title: Changing the paradigm of emergency response: The need for first-care providers.
abstract: There is a major gap in the security of the critical infrastructure - civilian medical response to atypical emergencies. Clear evidence demonstrates that, despite ongoing improvements to the first-responder system, there exists an inherent delay in the immediate medical care at the scene of an emergency. This delay can only be reduced through a societal shift in reliance on police and fire response and by extending the medical system into all communities. Additionally, through analysis of military data, it is known that immediately addressing the common injury patterns following a traumatic event will save lives. The predictable nature of these injuries, coupled with an unavoidable delay in the arrival of first responders, necessitates the need for immediate care on scene. Initial care is often rendered by bystanders, typically armed only with basic first-aid training based on medical emergencies and does not adequately address the traumatic injury patterns seen in disasters. Implementing an approach similar to the American Cardiac Arrest Act can improve outcomes to traumatic events. This paper analyses the latest data on active shooter incidents and proposes that the creation of a network of trauma-trained medic extenders would improve all communities' resilience to catastrophic disaster.
authors.affiliation: MD FAAEM, 3535 East Coast Highway, Suite 243, Corona del Mar, CA 92625, USA.
authors.forename: Joshua P
authors.initials: JP
authors.lastname: Bobko
authors.forename: Richard
authors.initials: R
authors.lastname: Kamin
mesh_terms: D004632:Emergency Medical Services / Q000458:organization & administration*; D006301:Health Services Needs and Demand; D006801:Humans; D014481:United States / Q000453:epidemiology; D014754:Violence / Q000706:statistics & numerical data*; D014948:Wounds, Gunshot / Q000150:complications / Q000453:epidemiology* / Q000628:therapy