Situational awareness during a full-scale exercise in an underground mine: A qualitative single-case study of the ambulance incident commander

Annika Eklund,Britt-Inger Saveman,Lina Gyllencreutz

doi:10.1016/j.ienj.2020.100950

Annika Eklund, Britt-Inger Saveman + Show 1 more

Open Access

https://doi.org/10.1016/j.ienj.2020.100950

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Abstract

IntroductionUnderground environments present challenges for providing and managing effective emergency care. Situational awareness (SA) has been suggested as a critical process to the management of care. AimThis study aims to explore the process of SA in the tasks of an ambulance incident commander (AIC) during a fullscale underground mine exercise. MethodsData consisted of video recordings, audiotapes and fieldnotes; these were subjected to content analysis based on the categories from the Busby Theory of Situational Awareness in Multi-casualty Incidents. ResultsThe results show that the underground mining environment presented the AIC with specific challenges for the SA process with respect to aspects such as situational information about the scene and the victims, as well as with making decisions for ambulance personnel so they could perform their work safely, and having a structured manner to counteract information overload. Both technical and non-technical aspects influenced the process. ConclusionThe AIC’s situational awareness was largely built through coordinated communications and actions with collaborating actors. The results of this study can be used for further exploration of how to train and support people in medical leadership roles on aspects of SA in emergency care, as well as on how to evaluate educational outcomes through exercises.

Highlights

Underground environments present challenges for providing and managing effective emergency care
Emergency medical services personnel have considered mining environments to be unfa miliar and unsafe, and they became passive during operations [15]
After they were dispatched to the incident, the ambulance incident commander (AIC) and medical incident commander (MIC) agreed that in their experience, the core challenges when caring for injury victims is the underground environment and not the care itself

Summary

Introduction

Underground environments present challenges for providing and managing effective emergency care. Results: The results show that the underground mining environment presented the AIC with specific challenges for the SA process with respect to aspects such as situational information about the scene and the victims, as well as with making decisions for ambulance personnel so they could perform their work safely, and having a structured manner to counteract information overload. Both technical and non-technical aspects influenced the process. Preparedness was higher among EMS personnel who had received training or education, or who had real-life experience in such environ ments [16]

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