From the Thesis Abstract: "Following many recent intentional mass casualty incidents (MCIs), bystanders have come to the rescue, helping those around them. These active bystanders, known as immediate responders, have saved lives by providing immediate care for life-threatening injuries, evacuating victims, and transporting the injured to hospitals. However, immediate responders also tend to overwhelm the closest hospital and inaccurately prioritize victims for treatment. Emergency responders must manage this emergent response to leverage the benefits of the extra help but to avoid unintended consequences. A literature review and analysis of recent MCIs reveals that existing planning assumptions do not account for bystander help; this thesis recommends a new paradigm for MCI management that takes into account the complexity of MCIs, including immediate responder emergence, and includes suggestions for training incident commanders to operate in these novel and complex environments. The thesis also provides recommendations for encouraging bystanders to become immediate responders by creating a helping culture, which can include providing community training and bolstering laws to protect Good Samaritans."
Naval Postgraduate School, Dudley Knox Library: https://calhoun.nps.edu/