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The U.S. Needs More Paramedics. Israel Might Have the Answer
This article was originally published in The Weekly Standard and was written by Mark Hemingway
The police response to the Parkland, Fla., school shooting has been much criticized for being cowardly and negligent. But one aspect of the poor response deserves more attention because it points the way toward saving lives in the future: Police didn’t just fail to enter the building quickly and engage the shooter, they also prevented paramedics from going in and retrieving the wounded.
“Everything I was trained on mass casualty events says they did the wrong thing,” a paramedic on the scene told Brian Entin, a reporter for Miami’s WSVN. “You don’t wait for the scene to be cleared. You go in immediately armed. Retrieve the victims. You can’t leave the victims laying there.” Paramedics on the scene were willing to risk their lives to go in, but “the response every time was law enforcement did not clear the scene and would not allow medical personnel in.”
The paramedic, who remained anonymous for fear of reprisal, is correct about the importance of quick treatment of the wounded. And this may be one area where improvement is readily achievable and uncontroversial. Ensuring that many more people, particularly those working at large institutions such as schools, receive comprehensive emergency medical training has much to recommend it. Sometimes first responders either can’t come in or don’t get there in time.
For Gavriel Friedson, the importance of more emergency medical training in schools is not a theoretical concern. He first received emergency medical training and began volunteering as a teenager. And his training quickly proved useful: “When I was 15 years old, I delivered my math teacher’s baby,” he tells The Weekly Standard. “One of the best things that ever happened in my life was being able to start volunteering at such a young age. It’s life-changing, and you get an amazing satisfaction from what it’s like to really help.”
Friedson grew up in Israel, where responding to emergencies is a more urgent matter of public safety than in the United States. (Amid the grief and horror over terror attacks and mass shootings, it’s worth noting that violent crime has declined by almost 50 percent since it’s apex in 1991.) Accordingly, Israel has an emergency response system that is in many ways a model to aspire to. And a significant part of that system depends on volunteers and private organizations.
Friedson began by volunteering with United Hatzalah—hatzalah means rescue in Hebrew—which provides medical training and supplies to over 4,000 volunteers across Israel. When emergencies are reported to the authorities, United Hatzalah is also made aware of the location and notifies nearby volunteers through its own communication network, often by text message. Volunteers are not obligated to respond but almost always do. United Hatzalah claims an impressive average response time of under three minutes; in some cities, the average response time is under 90 seconds.
The organization has made some pioneering innovations. The fast response times are often attributed to the “ambucycles” it supplies to volunteers. They are essentially motor scooters packed with a complete trauma kit and advanced medical devices such as defibrillators, blood sugar monitors, and oxygen tanks. The scooters can bypass traffic jams, go around debris, ride on sidewalks, and otherwise avoid impediments that would stop an ambulance.
Friedson, a former IDF medic who is now the deputy director of international operations for United Hatzalah, stresses that becoming a volunteer requires no special prerequisites and that training can be given to almost anyone physically capable. He recalls one incident where he was playing basketball and got a call that a 7-year-old girl had been hit by a bus. He hopped on his ambucycle and was the third volunteer on the scene.
The first was “a real estate lawyer and he literally was about to sign some sort of housing closure, and he hopped on the back of his motorcycle to respond to this emergency,” Friedson recalls. “He was coming in a suit and tie from his law firm.” The second was a butcher, and “he was coming in his apron and his boots and he stunk like fish. It doesn’t matter what you’re doing. You could be a lawyer, you can be working at the market, it could be a student … that’s the whole point of it. It’s grassroots community.”
While Friedson’s evangelism for United Hatzalah is based on his life experiences, it’s also his job. He now lives in the United States, where United Hatzalah was on the ground with volunteer medics in Florida and Houston after last year’s hurricanes. The experience was eye-opening about the need for improvement in America’s response to major emergencies.
“None of us were sure what we were going to do in a country like America, but especially in Florida, in the Keys, we ended up doing a lot,” says Friedson. “We found several missing persons before FEMA and the Red Cross even arrived, which was a huge awakening to the reality that even the best of the best needs a little bit more of a support system.”
The data also support the notion America’s emergency response systems are becoming more strained. In the decade between 2014 and 2024, job growth for EMTs in the United States is projected to be 24 percent. And it remains an exceptionally difficult job, where the median salary is around $32,000 a year.
Obviously, one way to alleviate the strain on professional first responders is to give emergency medical training to thousands of volunteers in all walks of American life. United Hatzalah has an American affiliate, United Rescue, that is in its infancy and currently working to import United Hatzalah’s model of training and deploying volunteers in a pilot program in Jersey City.
However, there’s a very long way to go before United Rescue would make the same impact here as United Hatzalah in Israel. In terms of relative population, 4,000 volunteer responders in Israel would be the equivalent of adding 160,000 volunteers in America. Not helping matters, Friedson says, is quite a bit of union opposition from professional first responders to the idea of an army of volunteers.
Still, it’s hard to imagine Americans objecting to the thought of 100,000 new ambucycles patrolling the streets. And unlike, say, the debate over gun rights, emergency medical training is hardly controversial: Voluntarism speaks to America’s Tocquevillean traditions, and such programs can even start in schools.
In fact, there already appears to be a broad consensus that training teenagers for emergency response is a good idea. The Federal Emergency Management Agency has a initiative called Teen CERT (Community Emergency Response Team) that’s aimed at teaching basic first aid, along with procedures for responding to specific disasters, e.g. how to turn off gas lines after an earthquake. And there are numerous state and local programs across the country aimed at EMT training for high schoolers, some of which are quite impressive. Notably, the commonwealth of Virginia has a detailed curriculum for High School Based Emergency Medical Technician (EMT) Educational Programs, and the small ambulance service in the hedge-fund hamlet of Darien, Connecticut is actually run entirely by local teenagers and was the subject of a recent documentary, High School 911. But so far, this is a largely patchwork effort–several calls to federal agencies and national emergency medical organizations reveals no one has a good handle on how many kids are getting EMT or emergency training and to what end. There’s a strong case to be made that training staff and students needs to be a foundational part of American education.
“When I was in college, I got there and I asked the dean of the school about the medical staff at the university and he said, ‘what medical staff? There is none,’” Friedson says. “I told him, ‘I have an ambucycle, I’m a first responder.’ The dean of the school gave me his parking spot, and I started taking my cycle to school every single day and created the first response team on campus. And then two years later the dean was so inspired, he went off and did the [emergency medical] course and now he’s a first responder.”
For Friedson, the Parkland shooting is both a call to improve procedures for security and safety at American schools and a reminder that, while ordinary citizens ranging from football coaches to JROTC students proved heroic that tragic day at Stoneman Douglas High School, we can give people the tools to do even more when they need to rise to the occasion. “If you can have medical personnel on staff, that would be great. But that’s expensive,” he says. “But you can also train seniors in high school. Get them to do an EMT course, and have a few EMTs on campus.”