Towards a theoretical framework for situational awareness in paramedicine

Situational awareness (SA) has been researched and described frequently in the literature, specifically, in high dynamic systems such as commercial aviation, air traffic control, nuclear energy, and offshore oil drilling. While paramedicine has been identified as a high dynamic system there is no known empirical data related to paramedicine and SA from a theoretical perspective. Without a theoretical framework in place for paramedicine, measurement tools, guidelines, and implications of not possessing SA will remain a challenge. The aim of this study is to review and critique what is currently known about SA, including a comparison and discussion regarding the most prominent theoretical frameworks for SA. In conclusion, it is argued that due to its success in being applied to other high dynamic systems as well as its ability to separate the process of SA from the product, Endsley's three-level framework of SA is best suited for applications in paramedicine.