A grounded theory exploration into situational adaptation strategies developed by Paramedics when dealing with mass casualty incidents
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AbstractThe Manchester (U.K.) Arena bombing took place on the 22nd May 2017 at 22:31, when a suicide bomber detonated an improvised explosive device in the foyer of the Manchester Arena, as the crowd was leaving an event. The attack claimed the lives of 22 people, and a further 116 people required medical treatment, mostly for ballistic injuries. A key objective for Ambulance Service Commanders was to establish a casualty management system consisting of clinical triage, treatment, and transport of patients from a Casualty Collection Point into the hospital network. To achieve this, two Hazardous Area Response Teams were deployed alongside Consultant and Advanced Paramedics. The purpose of which was to provide point of injury care within the vicinity of the blast area. Whereas previous studies have identified how individuals react to the biopsychosocial response to traumatic incidents post the event, understanding how Ambulance Service personnel adapt to situations while deploying to, or during mass casualty incidents, remains an area that has received limited research in relation to defining empirical evidence. This study aimed to identify a process that either supported or inhibited Paramedics in achieving situational adaptability when dealing with a mass casualty situation. Constructivist Grounded Theory was used as the chosen methodology, with fifteen Paramedics volunteering to participate in the research. Analysis identified eleven theoretical categories, which were then divided into four theoretical themes. Combined, these formed the basis for four major theoretical propositions: ‘Training & Education’, appropriate application of ‘Incident Management Frameworks’, established ‘Peer Support Networks’, and individual reaction to ‘Stress stimuli’. This study makes a novel contribution to the phenomenon of situational adaptively. The significance of the resulting theory is that situational adaptability can be enabled through the application of effective decision making strategies, being able to draw on previous experiences, along with effective scene management. This along with communication strategies, support from peers, the incident commander, and multi-agency partners. Key identified inhibitors are presented as situational stressors, perceptions of threat, risk appetite, and environmental stimuli. Consequently, it is now possible to provide four recommendations for Paramedics preparing to respond to mass casualty incidents.
CitationHooper, C. (2020). A grounded theory exploration into situational adaptation strategies developed by Paramedics when dealing with mass casualty incidents [Unpublished doctoral thesis]. University of Chester.
PublisherUniversity of Chester
TypeThesis or dissertation
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