Determinants of Paramedic Response Readiness for CBRNE Threats

Abstract

Paramedics play a pivotal role in the response to major emergencies. Recent evidence indicates that their confidence and willingness to respond to chemical, biological, radiological, nuclear, and explosives-related (CBRNE) incidents differs from that relating to their ''routine'' emergency work. To further investigate the factors underpinning their readiness to respond to CBRNE incidents, paramedics in New South Wales (NSW), Australia, were asked to complete a validated online survey instrument. Univariate and multivariate analyses were performed to examine associated factors determining readiness. The sample of 663 respondents was weighted to reflect the NSW paramedic population as a whole. The univariate analysis indicated that gender, length of service, deployment concern, perceived personal resilience, CBRNE training, and incident experience were significantly associated with perceived CBRNE response readiness. In the initial multivariate analysis, significantly higher response readiness was associated with male gender, university education, and greater length of service (10-15 years). In the final multivariate model, the combined effect of training/incident experience negated the significant effects observed in the initial model and, importantly, showed that those with recent training reported higher readiness, irrespective of incident experience. Those with lower concern regarding CBRNE deployment and those with higher personal resilience were significantly more likely to report higher readiness (Adjusted Relative Risk [ARR] ¼ 0.91, 95% CI: 0.84-0.99; ARR ¼ 1.40, 95% CI: 1.11-1.72, respectively). These findings will assist emergency medical planners in recognizing occupational and dispositional factors associated with enhanced CBRNE readiness and highlight the important role of training in redressing potential readiness differences associated with these factors. Paramedics have an integral role in mass casualty response. They may be called on to attend sites affected by chemical, biological, radiological, nuclear, and explosives-related (CBRNE) agents, including their calculated use by terrorist groups.1 Identifying factors that support the CBRNE response readiness of paramedics will assist workforce management and development with this critical group of responders.

Self‐reported preparedness of New Zealand acute care providers to mass emergencies before the Canterbury Earthquakes: A national survey

“…Another study among Australian paramedics in New South Wales found that training increases perception of CBRN readiness by 25%. Paramedics with previous experience were more likely to report readiness than inexperienced personnel . Interestingly, the study found that the benefit of having previous experience disappeared when controlling for training as a confounder .…”

Preparedness of Swedish EMS Personnel for Major Incidents in Underground Mines

“…Practical training is a strong factor for preparedness and it is stated [11] that the participants who had experience from real CBRNE events, experienced no significant higher readiness than those who performed a CBRNE exercise. A study on the correlation between the number of hours of training between paramedics and fire personnel practicing for major incidents and disasters and the perceived preparedness for these events showed that the level of perceived preparedness increased with the number of hours practiced [12].…”

“…It was found in another study that practical exercise compared to real events attained a more lasting knowledge of the performance of triage, which also enhances the idea of supplementing theoretical training with practical exercises. Practical exercises allow for feedback and the correction of errors in a safe learning environment, compared to actual events [11].…”

Perceived coping & concern predict terrorism preparedness in Australia

“…Efficacy-focused education for these workers may constitute cognitive ‘interventions’ that promote lower concern and greater response willingness; outcomes that may be crucial in maintaining emergency ‘surge’ capacity [17]. Among Australian paramedics for example, receipt of terrorism-related training focused on key competencies was found to be a stronger predictor of response readiness than career incident experience [36]. …”