Hatzolah Crisis Response Unit

At Hatzolah, we are continuously trying to live up to and improve on our motto: “Treatment excellence and unsurpassed response times.” One such effort is the newly established Hatzolah Crisis Response Unit (CRU).

In Hatzolah we always think about wanting to help someone on their “Worst Day”. We always look for ways to improve the “Worst Day” for the patient. However, we identified a big gap in the system, as the patient is not necessarily the only person experiencing the “Worst Day.” Sometimes it is not only the patient who is in need of assistance.

As critical or non-critical as a medical emergency may be, we are always faced with the loved ones who arrive shortly after us, panic and uncertainty present on their faces, in desperate need of information and answers to their questions. Sometimes this is easily accomplished by the paramedic on scene simply providing the family with some assurance that the patient is alive but presenting with an injury or condition which will be managed accordingly. The relief is visible and almost instantaneous as they are reassured that their child or family member is okay. Following this comes a rush of emotions with the realisation that our superb team was able to assist.

However, this is not always the case. There are many emergencies to which we respond, that have life changing and permanent outcomes, for the patient and also for the family, friends or bystanders present on scene.

Often the calls to which we are activated, such as car accidents, a fall from heights or cardiac arrest, involve critical patients who require all the available hands on scene. Many medications and procedures need to be provided to the patient, not allowing responders to divert their focus to any other person present. For example, a child going into cardiac arrest after being hit by a car, is obviously very distressing for the family, but also for those on scene who witnessed the incident (and subsequent events).

We realised that the “Worst Day” is not limited to the patient alone, but also to others present, experiencing the emotional impact of a traumatic event. Until now we have not had the dedicated expertise or resources to adequately provide desperately required psychological first aid on scene, in addition to medical treatment.

After identifying that United Hatzalah in Israel has a unit in place called Chosen (Hebrew), which deals specifically with the psychological needs of people involved in an emergency, we knew this was something that needed to be introduced into our local model. After many months of preparation, including selecting candidates and working out operational, logistical, halachic and legal implications of such a unit, we were finally ready to start training the Crisis Response Unit. This unit would be the first of its kind outside of Hatzolah Israel to be trained with such skills.

We were delighted to bring out 2 outstanding instructors from Israel to train our CRU and provide the necessary skills to take Hatzolah forward to assist the community further. Dr Adam Ballin and Rabbi Avi Tennenbaum are both active emergency medical responders, members of United Hatzalah’s Chosen unit and are both involved in the management and training of their unit members.

Approximately 35 CRU members were trained with the skills to provide on-scene psychological first aid and containment, to people affected by trauma. This unit is composed of selected current Hatzolah responders and dispatchers, as well as mental health professionals such as practising psychologists, social workers and Rabbis. This provided the synergistic effect and fortunate position where we could combine the resources of experienced responders who have the necessary ability to run scenes and contain the environment, with the expertise of active mental health professionals. This combination is exceptionally valuable and allows for different skill sets to come together to deal with very challenging situations, faced daily on our calls.

The training course was excellent, allowing us to apply theoretical information gleaned from the World Health Organisation and Israeli techniques, including information from leading experts such as Dr Farchi, with the practical applications during case simulations. The course gave us an approach of what to do on scenes as well as what not to do. Numerous real life examples and experiences were shared, ensuring the training was relevant and applicable for the South African setting.

We are in the final stages of acquiring the necessary equipment to stock the jump bags that will be issued to CRU members. Crisis Response Unit responders will be seen on the road wearing unique vests, with a lilac insignia, differentiating them from the medical responders.

We had the misfortune of having our first call activation for this unit less than 48 hours after going live. It was a great success for the team and highlighted the essential need for this unit.

With our Crisis Response Unit, we hope to be able to make a tremendous difference to the family members or bystanders at a horrifying scene, in addition to easing the patient’s difficult experience. This will allow us to focus 100% on the psychological needs of those people present on scene without taking away from the clinical management of the patient.