Chapter 4: Emergency response and aftermath: 'routinely requested to attend'

Context

2.4.11 A major disaster involving multiple fatalities and injuries presents a very different set of circumstances to those that occur in the routine practice of the emergency services, and it is important to understand that both the challenges and the response required are accordingly different. Several aspects must be taken into account.

2.4.12 First, the nature of a major disaster is outside the experience of those present or initially responding, making it difficult to assess what is happening and how best to react.

2.4.13 Second, the scale of casualties is overwhelming, causing shock and distress to witnesses and to members of the emergency services. The immediate impact and realisation hampers judgement and the capability to make decisions and take appropriate action. 

2.4.14 Third, the action required, at least initially, runs counter to the instincts and everyday experience of staff, who must suppress the urge to devote their attention to caring for the nearest injured casualty, focusing instead on assessing the situation, calling for necessary assistance, and establishing those in most need of immediate treatment.

2.4.15 Fourth, the reaction of bystanders, particularly if they are friends and relatives, driven by the desperate desire to help, understandably is often irrational, sometimes unhelpful and occasionally hostile, further impeding the ability of responders to take appropriate action.

Emergency services training

2.4.16 Emergency services plan for major disasters, train staff in their respective roles, and carry out exercises to test and improve the response. Training programmes should be designed to emphasise the particular difficulties facing responders.

2.4.17 However, because of the pressing needs of the day-to-day service, training and testing are often theoretical, 'table top' exercises. Even when simulations are conducted - and more recently attention has been paid to making these as realistic as possible - it is doubtful that emergency planning can prevent the initial, human reaction of paralysing shock among those involved in the initial response.

2.4.18 The first moments of a major disaster are inevitably characterised by chaos, with responders unable to act coherently. It is important that this immediate phase is limited and coordinated efforts are established as quickly as possible to mount an appropriate response in accordance with emergency plans, training, and staff roles and responsibilities. Effective leadership is crucial in promoting purposive action, bringing cohesion, responding to novel circumstances and supporting staff who are enduring emotional and physical exhaustion.

2.4.19 Eye-witness accounts of the immediate aftermath of the Hillsborough disaster confirm that all the above challenges were present. The response at Hillsborough, therefore, should be considered within this context.