Perceptions of the Moral Obligations of Pediatric Nurses During an Active Shooter Event in a Children's Hospital

Walden, Marlene; Lovenstein, Austin; Ramick, Amy; Spray, Beverly J.; Denton, Anthony; McGinley, Jodie; Eisenberg, Leah; Adams, Greg; Plunkett, Jeffrey; Moore, Henry T.; Goddard, Clayton; Wooley, Charles F.; McElroy, Staci

doi:10.1016/j.pedn.2021.07.014

Cited by 1 publication

(1 citation statement)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is akin to the differentiation between a shooting event or an active shooting event, in which the threat is still on-going, according to the US Department of Homeland Security (Washington, DC USA). 27 The dilemma of health professionals faced with physical harm and the well-being of their patients is not unique to EMS providers; 28,29 however, the critical nature of injuries and the unique nature of care requires significant attention be placed when dealing with emergency care in uncertainty.…”

Section: Introductionmentioning

confidence: 99%

Rethinking the Current “Stage-and-Wait” Paradigm

Ragoler

Radomislensky

Dolev

et al. 2023

Prehosp. Disaster med.

View full text Add to dashboard Cite

Introduction: The experience of terrorist incidents involving a secondary explosive device that targeted rescue forces led to changes in the safety protocols of these forces in most countries of the world. These protocols are the foundation of the current “Stage-and-Wait” paradigm that prohibits the entry of Emergency Medical Services (EMS) from entering the scene and treating casualties until it is deemed safe. These guidelines were established absent of an evidence-base detailing the risk to responders and the potential consequences to the injured on-scene. The lack of clarity is compounded by the fact that different situations, as well as operational considerations, such as the length of time until bomb squad arrival at the scene versus time of massive bleeding injuries, for example, impact outcomes must be taken into account. Objective: This study sought to shed light on this matter while employing an evidence-based approach exploring the investigations of the frequency of secondary explosion threats in terrorist attacks over the last 20 years and discussing some of the ethical challenges and ramifications ensuing. While this study does not propose an outright change to current guidelines, in light of the evidence gathered, an open review and discussion based on the findings may be beneficial. Methods: The Global Terrorism Database (GTD) was used as the data source of bombing incidents world-wide. Results: The results revealed that approximately 70 per-1,000 bombing incidents involved secondary explosions across regions and countries within the study period. Conclusion: This study emphasizes the need to rethink the current “Stage-and-Wait” paradigm by recommending brainstorming conferences comprised of multi-sectoral experts aimed at deliberating the matter. World-wide experts in emergency medicine, bioethics, and disaster management should cautiously consider all aspects of bomb-related incidents. These brainstorming deliberations should consider the calculated risk of secondary explosions that account for approximately 70 per-1,000 bombing incidents. This study highlights the need to re-examine the current versus new paradigm to achieve a better balance between the need to ensure EMS safety while also providing the necessary and immediate care to improve casualty survival. This ethical dilemma of postponing urgent care needs to be confronted.

show abstract

Section: Introductionmentioning

confidence: 99%