Introduction: On October 7, 2023, over 3,000 Hamas terrorists from Gaza invaded border communities in Israel, killing more than 1,200, mostly civilians, and injuring 1455. In addition, 239 Israelis and foreign nationals were taken hostage resulting in the country’s largest mass casualty event (MCE). Magen David Adom (MDA), Israel’s National Emergency Pre-Hospital Medical Organization began establishing Community Emergency Response Teams (CERT) based on the concept developed by the Federal Emergency Management Agency in the United States. Although in many places in the world the teams consist of laypersons, MDA chose the strategy of investing in health care providers such as nurses, paramedics, and emergency medical technicians to establish Professional Community Emergency Response Teams (P-CERT). All of the volunteers were vetted and officially registered by MDA. After the recruitment process, the volunteers accepted into the teams underwent comprehensive training, which included courses based on prehospital trauma life support (PHTLS), light search and rescue medicine, and management of an MCE. In addition to the technical training, emphasis was placed on the development of teamwork skills and cooperation with other emergency agencies including MDA, the fire department, and the police. A particular emphasis was placed on scenarios simulating complex emergency situations including prolonged field care. The teams were trained to work in three different areas: the disaster site, treatment station, and observation station.
Methods: This is a descriptive study of professional community emergency response teams that were initiated by MDA after the events of October 7, 2023.
Results: Over 11,440 volunteers were recruited who were affiliated with 593 community teams throughout Israel. Of the volunteers, 1890 received equipment for basic first aid, 6419 received equipment for basic life support, and 719 received equipment for advanced life support.
A model unit was established in the city of Modiin (population 100,000) that is located halfway between Jerusalem and Tel Aviv. In total over 150 medical personnel have joined the Modiin P-CERT. This included over 60 physicians, 35 nurses, 45 emergency medical technicians, and 8 paramedics. Other staff included pharmacists, physiotherapists, and laboratory technicians. Trainings included procedure stations including airway management and hemorrhage control techniques. Search and rescue training was conducted in a mock disaster site in the city. Mass casualty drills were conducted with an emphasis on managing and treating patients at the disaster site, treatment station, and observation station. Several physicians also took an advanced cardiac life support course and rode in the ambulance to gain prehospital experience. Advanced cardiac life support and basic life support equipment were given to the various medical staff.
Conclusion: Disaster response can be complex and communities that have health care workers who are willing to volunteer in response to an MCE should consider the P-CERT model. Important lessons from Israel include a central organizing body, an emphasis on PHTLS, focused training, and disbursement of appropriate equipment.