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...

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!