United Hatzalah took a lead role in a strategic mass casualty drill that took place last week. As an emergency medical response organization, our volunteers must prepare for the worst while we hope for the best. Several times a year, United Hatzalah conducts MCI (Mass Casualty Incident) drills throughout the country. These serve as important opportunities for our medics to practice their lifesaving skills under extreme, though alarmingly realistic, conditions. The drills also test the inter-agency communication and collaboration with our rescue partners at the IDF Home Front Command, Israeli Police, and Fire rescue services.

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EMTs “treating” patients at the scene

The drill was carried out on Monday in Givat Ze’ev, a suburb of Jerusalem. The town had suffered a real-life MCI less than a year ago when bleachers collapsed at the main Karlin synagogue. Many United Hatzalah veteran medics who had responded to that incident wanted to hone their skills and share their experiences. Representatives from the municipality along with local school and security officials were also keen to enhance their emergency preparedness. The requisite support and intervention of the IDF, Police, and Fire rescue services were in place for all agencies to perform their roles in the incident. As in real life, no hint was given to the responders as to the actual nature of the emergency, and they would only find out as the “smoke cleared”. 


The scenario chosen was a missile strike at a local high school. The drill was designed as a stress test of the level of professional care that our medics can provide under the most trying of circumstances. Artificially-generated smoke, a mock missile, upended desks, and dozens of screaming teens with horrific moulage “injuries”, created a frighteningly convincing environment. The first calls came in to United Hatzalah with the staccato frequency, confusion, and urgency common to such incidents.


EMTs with ambucycles were naturally the first on the scene, and with helmets still on their heads, they radioed back the initial assessments. A secondary “rocket” was neutralized by bomb-squad techs while “smoke and fire” were dealt with by the firemen. Once relative safety was achieved, medics began to enter the maelstrom to bring order out of the chaos. Some EMTs were only a bit older than the victims and could have been their brothers or sisters, some were old enough to be parents, and others, old enough to be grandparents.


An all-terrain rescue vehicle was called in to access areas rendered otherwise impassable by the “explosion”. Ambulances were dispatched to the staging areas, fly-cars brought senior staff to the scene to lead, delegate, and observe the rescue efforts. A mobile command center was dubbed the critical inter-agency communication and collaboration.

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United Hatzalah all-terrain rescue vehicle at the scene

Medics worked with available rescuers and on-scene staff to triage, tag, extricate, and evacuate the injured students. It was done in the order of priority that would bear the greatest chance of survival to the most amount of people. A forward treatment and secondary triage zone was established near the sports field to continue the emergency medical care and ensure the smooth flow of patients to available transport resources. Victims were classified as critical, urgent, or minor (red/yellow/green), and emergency medical intervention was provided accordingly. 


In addition to treating visible physical injuries, United Hatzalah pioneered the immediate evaluation and intervention for people suffering from Acute Stress Reactions (ASR) during traumatic incidents to prevent the onset of PTSD. As soon as the physical injuries were treated specially trained volunteers shifted from providing urgent medical treatment to providing psychotrauma and crisis response to the ‘walking wounded’ exhibiting signs of ASR.

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Eli Beer speaking to the volunteers at the scene


After the smoke cleared, the dust settled, and screams were just a memory, the volunteers gathered for a debrief and overview. United Hatzalah founder and president Eli Beer was on the scene and was very pleased with the level of professionalism and tenacity displayed by the volunteers. Senior municipal, IDF, and other officials shared their assessments and were uniformly impressed by the operational capabilities of United Hatzalah.

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