The UK capital was recently struck by a heinous terror attack. As the nation watched the events unfold on TV, authorities and citizens were most impressed with the speed and efficiency of police and the paramedics. The Ambulance Service declared the attack as a ‘major incident’. Social media was flooded with comments regarding what this meant, as it was already obvious for the whole nation that the attack was a ‘major incident’.
Translated to paramedic practice, declaring a ‘major incident’ helps with the command and control of dealing with the incident. It allows timely reallocation of resources. Despite continued pressure placed upon the emergency services, especially the ambulance service, it was evident that an efficient and effective tri-partied emergency response is readily available as and when required. Having this incident declared as a ‘major incident’, relatively early within the continuum of the event, allows for the infrastructure and processes to be managed through a set procedure, which spans all three blue light services, HEMS and other supporting resources.
The multiple casualty terrorist incident in Westminster, London, on Wednesday 22 March 2017, gave witness to the interagency approach of dealing with such events. Along with the Metropolitan Police Service, London Fire Brigade and London's Air Ambulance (HEMS London), the London ambulance service demonstrated their capability of providing a rapid multiple response to the incident. Along with their frontline paramedic crews, they were supported by members of the Hazardous Area Response Team (HART), specialist response units, HEMS London, and a supporting command and control infrastructure.
In recent times we have often heard a great deal from the media around the stress and strains placed upon the UK NHS ambulance service and hospital accident and emergency (A&E) services, in particular, the ambulance crews and nurses working to keep patients safe. Yet the events of 22 March are a stark reminder of the unpredictable, challenging and often dangerous role in which paramedics operate. The challenges and stress generated by these traumatic incidents require a special type of person to manage such events, often displaying self control and professionalism in these difficult times. Modern technology allows these awful events to be captured on film, either through close circuit television cameras (CCTV), mobile phone footage and aerial link footage from helicopters, which bring the horrors of the incident to us in real time.
The Westminster attacks were an alarming reminder that such events are always unprecedented, but something the paramedic forces need to be ready for. In addition to the paramedics' competence and integrity, what I found most striking was the compassion and detachment our paramedics had to operate with. Not only did they have to treat innocent civilians, but also the attacker who was wounded. Some angry members of the public criticised paramedics for treating the attacker who, to any onlooker, was a criminal. And yet, healthcare professionals were not at liberty to ignore a patient, innocent or otherwise. They must, as they did, attend to any injured human with the same compassion, regardless of moral judgement.