How First Responders Use Decision-Support Tools during Chemical Emergencies: The Nexus of Culture, Context, and Cognition

Although first responders use a wide range of decision-support tools to identify toxic chemicals during emergencies, few studies have analyzed the tasks and contexts in which such tools are used. Here we discuss an in-depth analysis of semistructured interviews conducted with 20 first responders from two US states. In the first phase of the analysis, we identified three intersecting themes related to the plurality of roles played by first responders, the combination of tools used, and the range of triggers leading to the use of decision-support tools. In the second phase of the analysis, an additional expert first responder through a series of interviews interpreted the results as emanating from a complex interplay of economic factors, and the trade-off between personal risk versus potential harm to victims and the environment. This emergent grounded theory provides insights into the cultural, contextual, and cognitive differences between decision-support tools used by first responders versus those used by clinicians, with implications for the design of more effective tools for first responders.