1Department of Emergency Medicine,Boston University School of Medicine,Boston,MassachusettsUSA.
3City of Boston Police Department Training Academy,Boston,MassachusettsUSA.
Prehosp Disaster Med. 2014 Aug;29(4):350-7. doi: 10.1017/S1049023X14000648. Epub 2014 Jul 9.
Emergency Medical Services (EMS) routinely stage in a secure area in response to active shooter incidents until the scene is declared safe by law enforcement. Due to the time-sensitive nature of injuries at these incidents, some EMS systems have adopted response tactics utilizing law enforcement protection to expedite life-saving medical care.
Describe EMS provider perceptions of preparedness, adequacy of training, and general attitudes toward active shooter incident response after completing a tactical awareness training program.
An unmatched, anonymous, closed-format survey utilizing a five-point Likert scale was distributed to participating EMS providers before and after a focused training session on joint EMS/police active shooter rescue team response. Descriptive statistics were used to compare survey results. Secondary analysis of responses based on prior military or tactical medicine training was performed using a chi-squared analysis.
Two hundred fifty-six providers participated with 88% (225/256) pretraining and 88% (224/256) post-training surveys completed. Post-training, provider agreement that they felt adequately prepared to respond to an active shooter incident changed from 41% (92/225) to 89% (199/224), while agreement they felt adequately trained to provide medical care during an active shooter incident changed from 36% (82/225) to 87% (194/224). Post-training provider agreement that they should never enter a building with an active shooter changed from 73% (165/225) to 61% (137/224). Among the pretraining surveys, significantly more providers without prior military or tactical experience agreed they should never enter a building with an active shooter until the scene was declared safe (78% vs 50%, P = .002), while significantly more providers with prior experience felt both adequately trained to provide medical care in an active shooter environment (56% vs 31%, P = .007) and comfortable working jointly with law enforcement within a building if a shooter were still inside (76% vs 56%, P = .014). There was no difference in response to these questions in the post-training survey.
Attitudes and perceptions regarding EMS active shooter incident response appear to change among providers after participation in a focused active shooter response training program. Further studies are needed to determine if these changes are significant and whether early EMS response during an active shooter incident improves patient outcomes.
急救医疗服务（EMS）通常会在安全区域待命，以应对活跃的枪手事件，直到执法部门宣布现场安全。由于这些事件中受伤的时间敏感性，一些 EMS 系统已经采用了响应策略，利用执法保护来加快救生医疗护理。
描述 EMS 提供者在完成战术意识培训计划后对活跃的枪手事件响应的准备情况、培训充分性和总体态度的看法。
在针对联合 EMS/警察活跃枪手救援小组响应的重点培训课程之前和之后，向参与的 EMS 提供者分发了一份未经匹配、匿名、封闭式格式的调查，使用五点李克特量表。使用描述性统计数据比较调查结果。根据先前的军事或战术医学培训进行的对响应的二次分析使用卡方分析。
256 名提供者参与了研究，88%（225/256）在培训前完成了调查，88%（224/256）在培训后完成了调查。培训后，提供者认为他们有足够的准备来应对活跃的枪手事件的协议从 41%（92/225）变为 89%（199/224），而他们认为有足够的培训在活跃的枪手事件中提供医疗护理的协议从 36%（82/225）变为 87%（194/224）。培训后，提供者认为他们不应该进入有活跃枪手的建筑物的协议从 73%（165/225）变为 61%（137/224）。在培训前的调查中，没有军事或战术经验的提供者更同意在现场宣布安全之前，他们永远不应该进入有活跃枪手的建筑物（78%比 50%，P =.002），而有经验的提供者则更相信他们在活跃的枪手环境中接受了充分的医疗培训（56%比 31%，P =.007），并且如果建筑物内仍有枪手，他们愿意与执法部门一起在建筑物内工作（76%比 56%，P =.014）。在培训后的调查中，对这些问题的回答没有差异。
在参加重点活跃枪手响应培训计划后，EMS 提供者对 EMS 活跃枪手事件响应的态度和看法似乎发生了变化。需要进一步的研究来确定这些变化是否显著，以及在活跃的枪手事件中早期 EMS 响应是否改善患者的结果。
