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Bystander Care of the Injured

"Bystander care" is becoming an increasingly common term in the vernacular of preparation for terrorist attacks and disasters. Dr. Rick Hunt, Director of the Division of Injury Response, CDC National Center for Injury Prevention and Control, recently called the train bombings in Madrid in 2004 "an inflection point," as there were more than 2,000 casualties. He pointed out the importance of bystanders to the response: "Look at photos of the Madrid bombings. How many uniforms do you see? The public must be prepared because they will be the ones with immediate access to the injured."

Health Resilience

Saving lives is critical in any emergency response, large or small, and must always be the first goal. Another important goal is resilience. The quality of the response and recovery to any mass casualty event is a predictor and reflection of the resilience in the location of the event, as well as to national resilience, insofar as the whole nation will be observing the response. If the public does not believe that appropriate actions were taken to save lives before, during, and after the event, resilience will be reduced. Resilience can be measured in how long and to what degree the public is able and willing to resume pre-event activities, including riding public transportation or attending large public gatherings.

ATS and the History of Bystander Care of the Injured

Prompted by the Department of Transportation National Highway Traffic Safety Administration (NHTSA), ATS developed its first Bystander Care of the Injured course in 1996, and published the course book and material in 1997. The program was evaluated, and more than 85 percent of course participants responded that they felt comfortable stopping at the scene of a car crash after the course vs. before the course, when they did not feel comfortable stopping. The course was then provided to NHTSA, which further developed into the First There, First Care Program.

ATS is currently working with federal agency partners, including the Department of Homeland Security and the Department of Health and Human Services to reintroduce Bystander Care of the Injured on a nation-wide scale.


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