Communication in sudden-onset major incidents. Patterns and challenges. A scoping review.

Abstract

Major incidents and disasters are rare occurrences that challenge society and health care systems substantially. The mobilization of extraordinary resources calls for robust preparedness plans, regular training and funding. Command & control is essential in major incident management. To achieve, maintain and execute command & control, communication within emergency medical services and between authorities involved in major incident and disaster management is paramount. The main aim of the master thesis is to explore communication between emergency medical services professionals in sudden-onset major incidents in a broader perspective. The thesis focuses on previous patterns and challenges in communication to provide policymakers with data for the improvement of future major incident preparedness. A scoping review of existing scientific and non-indexed literature describing communication in sudden-onset major incidents provides the sources of information in the thesis. Based on the included literature, this scoping review has found that the patterns in major incident communication are frequent breakdown with potential and actual consequences for patient survival, outcome and management and for the expedited return to a normal state. The challenges in major incident communication are predominantly inter-authority communication difficulties, system overload and lack of introduction and training in the use of communication devices. Cross-border incidents challenge communication substantively. The scoping review has shown that focus has been on describing the operational and tactical approach in sudden-onset major incidents and that communication challenges have not been assessed systematically. A general agreement that communication has been challenging exists; however, it remains mainly unquantified and improvised means of communication have been used extensively.