Safety First or Saving Lives? How Medical Responders Would Decide when Facing an Active Violent Incident. Results from an Explorative Cross-National Survey
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Nils Ellebrecht
,
Anna Joval
Abstract
In recent years, public authorities and rescue services have been discussing how Medical First Responders (MFRs) should behave in an Active Violent Incident (AVI) where it is necessary to weigh up self-protection and the rescuing of others. The aim of this exploratory study is to generate a preliminary picture of how European MFRs position themselves on this and related questions. With the help of a network of experts, an AVI scenario and accompanying questionnaire were developed and pretested. A refined version was then distributed among MFRs in eight European countries and Israel. We performed descriptive statistics and tested for significant differences among the participating countries. 1164 MFRs completed the survey. In the absence of police protection, a majority of respondents opted against providing immediate casualty care (56.6 %). Under certain circumstances, however, the rest decided in favour. More than 65.5 % did not fear disciplinary or legal consequences for not providing assistance immediately. Even with police protection, one in ten respondents would still not enter a “yellow zone”, one in four would leave this to Emergency Medical Services (EMS) units specifically trained for such operations. While there are very few strong contrasts between MFRs with different work experience, roles (supervisor/instructor) or additional qualifications (e.g., firefighting, military service), there are significant differences between MFRs from participating countries. Most notably, (1) only Norwegian participants identified, on average, a clear paradigm shift from “safety first” to “controlled risk taking”; (2) while 69.8 % of the Austrian cohort were unwilling to enter without being escorted by the police, among Norwegians MFRs the figure was 42.7 %; (3) the question whether “weapons” are “useful” equipment in such a scenario is particularly divisive (ranging from 14.3 % of German to 58.9 % of Israeli respondents). Although most of the questions were answered in the same way by a large majority, significant differences can be observed, especially between countries. We offer various explanations for these and discuss whether MFRs can actually remain passive given the situational normative forces inherent to an AVI.
Funding source: Horizon 2020 Framework Programme
Award Identifier / Grant number: No. 786670
Acknowledgements
We would like to thank NO-FEAR’s project team (particularly: Su Anson, Catherine Bertrand, Rachele Brancaleoni, Francesco Della Corte, Cornelia Madalina Dusciuc, Barbara Juen, Stefan Kaufmann, Alexander Kreh, Michael Lindenthal, Monica Linty, Natasha McCrone, Paloma Covadonga Rey Paterna, Frederik Francois Siem, Paloma Miravet Gonzales) as well as Kilian Bertho, Cristina Guerrero Camacho, Tina Ivanov, Marta Trayner, Britta Seifer, Lukas Simon Steiner and others for their support during the various stages of this study (especially in questionnaire development and translation and for promoting the survey in their countries).
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Research ethics: The study obtained positive feedback from NO-FEAR’s External Ethics Review Board. Magen David Adom’s (MDA) research committee (the committee is composed of MDA management representatives, senior physicians and researchers) approved the dissemination of the survey among MDA personnel. Compliance with European Union’s General Data Protection Regulation was monitored by NO-FEAR’s Ethics Advisor, Saverio Caruso. Personal data collected and used is limited to the participant’s occupation, country of work and work experience (in years). As no further personal data was collected, the survey remained completely anonymous.
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Informed consent: Not applicable.
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Competing interests: The authors declare that they have no competing interest.
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Data availability: SPSS dataset available by request.
List of Abbreviations
- AVI
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active violent incident
- CC
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Contingency coefficient
- DEPA
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Dispositivo Especial Preventivo Actos Antisociales (Preventive Action in Urban Riots and Antisocial Acts)
- EMS
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emergency medical services
- EMT
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emergency medical technician
- FEMA
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United States Federal Emergency Management Agency
- IPRED
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International Preparedness & Response to Emergency & Disasters
- MCI
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Mass Casualty Incident
- MFR
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Medical first responder
- PPE
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Personal Protective Equipment
- TECC
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Tactical Emergency Casualty Care
- TEMS
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Tactical Emergency Medical Support/Services
- TRU
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Tactical Response Units
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Artikel in diesem Heft
- Frontmatter
- Research Articles
- Safety First or Saving Lives? How Medical Responders Would Decide when Facing an Active Violent Incident. Results from an Explorative Cross-National Survey
- Use of Crisis Communication Strategies by Food Bank Network During a Global Pandemic
- Strategic Planning for Post-Earthquake Health Services Continuity: Leveraging Family Healthcare Centers in Istanbul
- Opinion
- Beyond Chinese Spy Balloons: Why We Need to Teach East Asian Studies in U.S. Homeland Security and Emergency Preparedness Programs
- Communications
- How a Chemical Weapons Threat Positively Impacted a Hospital’s Emergency Preparedness
Artikel in diesem Heft
- Frontmatter
- Research Articles
- Safety First or Saving Lives? How Medical Responders Would Decide when Facing an Active Violent Incident. Results from an Explorative Cross-National Survey
- Use of Crisis Communication Strategies by Food Bank Network During a Global Pandemic
- Strategic Planning for Post-Earthquake Health Services Continuity: Leveraging Family Healthcare Centers in Istanbul
- Opinion
- Beyond Chinese Spy Balloons: Why We Need to Teach East Asian Studies in U.S. Homeland Security and Emergency Preparedness Programs
- Communications
- How a Chemical Weapons Threat Positively Impacted a Hospital’s Emergency Preparedness
