewhere in the ballpark of 215,000. With that said, the rally was incredible with Stephen Colbert and Jon Stewart using humor to present an very serious issue in this country. In the spirit of what was said at the rally and its overall message of "we may disagree, but lets at least try to work together", GET OUT THERE AND VOTE! Its a right and we should use it to steer this country in the right direction, Republican or Democrat. Enjoy the polls people!

Monday, November 1, 2010

EMS: An Urban Study (The Idea)

I promised an update so here it is...I have just barely scratched the surface in my research. College= long, arduous hours of continuous, unrelenting assignments from multiple professors who do not communicate, nor understand the concept that we could possibly be taking more than one class. With that aside, the premise of the paper follows the development of EMS (as I noted in my earlier post) and with this, the corresponding development of urban hospitals and the affect of military research in emergency care in the field on the urban setting. My case study will be, most likely, a focus San Francisco EMS.

So, that's basically it for now. Things will start to move more once mid-November hits and finals inch closer and closer (it's like Halloween all over again! Yikes!), that is when the professors usually give us a little bit more leeway with our daily assignments to focus on the multitude of papers/finals/projects, etc. that will be assigned on top of those daily assignments. In any case, stay tuned.

Friday, October 29, 2010

Talking to a five year old about EMS...what to say?


            Hypothetical situation…you are asked to speak at a school to a group of approximately five year old kids about EMS for public safety awareness week (or whatever you want to call it). You are standing in front of about 15 kids expecting you to tell them some crazy cool stuff about driving ambulances with lights and sirens…so what do you say? You could start by telling them that, in all honesty, (especially if you are working for a private Ambulance Company) we do not use the sirens and lights all that often. In fact, kids we transport grandma or grandpa from point A-B and take discharges from hospitals home, etc. You could tell them that our job as an EMT is a thankless one, involving long, sleepless hours with little compensation. You could tell them about all those times you were harassed by patients, spit on, attacked, yelled/screamed at, treated like an idiot…You could tell them all these things and more. I like to think differently. I am one of those crazy optimistic people who think things can only get better. I happen to have a wonderful girlfriend who thinks the same way and she happens to be a pretty awesome teacher for young kids in pre-K education. She as proved to be an inspiration, with little pay or thanks for her job, she keeps a smile on her face even in the most tough of situations. Her positive attitude and passion for this age group has propelled me to think that maybe being an EMT is not all that bad, especially when every kid wants to be in a cool looking vehicle with lights and sirens (and guess what…I live that dream everyday!). I believe Sir Ernest Shackleton put it just right when he said, “Men and women wanted for hazardous journey. Small wages. Bitter cold. Long months of complete darkness. Constant danger. Safe return doubtful. Honour and recognition in case of success.” This is a hard job with constant danger and no recognition; however, there is success and with that success happiness knowing that what you have done has impacted someone’s life regardless of whether or not it was a routine transport to or from dialysis. We make an impact on all of our patients and they make an impact on us. In this job you are constantly learning, constantly meeting new people, constantly being put into situations that are challenging and dangerous. We are the few, the proud, the EMT.
            So, what do you say to the five year olds looking up at you with great expectations? You tell them the truth…this is a hard job and driving an ambulance can be fun, but I get to help people every day and that is what makes it worth every minute of my time I invest in this job. I get to help grandma and grandpa cross the street, I get to bring joy to people who may rarely have contact with the outside world, I get to save people who, without me, could get hurt and have no one to help them. I am not a superhero, I am not a hero in general, I am just a regular guy who wakes up every morning, makes a cup of coffee and goes to work. What I am, is an EMT, and this is my life. I have no secret identity, I do not hide from the world until needed…no…I stand proud to serve my community in rain, sleet, hail, blizzard, you name it, and for all that I do not expect thanks, nor medals, nor compensation, I do not stand at the top of a building with a big S on my shirt nor a picture of a bat…no…I  have served my community, I have possibly saved lives, possibly made someone happy for a brief moment, but my sense of accomplishment is making it home at the end of the day knowing I did all these great things while also getting the opportunity to see and spend time with the ones I love. So for all you kids out there, or those who are kids at heart, remember, as tough as our job may be, as little thanks as we may get, we do an important job and we are heroes, or, at least to those kids we are.

EMS Round Table Discussion

Yesterday, I went to observe a mock call session at another college with a fellow EMT from my squad. Needless to say, the mock call session was incredibly well done with details ranging from bystanders who were given specific details of what to say and what not to say on-scene (simulating the fact that some bystanders know more than others which further helps the responding EMT identify who would have more information on a scene), to fake blood and clothes for the EMTs to cut off the patient (Awesome!). This whole session got me thinking about how to effectively train/educate the EMTs/FRs at my school and I came up with an idea. Mind you, this idea came to me during a US Foreign Policy class round table discussion and made it very hard for me to concentrate for the rest of the class. The idea popped into my head because I observed how my professor set up our class discussion and our class in general. At the beginning of the week, my professor provides the class with a lecture outlining the particulars of the weeks topic (this week he lectured about Operation Ajax and the rise of fundamentalist Iran). Then, during the week, the class does the assigned readings and on Friday we all come together to discuss, in a round table setting, our thoughts on the readings and the topic. It works amazingly well and makes me very excited to go to his classes.
So, I combined what I observed in the mock calls at the other school and what I like so much about my foreign policy class and came up with this idea of practical with discussion, or, as I like to call it, the EMS round table discussion. We would offer a series of mock call sessions for our EMTs/FRs to practice physically arriving, assessing, and packaging on-scene (getting our EMTs/FRs comfortable with on-scene protocols and on-scene communication with patient, team members, and supporting units). On top of this series of mock call sessions, we would also provide a round table discussion on calls. The class would be arranged in a round table discussion format so as to facilitate equal and responsive dialogue. The class would be given a call with all the details for them to see on a white board/computer screen (no hidden vitals or anything like that, I want them to see everything about the patient). Then the class would discuss how they would approach this scene. The discussion would involve what safety precautions would need to be in place (i.e. Police, Fire, Hazmat, etc.) and what precautions the individual responders would need to take (i.e. Gloves, masks, etc.). The discussion would go on like this; presenting issues of what tools should be on-scene and what we could use for improvisation if those tools are not available. Questions of how the patient should be addressed, who should be performing what duties on scene, how should we be allocating resources, etc. etc. In this format, the class members can not only discuss and develop new ideas to approaching scenes, but also challenge each other on ways to handle a scene.
By integrating a series of mock calls and round table discussions, the EMTs/FRs are getting both training and education. The mock calls act as a training/educating forum with responders practicing their skills on-scene (training), then discussing what could be done better or differently (education). This is what happened at the other college. The round tables act as, primarily, an educational tool, with EMTs/FRs discussing multiple facets of handling calls (the reason why this would not have a training component is due to the fact that I believe that training revolves around more hands on skills and repetition of those skills as opposed to discussion and learning what those skills mean in relation to training, which I define as education).
Think of this idea in terms of potty training. At a young age, our parents put us on the toilet and expected us to practice the skill of using this strange device when we needed to use the bathroom. The training portion of this is the physical act of our parents placing us on the toilet and having us practice flushing, etc. This is training because we are being taught a skill and we practice it over and over again, but we aren’t told why we are doing this. That is where education comes in. Our parents do not just plop us on the toilet without explanation (or at least, good parents do not just do this) and expect us to know why we are doing this. Our parents explain that the toilet is important for hygiene, social acceptance, and public sanitation (this might be complicated for a young child to truly comprehend, but at least they know where it all goes right?) In any case, the training involves us repeating the steps of our bathroom follies and education is the reinforcement of that training with the understanding of WHY we do this, WHEN we do this, and HOW we do this.
So, like in potty training, we need to provide the training portion of the education of an EMT/FR and the educational portion. By providing EMTs/FRs with excitement in what their doing and an explanation as to why they are doing what they are doing, you can get a better quality EMT/FR. So, with all this said, I hope to implement this scheme of alternating between having a mock call session one week and having a round table discussion the next, giving our EMTs/FRs confidence on scene and an expanding knowledge of what all this crazy EMS stuff means.

Tuesday, October 26, 2010

EMS: An Urban Study

Dear Readers,

Over the next several weeks, I hope to share with you more than just insights on my personal views of EMS. For next few weeks leading up to Thanksgiving, I will be neck deep in research studying the development of Urban EMS for my US Urban History final research paper. During this time, I hope to share, in several installments, my findings. So, with that, keep your eyes open for some cool stuff!

Monday, October 25, 2010

Epiphany

Working on a college campus is, dare I say it, an adventure. From ETOH calls to severe trauma, our little squad has seen quite a number of incidents. We have responded to emergencies on and off campus, providing first response to MVAs and other injuries on the main street just off campus. And how cool is it now that we have a squad that has nearly doubled in size in a matter of a week? Most of these fresh first responders are surprisingly eager to learn more and as the weeks go on, more and more are interested in taking our EMT-Basic class. I remember when I was helping to teach the CPR class, that most of these same first responders did not raise a hand when asked about advancing to EMT certification. What does that say about the squad? We are getting better, we are attracting better people, and we are moving towards a higher quality of care. We are now, for the first time in our university EMS's history, getting a vehicle, nothing fancy and without emergency lights, but its a start. This way, we can get backboards and essential equipment to a scene faster and without sacrificing man power to do so. I firmly believe that our fellow students will begin realizing, if they haven't already, that there has been a positive, and noticeable, change in the way we handle emergency situations on campus. This change in confidence does not come from uniforms, being an all EMT service, or anything of that sort. We are a first responder group that has consistently proven ourselves on challenging scenes with one to multiple patients. We have earned the respect of the ambulance service that transports for us and we have earned the respect from those in the city around us. We have gained the confidence because we know we are good and we know we can do better.

Moral of the story: Training/Education, building trust, and building teamwork are ingredients in creating an amazing efficient, positive, and motivated group.

We volunteer thousands of hours per year in service to our school and we do so without one complaint. This is to all the EMT-Basics and First Responders that make up one of the best EMS squads on a college campus.

Tuesday, October 19, 2010

The Campus EMT/First Responder

I have been doing a lot of thinking recently regarding my position on my school's EMS squad. My official title is Training Liaison/Assistant although unofficially I am the Training Officer. My role is unofficial for a number of reasons that I would rather not delve into at this time, but this situation has raised an interesting point for me. One of the reasons I was told that the Training Officer position cannot be official at this time is that there is no one to replace me, that I am apparently the most qualified person for the job. Now, I pride myself on being able to teach people on my squad because teaching is not an easy job, it is thankless and takes a lot of effort and not every person can do it. Its a skill, a passion, and a desire. I see these traits in many people I work with on the squad. I see people capable and willing to educate new members. So why not make it an official position to train/educate people for our squad? Our goal is to go from a First Responder squad to an EMT squad and that takes a lot of hard work and requires a well trained, well educated, highly motivated group of volunteers and that is exactly what we should be working for. By offering regular classes on subjects ranging from vital signs to full out assessments and trainings where students are put to the test with rigorous practicals individual members will become increasingly comfortable with their skills and being placed in tough situations.

At the end of the day, this is a position that should be considered for all squads. Training/Education is no easy thing and it is hardly something one would want to throw out the window as not being important enough. Even if the trainings and classes are repetitive the most important part is that people feel more comfortable when they have seen themselves succeed repeatedly and once one has the basics down, it is easier to move on. So my answer to whether or not the Training Officer position should become permanent is simple...YES! and there are people who can do it and do it well.

Friday, October 8, 2010

Doesn't it feel good?

I was thinking over some of the calls I have had this year and was wondering exactly what is it that drives me to want to be in this field of work. To be honest, I still can't answer the question fully; however, what I have found is that being absent from EMS made the heart grow fonder. Over the course of my 6 month stay in Israel, I thought and did more with EMS than I thought possible. I began blogging about EMS, I began researching about EMS, I listened to podcasts about EMS, I practically lived and breathed EMS without actually stepping foot inside an ambulance (unless you count my brief stint with MDA). Coming back to the US, I have continued this obsession and am now on track to being a CPR instructor, getting my EMD, becoming a WEMT, and am now planning on Paramedic school. I am teaching, on a regular basis, new recruits to my College EMS squad, helping them feel comfortable on scene and being that go to guy that people can go to with even the weirdest of questions. Moral of the story: I am hooked and I love EMS. This is not love because of the money (or lack thereof) that exists in EMS, nor is because of the benefits (also questionable) in EMS; rather, my love for EMS stems from helping people. Seeing the smiles on the faces of patients whom I have helped, getting satisfaction from knowing that even my brief interaction with a patient has brightened their day, and lastly, feeling pride in what it is that I do on a daily basis. Yes, there are those days where work is frustrating and patients make you want to scream, but that doesn't matter in the long run. In the grand scheme of things, the good patients that make you feel worth something inside are what really count. Even for those bad patients, yes even them, we have done something for them whether they realize it or not, so feel pride in what you do each day, wake up with a smile, and do the best job you can do.

Monday, August 30, 2010

Education and Training

Education and Training...what is the difference you ask?

The definition of education is:
the act or process of imparting or acquiring general knowledge, developing the powers of reasoning and judgment, and generally of preparing oneself or others intellectually for mature life. 
 
The definition of training is:
the education, instruction, or discipline of a person or thing that is being trained: He's in training for the Olympics.
 
They look similar; however, difference between these two ideas is greater than you think. I wish to argue that education is far more beneficial for EMTs due to the fact that education is longer lasting and more comprehensive than training. According to the Office of Emergency Medical Services in Massachusetts, an EMT training course is approximately 110-150 hours with classroom and clinicals included. That means that an EMT is spending about 100 hours in a classroom learning about the many cases and situations they may run into during their career and 10-50 hours actually seeing and doing the job before being let out on the road. Now this is all well and good and the practical time is essential in any learning situation, but the problem here lies in the numbers. How can one say that they are fully qualified to save lives after a mere 110-150 hour course? The average college student takes triple and then some hours more of classroom time and, on top of classroom time, involve themselves in their future occupations through summer long or year long internships. Even with this much time and energy sacrificed on the part of the student to break into that career, they are still not fully considered prepared for their career until they achieve their masters degree, and, in some professions, a doctorate. For police officers, there is a requirement to have a degree in criminal justice and then the police academy for further education and training in tactics and fire arms among others. For professional firefighters, the general practice is to go to the fire academy or another college to receive a degree in fire science and, in addition, further education and training for hands on work in the department. 

Here is the key to making a good EMT, education and training coupled together in a four year bachelor degree program that offers EMTs classroom time and hands on training time. This would replicate education and training received by police officers and firefighters, as well as open opportunities for EMTs to advance themselves in their careers. Classroom time would be dedicated to the study of the human body, similar to classes taken by pre-med students with the added value of in-hospital observation time and ambulance ride time functioning as a year round internship, possibly offered to students during or after their second year of schooling. In the academic year 07-08, 1,563,000 people completed their bachelor's degrees, 32% higher than the previous year, 625,000 people completed their masters degrees, 45% higher than the previous academic year according to the National Center for Education Statistics. This proves that more individuals are seeking higher education in their professions.  Barring a degree in Emergency Management, there is no degree available for someone seeking to just be an EMT-Basic. Paramedics receive an associates degree that counts for approximately 60 college credits or the equivalent of 2 years of college education, but what if that associates degree could become a bachelors and then a masters especially for an EMT-Basic? 

A bachelors and masters degree program for EMTs would be a major step in taking the "trade" of EMS and making it a legitimate profession. Instead of being an Emergency Medical Technician, one can instead be called a Medic I or Medic II determined on level of education. A bachelors degree could essentially allow one to become the equivalent of an EMT-Basic or Medic I and a masters  could allow one to become the equivalent of a Paramedic or Medic II. Its a possibility, though not necessarily the best one. The concept here is not to determine a new name for the EMT, rather, the idea is to change the way we think about EMTs. The dedicated men and women who bravely and selflessly serve the public in this industry deserve to achieve a good education and more opportunities. This means a positive change in patient care and a better quality of care that always seems to be a discussion piece when examining EMS. 

Education and Training together can provide the EMT with the tools and knowledge necessary to be trusted with a greater variety of emergencies and allow the EMT to perform more skills. EMTs are not just glorified taxi drivers and ambulances are not just glorified taxis, EMTs are men and women dedicated to the safety and well being of the public and ambulances are their offices with the tools necessary for saving lives, lets give these men and women the education they deserve and the tools they need to continue performing this challenging and rewarding job.
 
 
 
 

Wednesday, June 9, 2010

Another Day with MDA

If anybody is reading my blog about my experience in Israel, you already know what I did today on my shift and need no explanation. This is also not the place where I discuss calls, I merely try and compare and contrast the US and Israeli EMS systems and offer my own input on things as I think of them.

Here are some differences I have noticed so far:

1. The chovshim and paramedics have the ability to leave a patient if they deny care even if they have als
2. Chovshim do not administer meds in Israel unlike in the US where we can administer seven as an EMT
3. MDA workers are not always out in the trucks, between calls they hang out at the base. In the US when I worked with the fire department this was true as well, but with my private ambulance I am sometimes sitting in the ambulance for 12 hours straight with a few calls in between to stretch my legs.

These are only a few observations...though I have to say, I really enjoy the rotating medic chair in the back of the Israeli ambulances...

Tuesday, June 8, 2010

When EMS and religion clash

There are definitely those times that arise in the field of EMS where religion plays into a situation. In Israel, this can be seen in the case of Haredim vs. Female Paramedics (and of course other instances as well). In Jewish tradition and text it is always stated that an individual's health comes before religious obligations. What does this mean? If you are dying of a heart attack you probably don't care whether or not a woman is working on you.

In a specific case that happened a little over a month ago, a female paramedic and her two other partners were dispatched to a to a synagogue in Jerusalem's Givat Shaul neighborhood after a man fainted. Unfortunately, when she arrived she was immediately shoved out of the synagogue because women are forbidden to enter this holy site. This just flat out ticks me off. As medics, male or female, we should be able to have access to our patients despite any religious quarums, that means even if the shul is closed to women, if someone's life is at stake let her in. This isn't the first time an event like this has happened in Israel. Another case left the victim dead after a similar occurence of forbidding a female partner to enter the scene.

So, if you are a very religious person and see women as a problem in a religious facility, I urge you to look at your friend who is possibly dying or suffering greatly and I encourage you to ask yourself, is it really worth all this? If G-d sent you an angel and it was a woman, would you really turn her down?

Think about it...

Subtle things

I am going to be honest, when I first came to Israel, I was thinking about how my skills that I had worked so hard on during the year were going to survive not being used for a semester. Of course this is also in retrospect a little knowing now what I didn't know then which is the fact the Magen David Adom never got me on an ambulance up until now. In any case, I was still worried back then even with the thought of being on an ambulance here and there in Israel. I was nervous, I was not confident in all of my skills and abilities, and I didn't feel like I was cut out for the job. This thought ebbed and flowed throughout my time here, with me floating on air some weeks and being absolutely overly obsessed with EMS to feeling down about it, not feeling like I could do it, and worrying constantly about whether or not I would be able to prove myself on an Israeli ambulance. After my first shift (the details of which will be in the next post) I realized just how great it felt to be sitting in an ambulance again responding to people in need. Even more recently, my whole outlook on myself changed in relation to my confidence in the field.

I was called by a friend to come and take a look at another friend who had drank way too much for her own good and was now vomiting heavily. I arrived to find her passed out and unresponsive. I immediately called her by name and when she didn't respond to verbal stimuli, I grabbed her hand and her eyes began to open slowly. Within a very short time, I had the patient talking, smiling, and squeezing my hand. After collecting a detailed list of past medical history, allergies, medications, symptoms, observations,and pulses and respirations, Magen David Adom arrived. The medics seemed impressed with my work and it made me feel on top of the world.

Over the past several months while studying abroad in Israel, I have taken the time to listen to EMS podcasts at every possible moment. I have read each and every morning, and sometimes during class, the multitude of blogs, journals, and social medias regarding EMS. I have even been waiting on edge to see the newest installment of Chronicles of EMS. I have to say that while experience has helped me hone my skills and will continue too, it has been this time of studying and listening to people in the field that I feel I have learned the most. I have still so much to learn and so much to see in EMS, but I have never been more excited to get back in an ambulance and start helping my patients. With my new skills that I have learned through reading Medic 999 and The Happy Medic about approaching patients I now have the confidence and knowledge to approach a patient in a polite way that will increase the patient's confidnece in my abilities. Through watching Chronicles of EMS I have now become aware of, and am searching for, differences between my US EMS system and the Israeli EMS system (I have really noticed these differences and plan on sharing them with friends and on this blog). I even ventured as far as to try and read up on the Italian EMS system which I became intrigued with when seeing an Italian ambulance (image above).

I have listened to podcasts throughout Israel and even throughout Italy (most notably my trip from Venice to Naples) so I can honestly say this learning has been a truly international adventure.

I am no expert and will never claim to be, but the skills I have acquired through reading, listening, and watching have thoroughly enhanced my abilities to take care of patients on scene and to understand my role in the EMS system. I thank all of those who take the time to write on their blogs, who take the time to create shows like Chronicles of EMS, and who take the time to make weekly podcasts. I think you all know this already, but what you do really does help people learn, often times, critical information. I have learned a lot from all of you, I have learned the value of patient care and initial patient contact, I have learned how to best take a pulse, how to search for the best possible blood pressure and what the best course of action is when you can get one. I have learned that even with nothing to help you (i.e. BP cuff, and other gadgets), just by being there with the patient and performing basic assessment skills, you can not only give the patient hope, but you can also provide equally excellent care. I have learned how to assess a patient and to treat the patient as opposed to the symptoms. I have learned that we all have our bad days and our tough calls, but that in the end of the day you need to pick yourself up and get back on that ambulance and try, try again. There are two quotes that I use daily to keep me going, here is one of them:

 "Anyone can give up, it's the easiest thing in the world to do. But to hold it together when everyone else would understand if you fell apart, that's true strength." -unknown

My experience the other night with the intoxicated patient, having no gear to help me out, really made me realize that the simplest of things such as just talking to the patient and holding their hand can be the difference between the patient getting significantly worse or significantly better. Without anything to help me and no other experienced EMS person with me, I found these subtle actions that I heard spoken of so much on the blogs and podcasts to be the life saver in this specific case.

Again, thank you for all you do...you have helped yet another EMT fulfill his potential and have given him the bug to learn more and more. Thank you for all you do!

Tuesday, May 25, 2010

"I spoke to the guy and am waiting for a reply"

This is what I heard about a week and a half ago (if that is really the amount of time, I think longer) from the overseas coordinator for Israel Experience Magen David Adom. Thankfully, I am now in touch with someone else at the Haifa base and I hope that in the coming week I will be able to get on an Israeli ambulance, even if it is only for 3 or 4 weeks. The kicker here is that when speaking with this guy at MDA he asked for my First Responder course completion certificate...I didn't get one. When I passed the test at the main office of the Israel Experience MDA program, they said "you passed, just call later in the week to complete the Hebrew portion and you will get on the ambulance that week, oh and here is your uniform"...oh how wrong they were! Two weeks later I finally got them to pick up their phones and have me take the Hebrew portion...needless to say I passed that portion too. Now the waiting game continues and with only a few more weeks left in Israel, I am not giving up!

Wednesday, May 12, 2010

Israeli Ambulance Service

I have still yet to be on an Israeli ambulance, if any of you follow my other blog "A Walk in the Desert", I wrote a little about my frustration with...you guessed it, Bureaucracy! This post, though, has nothing to do with that terrible word, but more to do with my observations before I get on the ambulance here. For those of you who are not familiar with Israel and its multitude of problems, Israel has been in a state of war since its founding in 1948 and even before that. It is due to this unfortunate constant state of war that Israel has developed a stellar ambulance and healthcare system. Like any great healthcare system, however, there are problems. I don't have a great grasp on the complexities of the Israeli healthcare system other than to say that it is similar to those in Europe being universal. According to an earlier discussion I had this year with Israelis about their health care system, if there is an emergency you can almost always see a doctor right away. There is the unfortunate hassle, though, of having to wait to see a doctor for, sometimes, up to a month or more for non-emergent care. This makes sense when looking at how many people are being cared for in the country, but still, its hard if you need someone to simply look at a small something-or-other that is bothering you. When discussing this with the Israelis they explained that it could be sometimes frustrating to wait, but all were satisfied with their system which has multiple levels of care. While everyone gets a basic package covered by the State, individuals can buy into more expensive packages if they so choose.

As for the Israeli ambulance service, my observations are limited to an outsider view and limited research. Israel's national ambulance service is called Magen David Adom (the red shield of David). Recognized by the Red Cross, this organization handles most, if not all, national emergency medical needs including domestic calls (medical or trauma) and military calls. During the most recent conflict in Israel with the launching of hundreds of rockets daily into Israel by Hamas terrorists, MDA responded with fleets of ambulances transporting victims from across Israel, especially Sderotm one of the hardest hit towns in Israel. Dealing with trauma is MDA's specialty having had many years dealing with terrorist attacks and wars. My impressions are that the Israeli ambulance does not spend a lot of time on scene. They are a "drive it like you stole it" type organization, preferring to get the patient to the nearest hospital ASAP without spending lots of time on scene. This is very much a trauma based system with lots of emphasis put on quickly and effectively stabilizing a patient on-route to the hospital.

MDA is largely made up of volunteers. There are five different levels of care takers on an Israeli ambulance: First Responder (generally most of the volunteers fit into this level of training), Chovesh (essentially an EMT-Basic), Chovesh Bachir (A senior EMT), Paramedic, and sometimes a physician. Usually a Lavan (literally translated as white), or BLS ambulance, is staffed by a first responder,a chovesh, and a chovesh bachir. The Natan (Mobile Intensive Care Unit)is generally staffed by a chovesh/chovesh bacir, a paramedic, and sometimes there is a physician on board. The Atan (Mobile Intensive Care Ambulance) is generally staffed the same as a Natan.

My goals over the next month and a half will be to learn as much as I can about how the Israeli ambulance and medical system work. I hope to learn more about emergency rooms in Israel and the care patients get throughout the entire process of transport to ER. I will post more as I begin volunteering with Magen David Adom.