Author Topic: The Pros And Cons Of Where You Live  (Read 724955 times)

Offline a mirrer

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Re: The Pros And Cons Of Where You Live
« Reply #4100 on: August 14, 2023, 03:54:07 AM »
It's controversial. No real need in UH/Beachwood, but guys do need their radios and sirens, so...

Maybe we'll be proven wrong, time will tell. But for now, doesn't seem like a great use of community resources.
This is the same response that la had 25 years ago when hatzala started and all the entrenched askant fought tooth and nail to shut it down. It only became accepted when people realized that the difference between average response time of 90 seconds for hatzala to 3 minutes for 911 can be life and death in many situations.

Offline Bored Bachur

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Re: The Pros And Cons Of Where You Live
« Reply #4101 on: August 14, 2023, 09:37:06 AM »
This is the same response that la had 25 years ago when hatzala started and all the entrenched askant fought tooth and nail to shut it down. It only became accepted when people realized that the difference between average response time of 90 seconds for hatzala to 3 minutes for 911 can be life and death in many situations.
although hatzolah in LA can't transport

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Re: The Pros And Cons Of Where You Live
« Reply #4102 on: August 14, 2023, 09:39:54 AM »
This is the same response that la had 25 years ago when hatzala started and all the entrenched askant fought tooth and nail to shut it down. It only became accepted when people realized that the difference between average response time of 90 seconds for hatzala to 3 minutes for 911 can be life and death in many situations.
Sounds good, IY"H that proves to be the case here as well.
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Re: The Pros And Cons Of Where You Live
« Reply #4103 on: August 14, 2023, 10:23:31 AM »
Hatzalah is not just about the response time. There is also the knowledge of all the local medical facilities, and what each one is good for. They also build relationships with the local medical facilities, and can help push things along in otherwise overcrowded emergency rooms. But the main benefit of hatzalah is not something tangible that can be expressed with response time stats or a list of services. It's that feeling of calm and trust that we have built in knowing if something goes wrong someone who truly cares will respond and let you know the best way to deal with the situation.

When my wife and I had to call hatzalah, aside from the calm and caring nature of their response, the sense of calm we had even before we called knowing that we *could* call. There is that confusion at first, am I overreacting? Should I call an ambulance? Should I just go to the ER? Maybe there is a 24 hour urgent care? Maybe no one needs to be called at all? With hatzalah, you don't have questions. You call, they respond and they will know if the kid can stay home, if they need to go to a hospital, etc. Even the best EMS response is going to be doing what is necessary to cover their behinds. If that means spending Shabbos in a hospital, so be it. Hatzalah knows what that means to you and won't send you there if it isn't necessary.

What that does for a community is not quantifiable, and it can be difficult to describe what an incredible resource it is. One way to think of it for me is: for medical questions, the Rebbe often advised people to consult a "rofeh yedid". Hatzalah is a 24/7 emergency rofeh yedid.

Offline Dan

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Re: The Pros And Cons Of Where You Live
« Reply #4104 on: August 14, 2023, 10:31:13 AM »
Hatzalah is not just about the response time. There is also the knowledge of all the local medical facilities, and what each one is good for. They also build relationships with the local medical facilities, and can help push things along in otherwise overcrowded emergency rooms. But the main benefit of hatzalah is not something tangible that can be expressed with response time stats or a list of services. It's that feeling of calm and trust that we have built in knowing if something goes wrong someone who truly cares will respond and let you know the best way to deal with the situation.

When my wife and I had to call hatzalah, aside from the calm and caring nature of their response, the sense of calm we had even before we called knowing that we *could* call. There is that confusion at first, am I overreacting? Should I call an ambulance? Should I just go to the ER? Maybe there is a 24 hour urgent care? Maybe no one needs to be called at all? With hatzalah, you don't have questions. You call, they respond and they will know if the kid can stay home, if they need to go to a hospital, etc. Even the best EMS response is going to be doing what is necessary to cover their behinds. If that means spending Shabbos in a hospital, so be it. Hatzalah knows what that means to you and won't send you there if it isn't necessary.

What that does for a community is not quantifiable, and it can be difficult to describe what an incredible resource it is. One way to think of it for me is: for medical questions, the Rebbe often advised people to consult a "rofeh yedid". Hatzalah is a 24/7 emergency rofeh yedid.
Makes sense, though worth noting there's no plans on hatzala here transporting patients.

CLE is also a city with a massive medical presence due to the Clinic and every shul here has multiple doctors, most of whom are extremely generous with their time and expertise. There's also an incredible Bikur Cholim network with hundreds of connected Doctors with hospital admin connections.

I've heard from some that would have preferred a response team of doctors and bikur cholim to be available as advisors and advocates, given the rapid EMS response times we have here.

I don't think anyone is fighting against this happening. But plenty are wondering if this is the best use of resources and approach. As I said, time will tell.
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Online Yehuda57

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Re: The Pros And Cons Of Where You Live
« Reply #4105 on: August 14, 2023, 10:42:21 AM »
Makes sense, though worth noting there's no plans on hatzala here transporting patients.

CLE is also a city with a massive medical presence due to the Clinic and every shul here has multiple doctors, most of whom are extremely generous with their time and expertise. There's also an incredible Bikur Cholim network with hundreds of connected Doctors with hospital admin connections.

I've heard from some that would have preferred a response team of doctors and bikur cholim to be available as advisors and advocates, given the rapid EMS response times we have here.

I don't think anyone is fighting against this happening. But plenty are wondering if this is the best use of resources and approach. As I said, time will tell.

There are other cities without patient transfers, though, FWIU the response times there are much slower, so there is a benefit to Hatzalah being on scene quickly, and then having EMS come a bit later to handle transport. If response times in CLE will be about the same for Hatzalah and EMS, I could envision arguments and fights between the two over who should be caring for the patient.

Offline Dan

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Re: The Pros And Cons Of Where You Live
« Reply #4106 on: August 14, 2023, 10:45:29 AM »
I could envision arguments and fights between the two over who should be caring for the patient.
For sure. In Beachwood, they'd probably be here within 30 seconds of each other.
I wonder what the plan for that is?
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Re: The Pros And Cons Of Where You Live
« Reply #4107 on: August 14, 2023, 10:47:39 AM »
For sure. In Beachwood, they'd probably be here within 30 seconds of each other.
I wonder what the plan for that is?

I guess the plan would be to call haztalah only and then have hatzalah call EMS after their initial response if they require transport

Offline herb

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Re: The Pros And Cons Of Where You Live
« Reply #4108 on: August 14, 2023, 10:49:47 AM »
Hatzalah is not just about the response time. There is also the knowledge of all the local medical facilities, and what each one is good for. They also build relationships with the local medical facilities, and can help push things along in otherwise overcrowded emergency rooms.
happens to be Cleveland bikur cholim is top notch and in this case hatzalah would probably lean on them, for sure in the beginning

Offline Dan

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Re: The Pros And Cons Of Where You Live
« Reply #4109 on: August 14, 2023, 11:01:55 AM »
I guess the plan would be to call haztalah only and then have hatzalah call EMS after their initial response if they require transport

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Offline Yehudaa

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Re: The Pros And Cons Of Where You Live
« Reply #4110 on: August 14, 2023, 11:11:34 AM »
Hatzalah is not just about the response time. There is also the knowledge of all the local medical facilities, and what each one is good for. They also build relationships with the local medical facilities, and can help push things along in otherwise overcrowded emergency rooms. But the main benefit of hatzalah is not something tangible that can be expressed with response time stats or a list of services. It's that feeling of calm and trust that we have built in knowing if something goes wrong someone who truly cares will respond and let you know the best way to deal with the situation.

When my wife and I had to call hatzalah, aside from the calm and caring nature of their response, the sense of calm we had even before we called knowing that we *could* call. There is that confusion at first, am I overreacting? Should I call an ambulance? Should I just go to the ER? Maybe there is a 24 hour urgent care? Maybe no one needs to be called at all? With hatzalah, you don't have questions. You call, they respond and they will know if the kid can stay home, if they need to go to a hospital, etc. Even the best EMS response is going to be doing what is necessary to cover their behinds. If that means spending Shabbos in a hospital, so be it. Hatzalah knows what that means to you and won't send you there if it isn't necessary.

What that does for a community is not quantifiable, and it can be difficult to describe what an incredible resource it is. One way to think of it for me is: for medical questions, the Rebbe often advised people to consult a "rofeh yedid". Hatzalah is a 24/7 emergency rofeh yedid.
+100.

I was once helping a relative who was recovering from a surgery due to a very badly broken bone. On shabbos he was in immense pain, to the extent that he was screaming in agony, and it was clear that he needed stronger medication than what had ben provided when he was discharged from the hospital. Hatzalah was called, and somehow they arrived *with a doctor and an orthopedist*, put the guy on a morphine IV, and enabled him to continue recovering at home. Had we simply called 911, I'm sure they would've transported him to the hospital, with similar results but being stuck waiting in the ER screaming in agony until he could get those meds, and having to deal with the stresses of a hospital on shabbos.

Another story that comes to mind is something that happened to my little brother when I was growing up. Hatzalah and 911 EMS showed up, and the 911 EMS basically said that for liability purposes they always *have to* advise that the best course of action is to transport to the hospital. The three hatzalah members who attended discussed it, and advised (off the record, also for liability purposes) that the situation was totally non-urgent, and that if we drove to the pediatrician we'd be just fine and we'd be able to avoid a very long ER wait at the bottom of the triage list. That's exactly what happened.

Again, during COVID I know someone who had relatively severe symptoms, and had been in the hospital earlier, was discharged and then things got worse, and long story short, Hatzalah responded and spent an hour calling all their connections to get in touch with the doctor that had treated the person in the hospital, and successfully tracked down the doctor and got the person some solid advice over the phone. That's not something that 911's EMS would ever do for you.

Another story that I remembered as I'm writing this- I'm close with a family who had a kid who was diagnosed with a severe illness, and on shabbos a few days later, the kid had some complications and had to be transported to the hospital. The mother was going to accompany the kid, but was an emotional mess, having learned of a pretty rough diagnosis a few days earlier. Hatzalah was able to advise that their poskim have ruled that a second person can ride in the ambulance on shabbos if the mother can't handle the situation alone. Again, without hatzalah there, the situation would've been much more challenging as the mother likely would've gone alone, with no support.

As @Yehuda57 said so eloquently, it's about having someone there who truly cares for you, and who is willing to do whatever it takes to get you the best help.

If you want to see how they care, look at how hatzalah members get to a call and get into the house quickly, versus how public ambulance drivers (in my city, at least) slowly get out of their ambulance and unload their equipment. I remember watching an ambulance pull up across the street from my office last year when COVID had mostly passed already, and I watched the paramedics spend *5 minutes* getting all their PPE on outside the ambulance and unloading their stuff, before going into the call. If the patient was in cardiac arrest, those 5 minutes may have well killed him (though our 911 response time is so bad that he may have been long dead in that case, unfortunately).

Offline Yehudaa

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Re: The Pros And Cons Of Where You Live
« Reply #4111 on: August 14, 2023, 11:22:14 AM »
Hatzalah Toronto has been operating successfully this way for decades. They can't transport, but they respond in 1-2 minutes and stabilize patients until the ambulance arrives, which is often life-saving in a city where the public EMS target response time for life-threatening calls is 8 minutes*. Hatzalah calls 911 immediately when you call them, for any call that they deem it necessary. They have a very good relationship with the 911 dispatchers and the fire/ems crews on the ground, and work well together.

*And that's on top of hold times when you call 911. During the last couple years there have been staffing shortages, resulting in hold times of up to 6-8 minutes to talk to a 911 operator in the first place. I called 911 to report a highway car accident that I witnessed this year, and spent a good 2-3 minutes on hold before an operator picked up. Add that together with an 8-minute response and a minute or two to get into the house (longer in apartment buildings, where much of our city lives), and any cardiac arrest is pretty much a lost cause.

Granted, CLE sounds like a much better 911 EMS than ours, but my point is that the Hatzalah/911 combination can work well.



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Re: The Pros And Cons Of Where You Live
« Reply #4112 on: August 14, 2023, 11:32:26 AM »
Also to note, I think one of the main budgets for fundraising money for hatzala is for ambulances, but if there is no transport the budget would be much lower?

That is to say, the CLE Hatzala won't need to raise millions of community funds to operate.

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Re: The Pros And Cons Of Where You Live
« Reply #4113 on: August 14, 2023, 11:34:51 AM »
I believe North-West Philly operates the same way. They can't transport, but they respond to assist.

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Re: The Pros And Cons Of Where You Live
« Reply #4114 on: August 14, 2023, 11:37:09 AM »
Also to note, I think one of the main budgets for fundraising money for hatzala is for ambulances, but if there is no transport the budget would be much lower?

That is to say, the CLE Hatzala won't need to raise millions of community funds to operate.
I imagine training, equipment, and insurance are all substantial costs, but are probably far less than buying, stocking and maintaining ambulances.

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Re: The Pros And Cons Of Where You Live
« Reply #4115 on: August 14, 2023, 11:59:29 AM »
Also to note, I think one of the main budgets for fundraising money for hatzala is for ambulances, but if there is no transport the budget would be much lower?

That is to say, the CLE Hatzala won't need to raise millions of community funds to operate.
The real question is if they will be billing insurance :)

Offline Sammy82

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Re: The Pros And Cons Of Where You Live
« Reply #4116 on: August 14, 2023, 02:21:06 PM »
IMHO, this is such a stupid conversation.
1. If they save even 1 life, it's worth it. And I'm sure you would agree if that one life was a family member of yours.
2. Do you really think that people aren't going to give to other organizations because they are giving to hatzalah? Doubtful
3. There is plenty of yiddisha gelt. Maybe people in Cleveland don't flaunt it as they do in other communities, but I'm sure if they could support restaurants, other community businesses, and organizations (as well as many nationwide and global organizations), there's enough for Hatzalah, without it hurting other organizations.
4. I work in healthcare. I would trust a 15-year-old lifeguard to do CPR, heimlich, and splinting more than most doctors. MDs are good in their specialty but unless they work in a related specialty, they have never done emergency care since their school days. So having several MDs in every shul doesn't help (unless they are trained and practicing EMTs, paramedics, etc).
5. Even if the MDs know do proper emergency care, what happens if an emergency happens outside of shul? You start running around and calling neighbors to see who's available to come at that moment? That's a great waste of time. Every hatzalah member will tell you, in case of emergency, call hatzalah central number/911 first and only then call your neighbor friend, etc. By creating hatzalah, you are streamlining the notification. So even if one neighbor isn't available or nearby, the member down the road is getting notified at the same exact time. No delay in care. And as mentioned previously, a few-second delay could be the matter between life and death.
I just don't get the pushback. Maybe it's that 'we're different than New York/New Jersey. We don't want to be like them' mentality. That's great if you want to do it with restaurants, keeping up with the Cohen's, double parking, etc. When it comes to saving lives, why in hecks name would you NOT want to be like NY and NJ who, by ALL standards, are second to none GLOBALLY (aside from EY maybe)?

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Re: The Pros And Cons Of Where You Live
« Reply #4117 on: August 14, 2023, 02:35:31 PM »
IMHO, this is such a stupid conversation.
1. If they save even 1 life, it's worth it. And I'm sure you would agree if that one life was a family member of yours.
By that token, everyone on Earth should be an EMT.
Or Hatzalah should employ hundreds of thousands of people.
Or everyone should spend everything they can to always have a EMT follow them around as much as possible.
It will surely save even more lives.

In the real world, resources are finite and everything has a cost-benefit analysis. When EMS takes 20 minutes, then there's obviously a good case for millions of dollars of spending to correct that.

When EMS takes 1-2 minutes, the cost-benefit analysis is obviously murkier and labeling it a stupid conversation instead of having an honest debate is infantile.
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Re: The Pros And Cons Of Where You Live
« Reply #4118 on: August 14, 2023, 02:38:46 PM »
4. I work in healthcare. I would trust a 15-year-old lifeguard to do CPR, heimlich, and splinting more than most doctors. MDs are good in their specialty but unless they work in a related specialty, they have never done emergency care since their school days. So having several MDs in every shul doesn't help (unless they are trained and practicing EMTs, paramedics, etc).
5. Even if the MDs know do proper emergency care, what happens if an emergency happens outside of shul? You start running around and calling neighbors to see who's available to come at that moment? That's a great waste of time. Every hatzalah member will tell you, in case of emergency, call hatzalah central number/911 first and only then call your neighbor friend, etc. By creating hatzalah, you are streamlining the notification. So even if one neighbor isn't available or nearby, the member down the road is getting notified at the same exact time. No delay in care. And as mentioned previously, a few-second delay could be the matter between life and death.
That idea wasn't to have them do EMS service, but be available to advise on what to do and help facilitate care, together with the world-class Bikur Cholim that CLE has.
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Re: The Pros And Cons Of Where You Live
« Reply #4119 on: August 14, 2023, 02:41:41 PM »
In the real world, resources are finite and everything has a cost-benefit analysis. When EMS takes 20 minutes, then there's obviously a good case for millions of dollars of spending to correct that.

When EMS takes 1-2 minutes, the cost-benefit analysis is obviously murkier and labeling it a stupid conversation instead of having an honest debate is infantile.
So where (in your opinion) is the push coming from to start Cleveland Hatzolah?