The grey area

Alex Grant

Faculty: Medical Science
Department: Department of Allied Health
Course: BSc (Hons) Paramedic Science
Category: Allied and public health

9 March 2018

Weeks have passed since my belated return to University and I have made a thorough indent into my 5,000-word Research Methodology assignment. I'm focusing on the grey area between warm and hot 'zones' where emergency services work in the event of a major incident.

Here, we discuss clinical papers in the branches of qualitative and quantitative research approaches and finalise with our own research proposal that informs our undergraduate major project (aka, dissertation).

We have had our first few lectures and support sessions in our dissertation module, each sharing our chosen topics and discussing current literature in that field. I have decided to explore major and mass casualty incidents, specifically looking at the current rules and procedures associated with ‘zone’ working. In a major incident, zones are declared and classified into three areas based on threat. The cold zone is where standard EMS is situated whereby it is declared safe by the police. The warm zone indicates an element of danger; the HART teams can proceed to work in these zones and work closely with other agencies such as the fire brigade and police. The hot zone is explicitly restricted to tactical firearms policing teams, as that is where the threat is ongoing. In discussion with a police officer, he spoke of there being a 'grey area' between the warm and hot zone, where there is potential for recommendations to inform practice.

My dissertation questions aims to evaluate the effectiveness of major incident response of the UK compared to other countries. There are many different systems of operation globally, that perhaps could be adopted by UK services. Since the Paris attack in November 2015, I have been thoroughly researching this field of tactical medicine and I am very pleased that I am able to follow this interest and incorporate it into my University education. A paper published after the Paris attack portrayed the deployment of emergency physicians along with the counter-terrorism teams in the Bataclan theatre. They demonstrated immense professionalism and heroism by extricating multiple casualties to the warm zone, where specialist EMS colleagues could aid in treatment and triage. The authors of the paper suggested this system saved lives and dramatically reduced delays in medical care in major incidences.

I attended the Brighton and Sussex medical school annual conference last year where the Metropolitan Police services’ Counter Terrorism Specialist Firearms Officers (CTSFO’s) were demonstrating their medical capabilities. They are highly trained and can deliver a wide range of live-saving interventions at the point of contact in the hot zone. I remained in contact with the team since, and I have subsequently visited their base and had meetings with various CTSFO’s about my dissertation topic. It was incredibly exciting and extremely beneficial – although I cannot disclose the details, it was a successful meeting that has strong potential to continue after my studies at Anglia Ruskin University.

After the productive few weeks I’ve had here so far in 2018, I have unfortunately had bad news. I will return to have further surgery very soon, meaning I will not graduate this summer with my colleagues I have studied with for three years. It was a difficult decision to make, however the paramedic staff have been nothing less than outstanding in accommodating my circumstances. I will not attend placement until the start of the next academic year – this is in order to solely focus my needs on recovering well from the operation as well as respecting the integrity of my academic assignments.

I have 17,000 words to write at Level 6 between now and August, so if you’ll excuse me I’ll pop back to my desk and continue writing!


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