Mobile attackers with bladed weapons, firearms, or explosive devices are currently a significant global threat to the public and emergency responders. The risk of chemicals, vehicles, and fire used as weapons adds further complexity to such attacks. Recent attacks have killed many innocent people: more than 9800 terror attacks occurred worldwide in 2018, resulting in 22 980 deaths.1 Some of these people might have survived had the medical response gained to access to them earlier. Emergency services face the problem of how to provide medical care to casualties in an area deemed under direct threat, known as the “hot zone.” Although many of the armed police responding in the hot zone are also trained to provide some lifesaving medical care, they are the same armed officers who are trained to first locate and stop the attackers—delaying their focus on medical interventions until the threat is controlled. The resulting therapeutic vacuum of medical intervention can last for minutes to hours after people are injured. We believe that the UK should adopt standard military practice in these attacks and enable armed police to give “care under fire,” alongside management of the immediate threat. Appropriately trained medical officers should also be integrated with the police in the hot zone: this happens in France, as seen in the Paris terror attacks in 2015. These steps would tackle many of the areas that currently encourage this potentially lethal therapeutic vacuum in the UK ...
Language: en
", language="en", issn="0959-535X", doi="10.1136/bmj.m298", url="http://dx.doi.org/10.1136/bmj.m298" }