Medics from around the world pushed to limits in Israeli forests

22:03, June 09, 2010      

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Mount Gilboa, a ridge above the Jezreel Valley in northern Israel and the site of a famous battle described in length in the Old Testament, isn't the place you would expect to see dozens of tense emergency medical teams running about, especially Chinese paramedics.

That's exactly the scene unfolded early Monday morning as three seasoned members of Beijing Red Cross 999 Emergency Rescue Center disembarked from an ambulance in white uniforms. They then rushed to strap themselves to harnesses and glided down a rope from the edge of a 50-meter cliff to reach an unconscious victim that had lost his footing.

If things had gone according to plan, the Chinese saviors would have faced the gruelling task of pulling their subject up the rope to the cliff top, where they would then load him into the ambulance. But time ran out, and the sweat-drenched rescue team grasped another rope for the steep climb back on foot.

Rappelling from a cliff isn't a common challenge for civilian emergency medical services (EMS) crew, but rather that of specialized military medevac units. Neither is walking across a makeshift rope bridge or wandering into a forest on horseback.

But for the organizers of the third International EMS Olympics, hosted by Israel's national emergency rescue and ambulance service Magen David Adom (MDA), it was all about putting the medical crew through the most unfamiliar and unconventional.


MDA (acronym for "Red Shield of David" in Hebrew) was formed in 1930 as a volunteer association with a single branch in Tel Aviv. In 2006, following decades of disagreement over the red star emblem, the organization was officially recognized by the International Committee of the Red Cross as the national aid society of Israel under the Geneva Conventions, and accepted as a member of the International Federation of Red Cross and Red Crescent Societies.

With a fresh appetite to exploit its new status to the full, MDA soon launched its first EMS Olympics, adopting an event pioneered by the Czech Republic and upgrading it with a few original Israeli ingredients, mostly adrenaline-pumping extreme challenges.

This year's event attracted 49 medical teams, of them 20 were foreign delegations, including China, Germany, France, Poland, Jordan and Norway. The Israelis brought along several army medical crew for reinforcement.

All teams, said the organizers, are the elite of their countries and were hand selected for the competition. Some nations regard it so seriously that they go as far as maintaining crew specially trained for the next international event.

Others are less privileged. Panama, for instance, established EMS only two years ago. Israeli professionals spent several months in Panama City to train field teams and instructors and assist in setting up logistics and emergency hot lines.

This week, the Panamanians faced the same rigors as everyone else, no shortcuts afforded. Some of the 11 scenarios that comprised the four-day games included rescuing a parachutist who landed on a tree, providing assistance to a woman in labor and treating injuries in a barn.

"I've been to competitions abroad, which pretty much offer the same scenarios but with a 'softer' approach," said Bezalel Avraham, MDA's chief safety and transportation officer, adding "our aim was to make it as hard as possible. It enables to raise the moral, motivation and professionalism of the crew."


By noon, away from the comfort of the hotel and under a scorching sun, the Chinese had already reached their third scenario for the day: Avraham's much thought after slalom driving track.

An Israeli driver was soon behind the wheel of an orange-white ambulance with a piece of cloth placed over his eyes. The task: to guide him verbally through the 300-meter track laden with obstacles. Success was a matter of good coordination consisting of "now right...stop."

"The driving scenario is purely Israeli and is based on our daily operational routine," said Avraham. "The emphasis here is on safety and team work. It also bears resemblance to real life, the crew assist the driver in controlling the situation once they enter harsh urban conditions. They provide additional pairs of eyes."

The criteria for judging a team's performance are similar in all such events: efficient teamwork, physical fitness and the ability to cope with uncertainty in difficult field conditions.

"The idea is to challenge them with unconventional situations," said Hagai, an instructor for a company that mostly provides extreme spot workshops for corporate executives.

"It forces out-of-the-box thinking, functioning under pressure and individual and team play under uncertainty," he added.

Despite the hair-raising feats added to the challenges, most were still mundane, the kind of things a typical EMS team, anywhere in the world, may encounter daily, like treating a victim who develops a severe reaction to bee-sting venom.

Here, the victim is a mannequin placed in the Jacuzzi of a rural guest house. A professional actress, hired for the purpose of adding a realistic human element, portrays the upset wife who also requires the attention of the Israeli paramedics. They perform resuscitation for several minutes, insert IV fluids and apply electric shock. In other scenarios, the medics must successfully change a flat tire, fast, because someone's life is on the line, and treat the victim of failed suicide attempt.

Who are the best? "It wouldn't be right or nice to say that we (the Israelis) are better," said Avraham. "The goal here is the passing of information and knowledge among the teams. There are misunderstandings and failures here and there, but eventually we all reach the same level and attain a peak of professionalism."


Besides the social bonds formed between the teams, and the rare opportunity to meet and exchange methods and techniques, the event is a crucial learning workshop for both the Israelis and foreigners.

Since its induction to the Red Cross, MDA is required to provide services to other countries in case of need. Most recently, MDA teams were dispatched to Port-au-Prince, Haiti, to assist with the disastrous aftermath of the earthquake that shattered the country, where they joined a team from the Norwegian Red Cross in setting up a field hospital.

Six months prior to that, dozens of MDA crew entered Jordan to treat and evacuate Israeli tourists wounded in a bus accident.

"The foreigners provide us information on things we usually don't have in Israel, mostly natural disasters, storms and severe weather conditions," said Avraham.

"If and when, God forbid, our crew will have to work in countries of the teams who came here, they will have a better understanding of the work methods and how to better communicate in the field in real time," he said.

For the foreign teams, it was a chance for practice in a field that Israel excels in: handling mass-casualty events, a type of expertise gained through years of wars and terror-related incidents.

"The Israelis have an advantage in mass-victim scenarios," said Dr. Yaniv Berliner, 32, an Israeli-born trauma surgeon, who headed the four-member Canadian delegation.

"It's due to their experience with bombing and car accident victims," he said, adding "they're very good at triaging (prioritizing) on the scene, being able to quickly determine who's dead, who's critically wounded and requires immediate evacuation, who's moderately wounded."

Berliner, who works for the London Health Sciences Center, a group of three local hospitals, said he's mostly used to dealing with a single patient at any given time. He was greatly impressed with the Israelis' use of 'Quick Trick,' an intubation technique that enables the quick opening of an airway in a victim.

"It has been really excellent," he said.

Source: Xinhua


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