Better Together: Changing the Social Process between First Responders and Bystanders Increases the Effectiveness of Emergency Response
Keywords:
Bystanders, First responders, Mass casualty incident, Help, Emergency, Cardio-pulmonary resuscitation (CPR), Immediate responders, Good samaritanAbstract
Bystanders are an integral part of an emergency scene. Their presence on site makes them the immediate potential responders, who can provide life-saving assistance as well as various rescue actions. Research has shown that bystanders are willing to and are capable of helping, especially (but not limited to) when a leader emerges, as the help is rooted in a collective action. In this article, we suggest a new framework for understanding the effectiveness of bystanders help, based on the evolving social process between bystanders and first responders. As we show, the transition from no help, at the very first moment right after the emergency has occurred, to an effective coordinated response where first responders and bystanders act together, goes through engagement of bystanders. Further, first responders should acknowledge the social organization of bystanders, utilize and leverage it in order to optimize their efforts. This framework has important insights for policy makers when managing emergency and disaster situations with limited resources.
References
Ashkenazi I, Hunt R. You’re it—you’ve got to save someone immediate responders, not bystanders. Front Public Health. 2019; 7: 361. doi: 10.3389/fpubh.2019.00361
Bennett S, Banyard VL, Garnhart L. To act or not to act, that is the question? Barriers and facilitators of bystander intervention. J Inter-pers Violence. 2014; 29(3): 476-496. doi: 10.1177/0886260513505210
Carragher R, Johnson J, Harder M. Factors that influence by-stander CPR: A narrative review. Int J Curr Res. 2017; 9(6): 52100- 52103.
Hung KK, Leung CY, Siu A, Graham CA. Good samaritan law and bystander cardiopulmonary resuscitation: Cross-sectional study of 1223 first-aid learners in Hong Kong. Hong Kong Journal of Emergency Medicine. 2019; 1-8. doi: 1024907919870928
Vaillancourt C, Stiell IG, Wells GA. Understanding and improv-ing low bystander CPR rates: A systematic review of the literature. CJEM. 2008; 10(1): 51-65. doi: 10.1017/s1481803500010010
Fischer P, Krueger JI, Greitemeyer T, et al. The bystander-effect: A meta-analytic review on bystander intervention in dangerous and non-dangerous emergencies. Psychol Bull. 2011; 137(4): 517-537. doi: 10.1037/a0023304
Avdeyeva TV, Burgetova K, Welch ID. To help or not to help? Factors that determined helping responses to Katrina victims. Analyses of Social Issues and Public Policy. 2006; 6(1): 159-173. doi: 10.1111/j.1530-2415.2006.00113.x
Shotland RL, Stebbins CA. Emergency and cost as determinants of helping behavior and the slow accumulation of social psycho-logical knowledge. Social Psychology Quarterly. 1983; 46: 36-46. doi: 10.2307/3033659
Charlotte B, Liebst LS, Poder P, Christiansen JM, Heinskou MB. Caring collectives and other forms of bystander helping behav-ior in violent situations. Curr Sociol. 2018; 66(7): 1049-1069. doi:
1177/0011392118776365 10. Bhanji F, Mancini ME, Sinz E, et al. Part 16: education, imple-mentation, and teams: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010; 122(18_suppl_3): S920-S933. doi: 10.1161/ CIRCULATIONAHA.110.971135
Lynch B, Einspruch EL, Nichol G, et al. Effectiveness of a 30- min CPR self-instruction program for lay responders: A controlled randomized study. Resuscitation. 2005; 67(1): 31-43. doi: 10.1016/j. resuscitation.2005.04.017
Latane B, Darley JM. Group inhibition of bystander interven-tion. J Pers Soc Psychol. 1968; 10: 215-221. doi: 10.1037/h0026570
Latane B, Darley JM. The Unresponsive Bystander: Why Doesn’t He Help? New York, USA: Prentice Hall; 1970.
Drury J, Carter H, Cocking C, Ntontis E, Tekin Guven S, Am-lôt R. Facilitating collective resilience in the public in emergencies: Twelve recommendations based on the social identity approach. Front Public Health. 2019; 7: 141. doi: 10.3389/fpubh.2019.00141
Romer D, Gruder CL, Lizzadro T. A person–situation ap-proach to altruistic behavior. J Pers Soc Psychol. 1986; 51: 1001-1012. doi: 10.1037/0022-3514.51.5.1001
Hortensius R, Neyret S, Slater M, de Gelder B. The relation be-tween bystanders’ behavioral reactivity to distress and later helping behavior during a violent conflict in virtual reality. PLoS One. 2018; 13(4): e0196074. doi: 10.1371/journal.pone.0196074
Ashkenazi I. The five dimensions and three brains of lead-ership. Paper presented at: Crisis leadership seminar. 1998; Beer-sheba, Israel.
Ashkenazi I. Do bystanders fail to act in emergencies? The Haiti Earthquake. Israeli Military Medicine. 2010; 7: 90-95.
Ashkenazi I, McNulty E, Marcus LJ, Dorn BC. The role of bystanders in mass casualty events: Lessons from the 2010 Haiti Earthquake. J Def Stud Resour Manage. 2012; 1: 2. doi: 10.4172/2324- 9315.1000103
Fischer P, Greitemeyer T, Pollozek F, Frey D. The unresponsive bystander: Are bystanders more responsive in dangerous emergen-cies? Eur J Soc Psychol. 2006; 36: 267-278. doi: 10.1002/ejsp.297
Harari H, Harari O, White RV. The reaction to rape by Ameri-can male bystanders. J Soc Psychol. 1985; 125(5): 653-658. doi: 10.1080/00224545.1985.9712039 6 Rapaport C et al
Schwartz SH, Gottlieb A. Bystander reactions to a violent theft: Crime in Jerusalem. J Pers Soc Psychol. 1976; 34(6): 1188-1199. doi: 10.1037//0022-3514.34.6.1188
Dovidio JF, Piliavin JA, Gaertner SL, Schroeder DA, Clark RD. The arousal: Cost-reward model and the process of intervention: A review of the evidence. Rev Pers Soc Psychol. 1991; 12: 83-118.
Dovidio JF, Piliavin JA, Schroeder DA, Penner LA. The Social Psychology of Prosocial Behavior. Mahwah, NJ, USA: Lawrence Erl-baum Associates; 2006.
Stop the Bleed. Web site. https://www.stopthebleed.org/. Ac-cessed December 3, 2019.
Community Fema. Web site. https://community.fema.gov/ until-help-arrives. Accessed December 3, 2019.
CPR and First Aid Emergency Cardiovascular Care. cpr-cours-es-and-kits. Web site. https://cpr.heart.org/en/cpr-courses-and-kits/hands-only-cpr. Accessed December 3, 2019.
Chan PS, McNally B, Tang F, Kellermann A. Recent trends in survival from out-of-hospital cardiac arrest in the United States. Circulation. 2014; 130(21): 1876-1882. doi: 10.1161/CIRCULA-TIONAHA.114.009711
Nielsen AM, Isbye DL, Lippert FK, Rasmussen LS. Engaging a whole community in resuscitation. Resuscitation. 2012; 83(9): 1067- 1071. doi: 10.1016/j.resuscitation.2012.04.012
Deakin CD, Shewry E, Gray HH. Public access defibrillation remains out of reach for most victims of out-of-hospital sud-den cardiac arrest. Heart. 2014; 100(8): 619-623. doi: 10.1136/ heartjnl-2013-305030
McCarty JC, Hashmi ZG, Herrera-Escobar JP, et al. Effective-ness of the American College of Surgeons Bleeding Control Basic training among laypeople applying different tourniquet types: A randomized clinical trial. JAMA Surg. 2019. doi: 10.1001/jama-surg.2019.2275
Benjamin EJ, Blaha MJ, Chiuve SE, et al. Heart disease and stroke statistics-2017 update: A report from the American Heart Association. Circulation. 2017; 135: e146-e603. doi: 10.1161/ CIR.0000000000000485
Berdowski J, Berg RA, Tijssen JG, Koster RW. Global incidenc-es of out-of-hospital cardiac arrest and survival rates: Systematic review of 67 prospective studies. Resuscitation. 2010; 81(11): 1479- 1487. doi: 10.1016/j.resuscitation.2010.08.006
Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics-2016 update: A report from the American Heart Association. Circulation. 2016; 133: e38-e360. doi: 10.1161/ CIR.0000000000000350
Riva G, Ringh M, Jonsson M, et al. Survival in out-of-hospi-tal cardiac arrest after standard cardiopulmonary resuscitation or chest compressions only before arrival of emergency medi-cal services: Nationwide study during three guideline periods. Circulation. 2019; 139(23): 2600-2609. doi: 10.1161/CIRCULA-TIONAHA.118.038179
Ro YS, Do Shin S, Song KJ, et al. Public awareness and self-efficacy of cardiopulmonary resuscitation in communities and outcomes of out-of-hospital cardiac arrest: A multi-level analysis. Resuscitation. 2016; 102: 17-24. doi: 10.1016/j.resuscita-tion.2016.02.004
Wissenberg M, Lippert FK, Folke F, et al. Association of na-tional initiatives to improve cardiac arrest management with rates of bystander intervention and patient survival after out-of-hospi-tal cardiac arrest. JAMA. 2013; 310(13): 1377-1384. doi: 10.1001/ jama.2013.278483
Ong MEH, Do Shin S, De Souza NNA, et al. Outcomes for out-of-hospital cardiac arrests across 7 countries in Asia: The Pan Asian Resuscitation Outcomes Study (PAROS). Resuscitation. 2015; 96: 100-108. doi: 10.1016/j.resuscitation.2015.07.026
Hasselqvist-Ax I, Riva G, Herlitz J, et al. Early cardiopulmo-nary resuscitation in out-of-hospital cardiac arrest. New Engl J Med. 2015; 372(24): 2307-2315. doi: 10.1056/NEJMoa1405796
Holmberg MJ, Vognsen M, Andersen MS, Donnino MW, An-dersen LW. Bystander automated external defibrillator use and clinical outcomes after out-of-hospital cardiac arrest: A system-atic review and meta-analysis. Resuscitation. 2017; 120: 77-87. doi: 10.1016/j.resuscitation.2017.09.003
Hansen CM, Kragholm K, Granger CB, et al. The role of by-standers, first responders, and emergency medical service providers in timely defibrillation and related outcomes after out-of-hospital cardiac arrest: results from a statewide registry. Resuscitation. 2015; 96: 303-309. doi: 10.1016/j.resuscitation.2015.09.002
Bulger EM, Snyder D, Schoelles K, et al. An evidence-based prehospital guideline for external hemorrhage control: American College of Surgeons Committee on Trauma. Prehosp Emerg Care. 2014; 18(2): 163-173. doi: 10.3109/10903127.2014.896962
Goralnick E, Chaudhary MA, McCarty JC, et al. Effectiveness of instructional interventions for hemorrhage control readiness for laypersons in the Public Access and Tourniquet Training Study (PATTS): A randomized clinical trial. JAMA Surg. 2018; 153(9): 791-799. doi: 10.1001/jamasurg.2018.1099 Submit your article to this journal | https://openventio.org/submit-manuscript/ Rapaport C et al
Ross EM, Redman TT, Mapp JG, et al. Stop the bleed: the ef-fect of hemorrhage control education on laypersons’ willingness to respond during a traumatic medical emergency. Prehosp Disaster Med. 2018; 33(2): 127-132. doi: 10.1017/S1049023X18000055
Adini B. The role of the on-scene bystander and survivor. Local Planning for Terror and Disaster: From Bioterrorism to Earthquakes. 2012; 163-175. doi: 10.1002/9781118397787.ch13
Glass TA. Understanding public response to disasters. Pub-lic Health Rep. 2001; 116(Suppl 2): 69-73. doi: 10.1016/S0033- 3549(04)50146-2
Mahon SE, Rifino JJ. The role of bystanders in disasters. In: Ci-ottone GR, Biddinger PD, Darling RG, et al, eds. Ciottone’s Disaster Medicine. Amsterdam, Netherlands: Elsevier Health Sciences; 2015.
Solnit R. A Paradise Built in Hell: The Extraordinary Communities That Arise in Disaster. New York, USA: Viking Press; 2009.
Fritz CE, Mathewson JH. Convergence behavior in disasters: A problem in social controlo. 9). Washington DC, USA: National Academy of Sciences-National Research Councel; 1957.
Kendra JM, Wachtendorf T. Elements of resilience after the world trade center disaster: Reconstituting New York City’s Emergency Operations Centre. Disasters. 2003; 27(1): 37-53. doi: 10.1111/1467-7717.00218
Der Heide EA. Convergence behavior in disasters. Ann Emerg Med. 2003; 41(4): 463-466. doi: 10.1067/mem.2003.126
Scanlon J, Helsloot I, Groenendaal J. Putting it all together: integrating ordinary people into emergency response. International Journal of Mass Emergencies and Disasters. 2014; 32(1): 43-63.
Levine M, Cassidy C, Sturmerm S, Snyder M. Groups, iden-tities, and bystander behavior. The Psychology of Prosocial Behavior: Group Processes, Intergroup Relations, and Helping. 2009; 209-222. doi: 10.1002/9781444307948.ch11
Drury J. No need to panic. The Psychologist. 2004; 3: 118-119.
Drury J, Cocking C, Reicher S. Everyone for themselves? A com-parative study of crowd solidarity among emergency survivors. Br J Soc Psychol. 2009; 48(3): 487-506. doi: 10.1348/014466608X357893
Drury J, Cocking C, Reicher S. The nature of collective resil-ience: survivor reactions to the 2005 London bombings. Interna-tional Journal of Mass Emergencies and Disasters. 2009; 27: 66-95.
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