Hatzolah emergency medical responder service: to save a life.
"First responders" are people trained in advanced first aid who can respond at the same time as, and often more quickly than, ambulance services to suspected medical emergencies. Hatzolah is a volunteer First Responder group, based on halakhic (Jewish legal) principles, in a localised area of metropolitan Melbourne with the highest density of Holocaust survivors outside Israel. Low numbers of "call-outs" to Victoria's Metropolitan Ambulance Service (MAS) from this community suggested that many were reluctant to make contact with a "uniformed" external agency. Hatzolah is an autonomous organisation operating under adapted MAS clinical practice guidelines and clinical governance processes. Hatzolah responders undergo an 18-month MAS training course comprising first aid, cardiopulmonary resuscitation, the use of semiautomated defibrillators, and oxygen therapy. We describe the first 11 years (1995-2005) of the Hatzolah service. The number of patients attended to annually has risen steadily, peaking at 867 in 2005. The most frequent reasons for call-outs were falls (19.4%), chest pain (9.7%), or respiratory distress (7.6%). Hatzolah's median response times were 2 or 3 min for all cases. They attended 35 patients with cardiac arrest (median response time, 2 min), and arrived before the MAS to 29 call-outs (83%). Nineteen patients (54%) with cardiac arrest were resuscitated and transported from the scene alive. Among those transported, significantly more had a shockable cardiac rhythm (50% v 13%, P = 0.03). Five (14%) survived to hospital discharge. Hatzolah has evolved into an organisation providing a complementary service to the MAS. It serves as a model for the establishment of other metropolitan community First Responder groups.
Chan
Tony
T
Austin Health, Melbourne, Victoria, Australia. tonychanau@yahoo.com.au
Braitberg
George
G
Elbaum
Danny
D
Taylor
David McD
DM
D000368:Aged; D016887:Cardiopulmonary Resuscitation; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility; D006323:Heart Arrest / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D007585:Jews; D008297:Male; D014739:Victoria / Q000453:epidemiology