First respondersLessons for first responders on the front lines of terrorism
Acts of terrorism are on the rise globally. Over the past several weeks alone, the world has seen stabbings, shootings and bombings in Flint, Tehran, London, Kabul and Bogota. Given the persistent risk of terrorist attacks and large-scale accidents, it’s more critical than ever to learn from past incidents. That will ensure that first responders can work together effectively during the chaotic but critical minutes and hours after an incident.
Acts of terrorism are on the rise globally. Over the past several weeks alone, the world has seen stabbings, shootings and bombings in Flint, Tehran, London, Kabul and Bogota.
We’ve spent the past several years researching how communities can prepare to provide urgent medical care to the large numbers of victims these events produce.
Given the persistent risk of terrorist attacks and large-scale accidents, it’s more critical than ever to learn from past incidents. That will ensure that first responders can work together effectively during the chaotic but critical minutes and hours after an incident.
Better coordination
Televised images of attack or disaster scenes often show patients being treated and transported by paramedics. Hours later, hospital press conferences often recount the heroic efforts of emergency physicians, trauma surgeons and nurses to minimize loss of life and limb.
But equally important are the actions of nonmedical first responders. Police, firefighters and even bystanders compress wounds, apply tourniquets or drive casualties to hospitals.
In the Boston marathon bombing, for instance, 264 victims transported to local hospitals survived, despite many serious injuries. This was credited not only to excellent triage, transport and care by medically trained paramedics, EMS and hospital staff, but also to immediate lifesaving actions by police and bystanders.
However, things do not always go so well. In the often chaotic post-incident scene, it can be difficult to coordinate the efforts of multiple response agencies and bystanders. Even as EMS personnel triage and transfer victims, law enforcement needs to maintain security, preserve evidence and locate potential perpetrators. That makes it challenging to manage access to and traffic around the scene.
For instance, an Orlando Police Department report on the Pulse nightclub attack cited the need for improved communication and coordination between the police and fire departments responding to the incident. While such problems do not always affect how many lives are saved, they can slow down the overall response.
Even when well-coordinated, those not trained in post-disaster casualty triage can unintentionally cause problems. They might transfer patients to hospitals that lack the resources needed to treat them, or transfer them in vehicles that lack critical life-support equipment, such as IVs or oxygen.
What’s more, unforeseen events such as poor weather or volume-related cell tower outages can create additional challenges.
