2025; 8(2): 46-64

DOI: 10.32114/CCI.2025.8.2.46.64
Published online: 2025-06-30 (first online 2025-03-23)

The role of paramedics in emergency medical teams responding to natural disasters: a scoping review.

Estelle C. Seton [1] , Tom Mallinson [2] , Carl A. Webster [1,3] .

[1] Institute of Health and Allied Professions, Nottingham Trent University, Nottingham, United Kingdom
[2] College of Remote and Offshore Medicine, Birżebbuġa, Malta
[3] European Pre-hospital Research Network, United Kingdom

    Abstract:

Abstract [EN]   - INTRODUCTION: Climate-related disasters have increased by over 80% in the last four decades. It is often the responsibility of Emergency Medical Teams (EMTs) to respond to the aftermath of disasters, delivering medical care and aid. Post-event evaluations have revealed flaws in the productivity and functionality of EMTs. This scoping review maps the existing literature regarding EMTs’ experiences in natural disaster response, highlighting areas of limitation in which paramedics may be able to contribute their knowledge and skills to improve the response. MATERIALS AND METHODS: A scoping review was conducted using the JBI method. The databases CINHAL, MEDLINE, Cochrane Library, and Scopus were searched with the following terms: (“paramedics” OR “paramedic” OR “emergency medical service” OR “EMT” OR “EMS”) AND (“perceptions” OR “attitudes” OR “experience” OR “disaster response”) AND (“humanitarian disaster” OR “natural disasters”) NOT (“simulation”). 340 papers were screened; 8 studies met the inclusion criteria. RESULTS: Analysis of the selected studies revealed four prominent themes: operational and access challenges, healthcare delivery and infrastructure, communication and data management, and resource utilisation and team management. CONCLUSIONS: EMT limitations range from logistical to systemic issues; there is a need to fill the public health gap currently found in EMTs. Enhancement of paramedic training on urgent and primary care around disease outbreak, and everyday healthcare provision after a disaster, would prove invaluable. Paramedics have the potential to offer a resolution to lack of basic healthcare provision after a natural disaster.

Streszczenie [PL]   - WSTĘP: Katastrofy związane z klimatem wzrosły o ponad 80% w ciągu ostatnich czterech dekad. Często obowiązkiem zespołów ratownictwa medycznego (EMT) jest reagowanie na skutki katastrof, dostarczanie opieki medycznej i pomocy. Oceny po zdarzeniu ujawniły wady w wydajności i funkcjonalności EMT. Niniejszy przegląd zakresu mapuje istniejącą literaturę dotyczącą doświadczeń EMT w reagowaniu na klęski żywiołowe, podkreślając obszary ograniczeń, w których ratownicy medyczni mogą wnieść swoją wiedzę i umiejętności w celu poprawy reagowania. MATERIAŁY I METODY: Przegląd zakresu przeprowadzono przy użyciu metody JBI. Bazy danych CINHAL, MEDLINE, Cochrane Library i Scopus przeszukano pod kątem następujących terminów: („ratownicy medyczni” LUB „ratownik medyczny” LUB „ratownictwo medyczne” LUB „EMT” LUB „EMS”) I („percepcje” LUB „postawy” LUB „doświadczenie” LUB „reagowanie na katastrofy”) I („katastrofa humanitarna” LUB „klęski żywiołowe”) NIE („symulacja”). Przeszukano 340 artykułów; 8 badań spełniło kryteria włączenia. WYNIKI: Analiza wybranych badań ujawniła cztery główne tematy: wyzwania operacyjne i dostępowe, świadczenie opieki zdrowotnej i infrastruktura, komunikacja i zarządzanie danymi oraz wykorzystanie zasobów i zarządzanie zespołem. WNIOSKI: Ograniczenia EMT obejmują kwestie od logistycznych po systemowe; istnieje potrzeba wypełnienia luki w zakresie zdrowia publicznego, która obecnie występuje w EMT. Nieocenione okazałoby się ulepszenie szkolenia ratowników medycznych w zakresie pilnej i podstawowej opieki w przypadku wybuchu choroby oraz codziennego świadczenia opieki zdrowotnej po katastrofie. Ratownicy medyczni mogą potencjalnie rozwiązać problem braku podstawowej opieki zdrowotnej po klęsce żywiołowej.

    Citation:

VANCOUVER FORMAT

Seton EC, Mallinson T, Webster CA. The role of paramedics in emergency medical teams responding to natural disasters: a scoping review. Crit. Care Innov. 2025; 8(2): 46-64.
DOI: 10.32114/CCI.2025.8.2.46.64

    Download article (PDF file): click here

    Read article:

    Additional materials:

No files

    References:

[1]	Metych M. Natural disaster. 2025. | (WWW) |
[2]	PTSD: National Center for PTSD | (WWW) |
[3]	Climate Centre. UN: Climate-related disasters increase more than 80% over the last four decades. | (WWW) |
[4]	Climate change impacts, risks and adaptation. EEA. | (WWW) |
[5]	Research and data to make progress against the world’s largest problems. OWD | (WWW) |
[6]	UK’s Emergency Medical Team. | (WWW) |
[7]	Emergency Medical Teams (EMT) in the Pacific: Strengthening national capacity for health emergency response. WHO. | (WWW) |
[8]	Emergency Medical Teams in Disasters and Conflicts | (WWW) |
[9]	Classification and Minimum Standards for Emergency Medical Teams. WHO. | (WWW) |
[10]	Dufty N, Stewart M. Evaluating emergency management after an event: gaps and suggestions. Aus J Emer Med. 2013; 28(4): 15-19. | Scholar Google |
[11]	Strengthen emergency medical teams for better response to disasters. WHO | (WWW) |
[12]	Emergency Medical Teams. PAHO. | (WWW) |
[13]	Kondo H, Koido Y, Kawashima Y, Kohayagawa Y, Misaki M, Takahashi A, et al.. Consideration of Medical and Public Health Coordination - Experience from the 2016 Kumamoto, Japan Earthquake. Prehosp Disaster Med. 2019; 34(2): 149-154. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[14]	Mavroulis S, Ilgac M, Tuncağ M, Lekkas E, Püskülcü S, Kourou A, et al.. Emergency response, intervention, and societal recovery in Greece and Turkey after the 30th October 2020, MW = 7.0, Samos (Aegean Sea) earthquake. Bull Earthq Eng. 2022; 20(14): 7933-7955. | Digital Object Identifier (DOI) | Scholar Google |
[15]	Hamilton RL, Södergård B, Liverani M. The Role of Emergency Medical Teams in Disaster Response: A Summary of the Literature. Natural Hazards. 2021; 110: 1417-1426. | Digital Object Identifier (DOI) | Scholar Google |
[16]	About Us. WHO. | (WWW) |
[17]	What you need to know to be a disaster response medic. | (WWW) |
[18]	Emergency Medical Teams Initiative. LEP. | (WWW) |
[19]	Oldenburger D, Baumann A, Banfield L. Characteristics of Medical Teams in Disasters. Prehosp Disaster Med. 2017; 32(2): 195-200. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[20]	Reay G, Rankin JA, Smith-MacDonald L, Lazarenko G. Creative adapting in a fluid environment: an explanatory model of paramedic decision making in the pre-hospital setting. BMC Emerg Med. 2018; 18(1): 42. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[21]	Schofield B, McLean S. Paramedics and health promotion. Perspect Public Health. 2022; 142(3): 135-136. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[22]	Allana A, Kuluski K, Tavares W, Pinto A. Building integrated, adaptive and responsive healthcare systems - lessons from paramedicine in Ontario, Canada. BMC Health Serv Res. 2022; 22: 595. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[23]	Nepal Physiotherapy Association. The Role of Physical Therapists in the Medical Response Team Following a Natural Disaster: Our Experience in Nepal. J Orthop Sports Phys Ther. 2015; 45(9): 644-646. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[24]	Ojukwu CP, Eze GO, Uduonu ME, Okemuo A, Umunnah J, Ede S, et al.. Knowledge, Practices and Perceived Barriers of Physiotherapists Involved in Disaster Management: a Cross-sectional Survey of Nigeria-based and Trained Physiotherapists. Int Health. 2021; 13(6): 497-503. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[25]	Trivedi N. Physiotherapy in Disaster Management: Physiotherapist View. Natl J Integr Res Med. 2017; 8(4); 32-34. | Digital Object Identifier (DOI) | Scholar Google |
[26]	Tan G. Barriers and facilitators to the participation of physical therapists in disaster response following natural hazard-driven sudden-onset disasters: A systematised integrative review of the literature. Int J Disaster Risk Reduct. 2024; 100: 104153. | Digital Object Identifier (DOI) | Scholar Google |
[27]	Munn Z, Peters MDJ, Stern C, Tufanaru C, McArthur A, Aromataris. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol. 2018; 18(1): 143. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[28]	Mak S, Thomas A. Steps for Conducting a Scoping Review. J Grad Med Educ. 2022; 14(5): 565-567. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[29]	JBI Manual for Evidence Synthesis. | (WWW) |
[30]	Page MJ, McKenzie JE, Bossuyt PM, Boutrol I, Hoffmann T, Mulrow C, et al.. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Res Meth Rep. 2021; 372: n71. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[31]	From the field: David Anderson. | (WWW) |
[32]	Watts P, Byrom T. Experiences of two paramedics deployed to the Phillipines in response to Typhoon Haiyan. J Paramed Pract. 2014; 6(10): 520-524. | Scholar Google |
[33]	Hugelius K, Adolfsson A, Örtenwall P, Gifford M. Being Both Helpers and Victims: Health Professionals’ Experiences of Working During a Natural Disaster. Prehosp Disaster Med. 2017; 32(2): 117-123. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[34]	Sorani M, Tourani S, Khankeh RH, Panahi S. Prehospital Emergency Medical Services Challenges in Disaster; a Qualitative Study. Emerg (Tehran). 2018; 6(1): e26. | PubMed (NCBI) | Scholar Google |
[35]	Kim H, Ahn, E, Lee K, Kim Y, Hong E. Disaster medical assistance in super typhoon Haiyan: Collaboration with the local medical team that resulted in great synergy. Ulus Travma Acil Cerrahi Derg. 2015; 21(2): 143- 148. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[36]	Ho MLL, Lim JZM, Tan MZW, Kok WL, Zhang JR, Tan MY, et al.. Humanitarian Assistance and Disaster Relief Mission by a Tripartite Medical Team Led by the Singapore Armed Forces After the 2015 Nepal Earthquake. Singapore Med J. 2016; 57(8): 426-431. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[37]	Lin X, Liu YG, Dan Y, Xing DG, Chen L, Du DY. China Medical Team: Medical Rescue for “4.25” Nepal Earthquake. Chin J Traumatol. 2017; 20(4): 235-239. | Scholar Google |
[38]	Brolin K, Hawajri O, Schreeb JB. Foreign Medical Teams in the Philippines after Typhoon Haiyan 2013 - Who Were They, When Did They Arrive and What Did They Do? PLoS Curr. 2015; 5(7): ecurrents.dis.0cadd59590724486bffe9a0340b3e718. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[39]	Klein TA, Irizzary L. EMS Disaster Response. Treasure Island: StatPearls Pubishing: 2020. | PubMed (NCBI) |
[40]	Exploring the Complications of Counting Casualties After Natural Disasters. | (WWW) |
[41]	Wanner GK, Loyd JW. EMS Care Teams in Disaster Response. Treasure Island: Stat Pearls Publishing; 2025. | PubMed (NCBI) | Scholar Google |
[42]	Burkle FM. Operationalizing public health skills to resource poor settings: is this the Achilles heel in the Ebola epidemic campaign? Disaster Med Public Health Prep. 2015; 9(1): 44-46. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[43]	Hamdanieh LA, Marzaleh MEA, Ostadtaghizadeh AY, Soltani AI. Challenges of Emergency Medical Teams and Deploying a Field Hospital in the Aftermath of the Beirut Blast: A Qualitative Study. Disaster Med Public Health Prep. 2023; 17: e114 | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[44]	Eaton G, Tierney S, Wong G, Oke J, Williams V, Mahtani KR. Understanding the roles and work of paramedics in primary care: a national cross-sectional survey. BMJ Open. 2022; 12(12): e067476 | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[45]	Schofield B, Voss, S, Proctor A, Benger J, Coates D, Kirby K, et al.. Exploring how paramedics are deployed in general practice and the perceived benefits and drawbacks: a mixed-methods scoping study. BJGP Open. 2020; 4(2): bjgpopen20X101037. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[46]	Jaiswal R, Donahue J, Reilly MJ. Disaster Risk Management. Ciott Disas Med. 2016: 167–177. | Digital Object Identifier (DOI) |
[47]	Pourhosseini SS, Ardalan A, Mehrolhassani MH. Key Aspects of Providing Healthcare Services in Disaster Response Stage. Iran J Public Health. 2015; 44(1): 111-118 | PubMed (NCBI) | Scholar Google |
[48]	Emergency cycle. WHO | (WWW) |
[49]	Resources and Phases of Disaster Relief | (WWW) |
[50]	Before an Emergency. Government of Canada | (WWW) |
[51]	Disaster Management. Physiopedia. | (WWW) |
[52]	Bartholdson S, Schreeb JV. Natural Disasters and Injuries: What Does a Surgeon Need to Know? Curr Trauma Rep. 2018; 4(2): 103-108. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[53]	Disaster Recovery Guidance Series Health Sector Recovery | (WWW) |
[54]	POST-DISASTER NEEDS ASSESSMENTS GUIDELINES. Volume B. Social Sectors - Health. 2014. WHO | Digital Object Identifier (DOI) |
[55]	The Regulation and Management of International Emergency Medical Teams. WHO | (WWW) |
[56]	Hamdanieh LA, Ahmadi Marzaleh ME, Ostadtaghizadeh AY, Soltani AI. Challenges of Emergency Medical Teams and Deploying a Field Hospital in the Aftermath of the Beirut Blast: A Qualitative Study. Disaster Med Public Health Prep. 2023; 17: e114. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[57]	Balde T, Oyugi B, Mbasha JJ, Kamara R, Monterrey LGM, Relan P, et al.. The Emergency Medical Teams Initiative in the WHO African Region: a Review of the Development and Progress Over the Past 7 Years. Front Public Health. 2024; 12: 1387034. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[58]	Binder, SB, Baker CK. Culture, Local Capacity, and Outside Aid: a Community Perspective on Disaster Response After the 2009 Tsunami in American Sāmoa. Disasters 2017; 41(2): 282-305. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[59]	Emergency Medical Teams enhance domestic capacity to respond to public health emergencies | (WWW) |
[60]	Paramedics and their role in Hospitals | Digital Object Identifier (DOI) |
[61]	College of Paramedics. What is a Paramedic? | (WWW) |
[62]	Karn M, Sharma, M. Climate change, natural calamities and the triple burden of disease. Nat Clim Chang. 2021; 11: 796-797. | Digital Object Identifier (DOI) | Scholar Google |
[63]	Bell SA, Horowitz J, Iwashyna TJ. Health Outcomes After Disaster for Older Adults With Chronic Disease: A Systematic Review. Gerontologist 2020; 60(7): e535-e547. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[64]	Eaton G, Wong G, Williams V, Roberts N, Mahtni KR. Contribution of paramedics in primary and urgent care: a systematic review. Br J Gen Pract. 2020; 70(695): 421-426 | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[65]	Paramedic Specialist in Primary and Urgent Care Core Capabilities Framework | Digital Object Identifier (DOI) |
[66]	The standards of proficiency for paramedics. HCPC. | (WWW) |
[67]	The Role of Paramedics in Different Healthcare Settings | (WWW) |
[68]	Matani KR, Eaton G, Catterall M, Ridley A. Setting the scene for paramedics in general practice: what can we expect? J R Soc Med. 2018; 111(6): 195-198. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |
[69]	Pascapurnama DN, Murakami A, Chagan-Yasutan H, Hattori T, Sasaki H, Egawa S. Integrated Health Education in Disaster Risk Reduction: Lesson Learned from Disease Outbreak Following Natural Disasters in Indonesia. Inter J Disas Risk Red. 2018; 29: 94-102. | Scholar Google |
[70]	Kouadio IK, Aljunid S, Kamigaki T, Hammad K, Oshitani H. Infectious diseases following natural disasters: Prevention and control measures. Expert Rev of Anti Infective Ther. 2012; 10(1): 95-104. | Digital Object Identifier (DOI) | PubMed (NCBI) | Scholar Google |