As emergency medical teams treated children injured in a tragic event at a daycare center in Jerusalem’s Romema neighborhood on Monday, United Hatzalah dispatched its Psychotrauma and Crisis Response Unit to provide support for parents waiting to be reunited with their young ones.
What began as an initial report of one infant in cardiac arrest quickly escalated to two unresponsive children, triggering a pivot to suspected environmental or toxicological danger, fast evacuation, and intensive support for parents and toddlers alike.
For United Hatzalah volunteer Daniel Katzenstein, the incident began with a call to dispatch and the message “Something’s wrong with a child.”
A caller who hangs up after giving an address yet providing few details about the situation, “is one of the worst things we can get in the dispatch because you’re going to be walking into anything from zero to 100,” Katzenstein told The Jerusalem Post. The moment it is clear that multiple children are unconscious, first responders treat the incident as a potential environmental threat.
“We don’t know if it’s poison. We don’t know if it’s terror. We don’t know if it’s criminal. We don’t really care [it doesn’t matter]. But this is no longer a safe place for the people we’re treating. It’s no longer a safe place for us as first responders,” Katzenstein said.
Hatzalah prioritizes CPR over optics
“I don’t want to steal some of the newspaper’s selling points, but as far as kids in every corner and in the bathroom, all that stuff, that’s bogus. Because what happened was that when they [Hatzalah] went in to start CPR, they moved the kids out of the room into any area.”
Katzenstein explained that when performing CPR, space is needed for many people. And it is loud, so to avoid waking the kids, the mattresses were moved.
“What are you going to do? You take a kid, get out. Right now, I’ve got an emergency; I don’t care about optics. I care about the emergency right here. I don’t know if anyone even contemplated how bad it looked, or optics,” he said.
As crews recognized the signs of a possible toxic exposure, they “backpedaled,” pulling everyone out of the building while firefighters entered, “geared up for battle” in full masks and protective gear.
Katzenstein stated he “switched hats” as soon as he heard that CPR was being performed on a child because such calls almost always require psychotrauma support for families and bystanders.
“And then they said second CPR, and I realized this was something else,” Katzenstein said, noting this was when he decided to go to the scene.
Katzenstein said that upon arriving at the scene, the sight of firefighters in full gear signaled serious concern. His first thought, he recounted, was carbon monoxide poisoning, but he emphasized that responders do not fixate on theories during an unfolding crisis.
“Part of psychotrauma response is what’s called psychological first aid, taking care of basic needs,” he explained.
“A person cannot function in their optimal psychological state. If their basic physical needs are not addressed, someone who is shivering from the cold, someone whose nose is running from crying… he will not be functioning optimally in that state, so we need to address that first. We’ll get him a coat. We’ll get some tissues, whatever it takes.
The first responders quickly realized that the children were at risk of hypothermia because they weren’t dressed for the outdoors. Therefore, he explained, the decision to evacuate had to be matched with rapid transfers to warmer locations.
Katzenstein described this as “psychological first aid,” the initial phase of psychotrauma care. Teams secured warmth, privacy, and communication tools while maintaining situational safety.
According to Katzenstein, activating the psychotrauma unit meant bringing not only clinicians but also support volunteers to handle logistics so medics could concentrate on stabilization and transport.
To reunite parents and children quickly, the team set up a WhatsApp-based relay system. Volunteers photographed children before transport, sent the images, and coordinated with United Hatzalah personnel embedded in hospital emergency rooms.
Those staff served as “eyes and ears” for the field, tracking which children had arrived, who was identified, and which parents were still searching.
“We had quite the network running between the EMTs in the field, the emergency room adjunct staff, and the psychotrauma crisis response,” Katzenstein said.
He added that some haredi parents did not use WhatsApp, so volunteers adapted on the spot, asking repeatedly, “Is this your kid?” as they matched images and names and arranged rides.
At one point, he handed over his own car keys so volunteers could shuttle parents to and from hospitals. “Take my car,” he told them. “Go to Ein Kerem, and come back.”
Katzenstein described a structured approach to preventing acute stress from hardening into longer-term disorders. He said that teams coach controlled breathing, including a breathing exercise he calls af al pi (a play on “nose, hold, mouth”) to counter hyperventilation and restore clear thinking.
Two phrases anchor the early intervention, he said: “The incident is over” and “I am fine.” He asks distraught people to repeat those lines, and if they cannot yet do so, he waits and revisits until they can.
“I don’t know where my child is, but if I am fine, I can speak and deal with everything that is going on,” he explained, emphasizing the inefficiency of simply telling someone to “calm down.”
“Telling people ‘calm down’ is not productive,” he said. “Calming people, that is the initial strategy of the response mechanism: to settle people, to orient them to what is happening, and to prevent the early onset of PTSD.”
He emphasized that for parents, speculating about causes does not help in the moment. “They don’t care whether it was a terror attack or whether it was poison, whether it was malicious, negligent, or accidental,” he said. “They want their child.” His focus, he said, is to stop parents from expending precious emotional energy by running randomly and instead guide them efficiently toward reunification.
While he said he wasn’t inside the daycare center and did not assess conditions there, he noted the value of cultural fluency when addressing families under extreme stress.
As a haredi volunteer himself, he said he knows how to speak with spouses in ways that respect communal norms; for example, involving a husband when addressing a hassidic wife. He added that United Hatzalah established an Arab psychotrauma team so Arabic speakers and culturally fluent responders can lead care when needed.
Once transports were complete, the team moved parents off the street to a community center on Petah Tikva St. around the corner, where they had bathrooms, water, paper and pens, and a quieter space. Municipal social workers arrived toward the end of the incident to join hospital social workers in formally taking over. “It’s teamwork, it’s a handoff,” Katzenstein said.
He said that United Hatzalah responders also support one another after such events. That evening, he recounted, all responders who were on scene, whether primary or secondary, were invited to a debrief circle at headquarters to process the experience together. “Every single responder who responded… is invited,” he said.
When asked whether shifting theories about the cause, from possible gas to poisoning to other scenarios, changed the approach that was used, Katzenstein was clear: The specifics “essentially… do not matter” during the first hours.
“I am not going to get lost in the weeds of what happened. I am going to help parents find their children,” he said. The task was to keep parents focused, conserve their emotional resources, and ensure that every child and guardian was matched as quickly as possible.
“I think this was the team’s finest hour,” he said.
“The very best of the team – providing that bridge service from the scene to the social-work network that already exists.”