Disasters on campus: A cross-sectional survey of college EMS systems’ preparedness to respond to mass casualty incidents
DOI:
https://doi.org/10.5055/ajdm.2021.0411Keywords:
collegiate emergency medical services, mass casualty incidents, emergency preparednessAbstract
Objective: The objective of this study was to assess the training and readiness levels of Collegiate Emergency Medical Service (EMS) providers to respond to mass casualty incidents (MCIs).
Methods: An anonymous cross-sectional survey of Collegiate EMS providers was performed.
Participants: Participants were US-based EMS providers affiliated with the National Collegiate
Emergency Medical Services Foundation.
Outcome measures: The main outcome measures were levels of EMS experience and MCI training, subjective readiness levels for responding to various MCI scenarios, and analyzing the effect of the COVID-19 pandemic on MCI response capabilities.
Results: Respondents had a median age of 21 years (interquartile range IQR 20, 22), with 86 percent (n = 96/112) being trained to the Emergency Medical Technician-Basic level. Providers reported participating in an average of 1.6 MCI trainings over the last four years (IQR, 1.0, 2.2). Subjective MCI response readiness levels were highest with active assailant attacks followed by large event evacuations, natural disasters, hazardous material (HAZMAT) incidents, targeted automobile ramming attacks, explosions, and finally bioweapons release. Disparate to this, only 18 percent of participants reported training in the fundamentals of tactical and disaster medicine. With respect to the effect of the COVID-19 pandemic on MCI readiness, 27 percent of respondents reported being less prepared, and there was a statistically significant decrease in subjective readiness to respond to HAZMAT incidents.
Conclusion: Given low rates of MCI training but high rates of self-assessed MCI preparedness, respondents may overestimate their readiness to adequately respond to the complexity of a real-world MCI. More objective assessment measures are needed to evaluate provider preparedness.
References
Virginia Tech Review Panel: Mass Shootings at Virginia Tech Addendum to the Report of the Review Panel. Published online November. Available at https://scholar.lib.vt.edu/prevail/docs/April16ReportRev20091204.pdf, 2009.
Mrad DF, Hanigan AJS, Bateman JR: A model of service and training: Threat assessment on a community college campus. Psychol Serv. 2015; 12(1): 16-19. DOI: 10.1037/a0037202.
Bachman MW, Anzalone BC, Williams JG, et al.: Evaluation of an integrated rescue task force model for active threat response. Prehospital Emerg Care. 2019; 23(3): 309-318. DOI: 10.1080/10903127.2018.1521487.
Levy MJ: Intentional mass casualty events: Implications for prehospital emergency medical services systems. J Spec Oper Med Peer. 2015; 15(4): 157-159.
Fisher J, Ray A, Savett SC, et al.: Collegiate-based emergency medical services (EMS): A survey of EMS systems on college campuses. Prehosp Disaster Med. 2006; 21(2): 91-96. DOI: 10.1017/s1049023x00003411.
Atif A, Richards D, Bilgin A: Estimating non-response bias in a web-based survey of technology acceptance: A case study of unit guide information systems Published online 2012; 11: 1-10.
Pasley AM, Parker BM, Levy MJ, et al.: Stop the bleed: Does the training work one month out? Am Surg. 2018; 84(10): 1635-1638.
Weinman S: Retention of tourniquet application skills following participation in a bleeding control course. J Emerg Nurs. 2020; 46(2): 154-162. DOI: 10.1016/j.jen.2019.10.020.
Goralnick E, Chaudhary MA, McCarty JC, et al.: Effectiveness of instructional interventions for hemorrhage control readiness for laypersons in the public access and tourniquet training study (PATTS): A randomized clinical trial. JAMA Surg. 2018; 153(9): 791-799. DOI: 10.1001/jamasurg.2018.1099.
de Ruijter PA, Biersteker HA, Biert J, et al.: Retention of first aid and basic life support skills in undergraduate medical students. Med Educ Online. 2014; 19: 24841. DOI: 10.3402/meo.v19.24841.
Frederiks ER, Romanach LM, Berry A, et al.: Making energy surveys more impactful: Testing material and non-monetary response strategies. Energy Res Soc Sci. 2020; 63: 101409. DOI: 10.1016/j.erss.2019.101409.
Groves RM, Peytcheva E: The impact of nonresponse rates on nonresponse bias: A meta-analysis. Public Opin Q. 2008; 72(2): 167-189. DOI: 10.1093/poq/nfn011.
Goyder J: The Silent Minority: Nonrespondents on Sample Surveys. Milton Park: Routledge, 2019.
Kenhove PV, Wijnen K, Wulf KD: The influence of topic involvement on mail-survey response behavior. Psychol Mark. 2002; 19(3): 293-301. DOI: 10.1002/mar.1053.
Dunning D, Griffin DW, Milojkovic JD, et al.: The overconfidence effect in social prediction. J Pers Soc Psychol. 1990; 58(4): 568-581. DOI: 10.1037//0022-3514.58.4.568.
Muller A, Sirianni LA, Addante RJ: Neural correlates of the Dunning–Kruger effect. Eur J Neurosci. 2021; 53(2): 460-484. DOI: 10.1111/ejn.14935.
Prozesky DR, Molwantwa MC, Nkomazana O, et al.: Intern preparedness for the CanMEDS roles and the Dunning-Kruger effect: A survey. BMC Med Educ. 2019; 19(1): 422. DOI: 10.1186/s12909-019-1836-z.
Ahmed O, Walsh TN: Surgical trainee experience with open cholecystectomy and the Dunning-Kruger effect. J Surg Educ. 2020; 77(5): 1076-1081. DOI: 10.1016/j.jsurg.2020.03.025.
Belmont PJ, McCriskin BJ, Sieg RN, et al.: Combat wounds in Iraq and Afghanistan from 2005 to 2009. J Trauma Acute Care Surg. 2012; 73(1): 3-12. DOI: 10.1097/TA.0b013e318250bfb4.
Kragh JF, Walters TJ, Baer DG, et al.: Survival with emergency tourniquet use to stop bleeding in major limb trauma. Ann Surg. 2009; 249(1): 1-7. DOI: 10.1097/SLA.0b013e31818842ba.
Weppner J, Lang M, Sunday R, et al.: Efficacy of tourniquets exposed to the Afghanistan combat environment stored in individual first aid kits versus on the exterior of plate carriers. Mil Med. 2013; 178(3): 334-337. DOI: 10.7205/MILMED-D-12-00454.
Smith ER, Shapiro G, Sarani B: The profile of wounding in civilian public mass shooting fatalities. J Trauma Acute Care Surg. 2016; 81(1): 86-92. DOI: 10.1097/TA.0000000000001031.
Mills B, Dykstra P, Hansen S, et al.: Virtual reality triage training can provide comparable simulation efficacy for paramedicine students compared to live Simulation-Based scenarios. Prehospital Emerg Care. 2020; 24(4): 525-536. DOI: 10.1080/10903127.2019.1676345.
Tovar MA, Bell RS, Neal CJ: Epidemiology of blast neuro-trauma: A meta-analysis of blast injury patterns in the military and civilian populations. World Neurosurg. 2021; 146: 308-314.e3. DOI: 10.1016/j.wneu.2020.11.093.
Edwards DS, McMenemy L, Stapley SA, et al.: 40 years of terrorist bombings—A meta-analysis of the casualty and injury profile. Injury. 2016; 47(3): 646-652. DOI: 10.1016/j.injury.2015.12.021.
Luigi Ingrassia P, Ragazzoni L, Carenzo L, et al.: Virtual reality and live simulation: A comparison between two simulation tools for assessing mass casualty triage skills. Eur J Emerg Med. 2015; 22(2): 121-127. DOI: 10.1097/MEJ.0000000000000132.
Lowe J, Peng C, Winstead-Derlega C, et al.: 360 virtual reality pediatric mass casualty incident: A cross sectional observational study of triage and out-of-hospital intervention accuracy at a national conference. J Am Coll Emerg Physicians Open. 2020; 1(5): 974-980. DOI: 10.1002/emp2.12214.
Merkle DM: Nonresponse bias. In Encyclopedia of Survey Research Methods, pp. 532-533. New York: SAGE Publications, Inc., 2008.
Lahaut VMHCJ, Jansen HAM, van de Mheen D, et al.: Estimating non-response bias in a survey on alcohol consumption: Comparison of response waves. Alcohol Alcohol. 2003; 38(2): 128-134.
Studer J, Baggio S, Mohler-Kuo M, et al.: Examining nonresponse bias in substance use research—Are late respondents proxies for non-respondents? Drug Alcohol Depend. 2013; 132(1): 316-323.
Published
How to Cite
Issue
Section
License
Copyright 2007-2023, Weston Medical Publishing, LLC
All Rights Reserved
