Www.bcas.ca
Download
1 / 36

bcas - PowerPoint PPT Presentation


  • 118 Views
  • Uploaded on

www.bcas.ca. www.ceep.ca. EMS Preparedness for Tactical Violence. Karen Wanger MDCM, FRCPC Regional Medical Director BC Ambulance Service. CAEP 2009. Disclosure.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'bcas' - abril


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript


Ems preparedness for tactical violence
EMS Preparedness for Tactical Violence

Karen Wanger MDCM, FRCPC

Regional Medical Director

BC Ambulance Service

CAEP 2009


Disclosure
Disclosure

  • I do not have an affiliation (financial or otherwise) with any commercial organization that may have a direct or indirect connection to the content of my presentation.

  • And I am not Demi Moore...


Learning objectives
Learning objectives

  • Understand “tactical EMS” vs. “tactical EMS”

  • Learn what the perceived preparedness status is of front line responders in Canada


Introduction
Introduction

  • Paramedics are essentially the only medical personnel routinely at the scene of violent episodes

  • 8.5% of scenes are the result of some form of violence

  • Up to 90% of EMS staff report an episode of violence directed at them.

CAEP 2009


Tactical violence
Tactical Violence

  • Defined as:

    • “the deployment of extreme violence in a non-random fashion so as to achieve a tactical or strategic goal”

  • Preparation for Tactical Violence is a routine part of training for police and military but not EMS

CAEP 2009


Tactical violence1
Tactical Violence

  • Tactical violence = multi agency approach

  • Targeted violence + law enforcement = change from “normal” EMS response mode

  • Safe and efficient functioning specific training including training with the other responding agencies.

CAEP 2009


Tactical teams
Tactical Teams

  • A few

  • These teams are generally deployed in advance of a call when law enforcement is planning a tactical manoeuvre.

CAEP 2009


Tactical violence2
Tactical Violence

  • Violence that is “tactical” in nature employed by an outside “agency” as in terrorism would occur without warning.

  • The estimated time to scramble a specialist tactical team is roughly one hour

  • Front line paramedics would be required to manage the scene for that time.

CAEP 2009


Violence
Violence

  • Paramedics are experienced and well versed in dealing with interpersonal violence on calls.

  • Patient/patient or “perp”/patient.

  • Violence towards a paramedic is generally one-on-one from a patient and is understood by the paramedic

CAEP 2009


Tactical v responders
Tactical v. responders

  • A large component of “intentional/random” violence or violence directed towards responders changes everything.

  • Including subsequent processing.

CAEP 2009


Targeted tactical management
Targeted tactical - management

  • Isreali paramedics approach tactical violence scenes differently from other MCI’s. It is understood that secondary devices aimed at responders are a reality.

  • Casualties are moved quickly and the scene emptied in minutes.

CAEP 2009


Are we prepared
Are we prepared?

  • Survey of pre-hospital providers in BC and Ontario

  • January to June 2006

  • Daniel Kollek and Michelle Welsford.

  • Addressed the self-reported training and readiness in the following areas:

CAEP 2009


Survey topics
Survey topics:

  • 1. Training for response to a tactical violence or terrorist scene;

  • 2. The level of comfort responding to a complex event (mass casualty, violent, etc);

  • 3. The level of comfort in detecting and dealing with the emotional impact of providing care;

  • 4. The added emotional impact caused by violence, clinical load, and child injuries at the event scene.

CAEP 2009


Topics and methodology
Topics and Methodology

  • Emotional impact was assessed by grading response to a variety of scenarios including violence and tactical violence, and the presence of combinations of adult and paediatric victims.

CAEP 2009


Population
Population

  • Ontario and BC paramedics and first responders

  • Posted on a website only accessible by individuals knowing its complex address.

  • Invitation by email and poster in Ontario

  • In BC email invitations to paramedics through BC Ambulance. FR’s invited via FCABC distribution.

CAEP 2009


Survey questions
Survey questions

  • 3 basic areas:

    1) Scenarios – quantify degree of distress 1 (“not distressing to any significant degree”) to 5(“distressing to the degree that you would not be able to deliver care”)

CAEP 2009


Survey questions1
Survey questions

  • 2) Report degree of training and comfort in responding to the following events:

    • Fire

    • Response to an unstable building

    • Response to a terror event

    • Response requiring use of elevated PPE

    • Response to a tactical violence situation

CAEP 2009


Survey questions2
Survey questions

  • 3) Ability to recognize emotional distress in self or partner and comfort with CISD

CAEP 2009


Results
Results

  • 1028 respondents

    • Mostly male (75%)

    • Mostly PCP (55%)

    • Age 36-50 (48%)

    • Wide range of years of experience

    • Predominantly front line personnel

CAEP 2009


Results training
Results - training

  • Regarding “procedures to follow in responding to a tactical violence scene where there my be further violence” 77% of 876 respondent stated they had received no training.

  • 92% of 289 respondents stated police to be in control of site access in a tactical violence situation but 4.5% “did not know” who would be in control of the scene.

CAEP 2009


Results training1
Results - training

  • “...trained to function under conditions of tactical violence”. 89% of 288 respondents – “never” (46%) or “>1yr”

  • Only 27% of 291 respondents had “..any field exercise with other (non-medical) first responders”. 37% had exercised more than 1 year ago and 36% “never”

CAEP 2009







Progress
Progress

  • MCI training

  • Awareness training


Discussion
Discussion

  • Targeted tactical violence is a reality

  • Some paramedics are trained to back up police in tactical situations organized and controlled by PD

  • A paucity of front line paramedics are trained to respond in a situation of tactical violence targeted at first responding crews. Some don’t even know who would be in charge.

CAEP 2009


Discussion1
Discussion

  • Even the “lesser” of the factors in the scenarios more than doubled the emotional impact of the event as rated.

  • These factors are not unusual (child injury, assault, etc)

  • Emotional self care is not part of standard training for paramedics

CAEP 2009


Discussion2
Discussion

  • Monitoring for psychological impact is not routinely carried out although some services have implemented post incident debriefing.

  • 97% of respondents admitted to occasional unwanted memories of distressing events with 31% stating it would take up to a week to process the event and 15% stated they did not think they would “ever get over witnessing such an event”

  • 26% stated they would process the event immediately and it would not bother them for any significant length of time.

CAEP 2009


Tema conter foundation
Tema Conter Foundation

www.tema.ca

CAEP 2009


Conclusions
Conclusions

  • Inadequate numbers of EMS personnel are prepared to function at a scene of terror or tactical violence directed at responders. Awareness and education should be provided

  • The emotional effect on paramedics of violence requires greater attention