Israeli Emergency Guide

Step 1: Emergency Phone Numbers

Israel has dedicated emergency numbers. Provide the correct number based on the situation.

Key facts about MDA:

• National emergency medical service, operating since 1950
• 189 stations across Israel with over 2,000 ambulances
• Average response time: 8.3 minutes nationwide
• Staffed by approximately 4,000 EMTs and paramedics plus 26,000 volunteers
• Supplies 100% of IDF blood needs through MDA Blood Services

Step 2: When to Call MDA vs Visit Terem vs Go to ER

Help the user decide where to seek care based on the severity of their situation.

Decision guide:

1. If the person is unresponsive, not breathing, or has severe bleeding, call 101 immediately.
2. If the condition is painful but stable and does not require hospitalization, Terem is faster and cheaper.
3. If unsure, call 101. The MDA dispatcher will advise whether an ambulance is needed.

Step 3: Israel's Hospital System and Trauma Centers

Israel has 5 Level-1 trauma centers equipped for the most severe injuries.

Additional major hospitals:

• Ichilov (Sourasky), Tel Aviv: major ER, central location
• Kaplan, Rehovot: serves southern coastal area
• Ziv, Tzfat: serves upper Galilee
• Wolfson, Holon: southern Tel Aviv metropolitan area

Step 4: ER Process (Chadar Miyun)

When arriving at a hospital ER (chadar miyun, חדר מיון), expect the following process:

Cost information:

• ER copay (ishtalmut): approximately 100 NIS
• Copay is waived if the patient is admitted to the hospital
• Copay is waived if referred by MDA ambulance
• Children under 18 and pregnant women may have reduced or waived copays depending on kupat cholim

Triage priority levels:

1. Immediate (red): life-threatening, seen immediately
2. Urgent (orange): serious, seen within 15-30 minutes
3. Less urgent (yellow): stable but needs ER care, may wait 1-2 hours
4. Non-urgent (green): could be seen at clinic, longest wait

Step 5: Terem Urgent Care Clinics

Terem (טרם) operates urgent care clinics for non-life-threatening emergencies.

When to use Terem:

• Fractures and sprains (not compound fractures)
• Cuts requiring stitches
• High fever, especially in young children
• Ear and eye infections with acute pain
• Minor burns
• Urinary tract infections

Advantages over hospital ER:

• Shorter wait times (typically under 1 hour)
• Lower cost than ER visit
• X-ray and basic lab services available
• No referral needed
• Accepted by all kupot cholim

Step 6: Patient Rights During Emergencies

Under Israeli law (Patient Rights Law, חוק זכויות החולה), patients have the following rights even during emergencies:

Important: If a patient is unconscious or unable to give consent, medical staff may perform life-saving procedures under the emergency exception (pikuach nefesh, פיקוח נפש).

Step 7: Blood Donation Through MDA

MDA Blood Services (שירותי הדם של מד"א) manages Israel's entire blood supply.

Key facts:

• MDA supplies 100% of blood products for Israeli hospitals and the IDF
• Israel needs approximately 800 blood donations per day
• Blood types O-negative and B-negative are in constant high demand
• Donors receive a free health screening (blood pressure, hemoglobin, pulse)
• Donation is voluntary and unpaid in Israel

Example 1: Someone Collapses in the Street

User says: "Someone just collapsed near me and isn't responding. What do I do?"

Actions:

1. Call 101 (MDA) immediately
2. Tell the dispatcher your exact location (street name, landmark, or building)
3. Check if the person is breathing; the dispatcher will guide you through CPR if needed
4. Do not move the person unless they are in immediate danger (fire, traffic)
5. Stay on the line until the ambulance arrives (average response: 8.3 minutes)

Result: MDA dispatches the nearest ambulance. If in a public area, nearby defibrillators (AED) may be available (ask the dispatcher).

Example 2: Child Has a High Fever on Shabbat

User says: "My 3-year-old has a fever of 39.5 and it's Friday night. Where do I go?"

Actions:

1. For a fever of 39.5 in a young child, Terem urgent care is the most appropriate option
2. Locate the nearest Terem clinic (Jerusalem Romema is open 24/7 including Shabbat)
3. Bring the child's teudat zehut and kupat cholim card
4. If the child has difficulty breathing, is lethargic, or has a rash, call 101 instead

Result: Terem can evaluate the child, run basic tests, and prescribe medication. Wait times are typically under 1 hour.

Example 3: Tourist Breaks an Arm

User says: "I'm a tourist in Tel Aviv and I think I broke my arm. What should I do?"

Actions:

1. If the bone is not protruding and bleeding is controlled, go to Terem or a hospital ER
2. In Tel Aviv, Ichilov (Sourasky Medical Center) is centrally located
3. Bring your passport and travel insurance documents
4. ER copay is approximately 100 NIS; travel insurance should cover this
5. Hospitals are required to treat you regardless of insurance status

Result: X-ray and treatment at Terem or the hospital. Non-residents may be billed at higher rates, so having travel insurance is important.

Example 4: Locating the Nearest Trauma Center

User says: "There's been a serious car accident near Beer Sheva. Which hospital handles major trauma?"

Actions:

1. Call 101 (MDA). For major trauma, MDA will transport to the nearest Level-1 trauma center
2. In the Beer Sheva area, Soroka Medical Center is the Level-1 trauma center
3. Soroka is the only Level-1 trauma center in the Negev region
4. Do not attempt to transport a severely injured person yourself unless MDA instructs you to

Result: MDA dispatches a Mobile Intensive Care Unit (MICU) staffed by paramedics for major trauma cases.

References

• references/hospital-directory.md -- Complete directory of Israeli hospitals by region (North, Center, South, Jerusalem), including all 5 Level-1 trauma centers, emergency department phone numbers, clinical specialties, and pediatric and psychiatric facilities. Consult when a user needs to find the nearest hospital, identify which hospital handles specific specialties, or locate a trauma center.
• references/first-aid-basics.md -- Quick reference for basic first aid procedures (CPR for adults/children/infants, severe bleeding, burns, choking, heatstroke) with Israeli-specific context including desert snake bite response, Mediterranean jellyfish sting treatment, earthquake procedures, and regional heat risks. Consult when a user needs step-by-step first aid instructions or faces a region-specific emergency.

Error: "I called 101 but no one answers in English"

Cause: MDA dispatchers primarily speak Hebrew. English availability varies by region and time. Solution: Say "English" or "Anglit" (אנגלית) clearly. If no English-speaking dispatcher is available, try calling 112 (the unified European emergency number), which may route to an English-capable operator. Alternatively, ask a nearby Hebrew speaker to assist with the call.

Error: "The ER is charging me even though I came by ambulance"

Cause: Not all ambulance transports automatically waive the ER copay. The waiver typically applies when MDA determines the transport is medically necessary. Solution: Ask the billing department (mishrad haheshbonot, משרד החשבונות) to verify your case. If MDA transported you and marked the call as an emergency, the copay should be waived. Keep your MDA transport documentation as proof.

Error: "I don't know which kupat cholim I belong to"

Cause: Many residents, especially new immigrants (olim), are unsure of their health fund registration. Solution: Check your kupat cholim membership by calling the National Insurance Institute (Bituach Leumi, ביטוח לאומי) at *6050 or visiting any kupat cholim branch with your teudat zehut. You can also check online through the Ministry of Health website. In an emergency, hospitals will treat you regardless of kupat cholim membership.