The Therapeutic Vacuum

Traditional incident management plans call for emergency medical services to wait at a safe forward point while the police ensure that the scene is safe. While maximising the safety of first responders, casualties are bleeding and dying from preventable deaths.

The term therapeutic vacuum has been applied to dynamic, terror related incidents where there is a deliberate delay in the provision of advanced medical care due to the priority need to neutralise the threat and secure the scene.

This delay gives rise the Therapeutic Vacuum – a lack of medical care that lasts as long as it takes for the threat to be neutralised. World events have forced a re-think of this approach and good evidence is showing that we can implement simple, effective measures to not only stop the killing, but also stop the dying.

Military conflicts over the past 20 years highlight how easy it is for terrorists and issue-motivated individuals to access, develop and employ improvised explosive devices. On their own, or in concert with marauding active shooters, the modern terror threat is a frightening possibility as we have witnessed in cities around the world. What recent studies are showing is that the frequency and complexity of attacks is increasing. We need to prepare our citizens and medical responders for this event.