Canadian Operational and Emotional Prehospital Readiness for a Tactical Violence Event

Abstract

Providing prehospital care poses unique risks. Paramedics are essentially the only medical personnel who are routinely at the scene of violent episodes, and they are more likely to be assaulted than are other prehospital personnel. In addition to individual acts of violence, emergency medical services (EMS) providers now need to cope with tactical violence, defined as the deployment of extreme violence in a non-random fashion to achieve tactical or strategic goals. This study reviewed two topics; the readiness of EMS crews for violence in their environment and the impact of violence on the EMS crew member. This latter also evaluated the access and effectiveness of emotional support available to caregivers exposed to violent episodes.The results of the survey indicate a significant lack of preparedness for situations involving tactical violence. A total of 89% of respondents either had never had such training or had been trained more than one year ago. Thirty-six percent of respondents had never engaged in a field exercise with other responding agencies, and 4.5% of respondents were not aware of who would be in charge in such an event. In addition, this study indicates that EMS crews are exposed to events with significant emotional impacts without access to appropriate training and adequate support.

Triage in Complex, Coordinated Terrorist Attacks

“…[15][16][17] Terrorist events and incidents with tactical violence are self-reported by paramedics as types of responses they are least comfortable with, feel least prepared for, and impart the highest levels of stress. 18 The overwhelming nature of CCTAs for prehospital responders emphasizes the need for triage systems that are able to be recalled and implemented effectively under situations of high stress with reduced fine motor skills.…”

Midwifery student reactions to workplace violence

“…While research into workplace violence in healthcare emphasises the prevalence rates and types of violence encountered (4,9), solutions offered often focus on what a victim of workplace violence can do to prevent or minimise the severity of the incident (10,11). A 2014 study into workplace violence against Canadian paramedics found that during a workplace violence incident, victims will attempt to deal with the situation themselves, call for help from a partner or police, physically or chemically restrain the perpetrator and in severe cases, retreat from the scene to the ambulance until the perpetrator has been subdued (12).…”

Canadian healthcare readiness for public health emergencies

“…4 When surveyed about preparedness for MCI, 89% of respondents have never received training for events involving tactical violence and 36% have never engaged in multiagency field exercises. 5 The lack of training puts the safety and health of EMS personnel at risk, which may lead to anxiety and hesitation in firstline workers, and, ultimately, jeopardizes the effectiveness of the response. EMS are not the only first responders to a crisis scene and lack of training with other agencies decreases the cohesiveness, …”