Multi-casualty incidents (MCIs) continue to occur throughout the world, whether they be mass shootings or natural disasters. Prehospital emergency services have done a professional job at stabilizing and transporting the victims to local hospitals. When there are multiple casualties, there may not be enough professional responders to care for the injured. Bystanders and organized volunteer first responders have often helped in extricating the victims, stopping the bleeding, and aiding in the evacuation of the victims. Magen David Adom (MDA translated as “Red Shield of David”), the national Emergency Medical Services (EMS) provider for Israel, has successfully introduced a program for volunteer first responders that includes both a mobile-phone-based application and appropriate life-saving equipment. Most of the responders, known as Life Guardians, are already medical professionals such as physicians, nurses, or off-duty medics. They are notified by a global positioning system application if there is a nearby life-threatening incident such as respiratory or cardiac arrest, major trauma, or an MCI. They are given a kit that includes a bag-valve mask device, oropharyngeal airways, tourniquets, and bandages. There are currently 17,000 Life Guardians, and in the first-half of 2017, they responded to 253 events.

The Life Guardians are essentially an out-of-hospital manpower multiplier using a simple crowdsourcing application who have the necessary skills and equipment to treat those in cardiopulmonary arrest, or victims of trauma, including MCIs. Such a model can be integrated into other systems throughout the world to save lives.

JaffeE, DadonZ, AlpertEA. Wisdom of the Crowd in Saving Lives: The Life Guardians App. Prehosp Disaster Med. 2018;33(5):550–552.