title: 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] = 0.91, 95% CI: 0.84-0.99; ARR = 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.
authors.affiliation: Disaster Response & Resilience Research Group (DRR), School of Medicine, University of Western Sydney, Sydney, New South Wales, Australia. g.stevens@uws.edu.au
authors.forename: Garry
authors.initials: G
authors.lastname: Stevens
authors.forename: Alison
authors.initials: A
authors.lastname: Jones
authors.forename: George
authors.initials: G
authors.lastname: Smith
authors.forename: Jenny
authors.initials: J
authors.lastname: Nelson
authors.forename: Kingsley
authors.initials: K
authors.lastname: Agho
authors.forename: Melanie
authors.initials: M
authors.lastname: Taylor
authors.forename: Beverley
authors.initials: B
authors.lastname: Raphael
mesh_terms: D000293:Adolescent; D000328:Adult; D000488:Allied Health Personnel / Q000706:statistics & numerical data*; D002983:Clinical Competence / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004189:Disaster Planning / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D054527:Mass Casualty Incidents; D008875:Middle Aged; D009517:New South Wales; D055815:Young Adult