Practical thoughts on #SpontaneousResponders
It's important to acknowledge that the first people to respond to any incident will often be the lay person who uses their initiative; the relative, the work colleague, the fellow commuter
Day to day, this can be the difference
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It's important to acknowledge that the first people to respond to any incident will often be the lay person who uses their initiative; the relative, the work colleague, the fellow commuter
Day to day, this can be the difference
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We will all meet / have met a patient who was saved by a non-uniformed #SpontaneousResponder
Perhaps via public access defibrillation or good first aid
This is the system working! Amazing projects like @GoodSamApp/@ThecitizenAID show us how
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Perhaps via public access defibrillation or good first aid
This is the system working! Amazing projects like @GoodSamApp/@ThecitizenAID show us how
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But what about when the incident is less 'routine'
Think big
Explosions, terrorist attacks & major incidents all come with a #TherapeuticVacuum. A clinical void where formal incident response is delayed by ongoing threat / due to the demands of co-ordination prior to access
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Think big
Explosions, terrorist attacks & major incidents all come with a #TherapeuticVacuum. A clinical void where formal incident response is delayed by ongoing threat / due to the demands of co-ordination prior to access
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With this change in scale we will continue to see the lay person using their initiative
However with larger incidents, we are more likely to see off-duty professionals, whether healthcare, police or otherwise.
The right people in the wrong place at the right time.
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However with larger incidents, we are more likely to see off-duty professionals, whether healthcare, police or otherwise.
The right people in the wrong place at the right time.
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Hands up who has met this guy in training? Or perhaps even played him in a scenario?
✋🤚✋🖐️🤚✋🖐️✋☝️
Thought so!
The loud, irritating distraction? Incessant inconsolable theatrical distress? Perhaps he kept trying to steal your s**t?
Actively "Stress Inoculating" you
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✋🤚✋🖐️🤚✋🖐️✋☝️
Thought so!
The loud, irritating distraction? Incessant inconsolable theatrical distress? Perhaps he kept trying to steal your s**t?
Actively "Stress Inoculating" you
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He has a place. But not here.
We need to be preparing to respond to incidents like this.
Our aim is not to test our conflict resolution with a bad actor until he is coached behind a police cordon.
Our aim is to integrate into this team of #SpontaneousResponders
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We need to be preparing to respond to incidents like this.
Our aim is not to test our conflict resolution with a bad actor until he is coached behind a police cordon.
Our aim is to integrate into this team of #SpontaneousResponders
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It's not enough to simply nod and agree
"Yes Sean, there will be #SpontaneousResponders. I get it, thanks"
There might also be a Fire Appliance on-scene. Knowing that fact doesn't mean you're able to use it when you get there.
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"Yes Sean, there will be #SpontaneousResponders. I get it, thanks"
There might also be a Fire Appliance on-scene. Knowing that fact doesn't mean you're able to use it when you get there.
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We need to consider this integration as it's own skill and train for it as we would do anything else.
How often have you practiced instructing a lay person how to log roll, cut off clothings, apply pressure or maintain an airway?
Sounds basic, yes. It won't be on the day
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How often have you practiced instructing a lay person how to log roll, cut off clothings, apply pressure or maintain an airway?
Sounds basic, yes. It won't be on the day
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How often have you practiced arriving to a semi-established scene where the demands on the responder out-strip their clinical capability?
I don't mean 1 paramedic & 12 patients
Nor a difficult bystander
But a concerned clinician, caught up in the incident with a patient
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I don't mean 1 paramedic & 12 patients
Nor a difficult bystander
But a concerned clinician, caught up in the incident with a patient
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Practice.
You'll be amazed at how your methods will change. Anatomical descriptions will be replaced with 'bladed' points with the hand. Terminology will boil down to its least confusing.
High threat comms:
Clear. Loud. as an Order. with Pauses.
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You'll be amazed at how your methods will change. Anatomical descriptions will be replaced with 'bladed' points with the hand. Terminology will boil down to its least confusing.
High threat comms:
Clear. Loud. as an Order. with Pauses.
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How many gloves do you carry?
There will be blood. Protect your #SpontaneousResponders. Carry more.
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There will be blood. Protect your #SpontaneousResponders. Carry more.
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How many trauma sheers/TufCut scissors do you carry?
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Arriving as an initial response will never be a comfortable place to be. Lots to do. More than you can.
So, optimise your #SpontaneousResponders
Provision of shears allows your new team to look for injuries; it's preempting a clinical course & will find big sick for you
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So, optimise your #SpontaneousResponders
Provision of shears allows your new team to look for injuries; it's preempting a clinical course & will find big sick for you
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One of the most significant limitations to clinical care in these environments is casualty flow & extrication?
Boiled down, it's a mass manual handling exercise
#SpontaneousResponders are there. Use them, teach them. Use simple techniques, safely taught on-scene.
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Boiled down, it's a mass manual handling exercise
#SpontaneousResponders are there. Use them, teach them. Use simple techniques, safely taught on-scene.
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Treatment doesn't wait for formal triage to occur - there is no orderly queue.
Yes, we need to quantify & stratify what we have, but our patients & their families do not care whether you bring a snap band, triage tag or sharpie. The want, expect & deserve immediate care
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Yes, we need to quantify & stratify what we have, but our patients & their families do not care whether you bring a snap band, triage tag or sharpie. The want, expect & deserve immediate care
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We know that formal triage takes time, time other patients may not have - ultimately it's a whole other topic on its own.
For now, let's consider it as a concurrent activity alongside early haemorrhage control and early patient access.
All are important. All need to happen
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For now, let's consider it as a concurrent activity alongside early haemorrhage control and early patient access.
All are important. All need to happen
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Community training is integral to resilience.
We need to include the concept into our planning, training and operational response.
Ensure your formal responders are prepared to work with, enable and support those already trying their hardest - those that want to help!
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We need to include the concept into our planning, training and operational response.
Ensure your formal responders are prepared to work with, enable and support those already trying their hardest - those that want to help!
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