Push to change system after Bondi attack
Paramedics responding to the fatal Westfield Bondi Junction stabbing rampage were so committed to their patients they found it difficult to move on, with an inquest told an international tool to triage patients could have been significantly beneficial on the day of the attack.
Dawn Singleton, Yixuan Cheng, Faraz Ahmed Tahir, Ashlee Good, Jade Young and Pikria Darchia were all killed by Joel Cauchi at Westfield Bondi Junction on April 13, 2024, before he was then shot dead by police.
A coronial inquest into the attack was told some paramedics were hesitant to move on as they were so committed to treating their patients on the day of the fatal attack, with experts convening on Friday to discuss the benefits of implementing a UK innovation coined the ten second triage (TST) tool in NSW. Bondi stabbing victims (top l-r) Jade Young, Ashlee Good, Dawn Singleton, (bottom l-r) Cheng Yixuan, Faraz Tahir and Pikria Darchia. Credit: Supplied
The TST allows first responders to triage patients within 10 seconds.
First responders walk through a series of rapid steps to triage a patient, with prompts including is the person walking, talking or breathing.
Patients are then quickly assessed as priority one or priority two, and lifesaving interventions are carried out.
Emergency medicine expert Phil Cowburn told the court that seconds was simply a guideline: for instance, patients who are walking can be triaged in less than 10 seconds, while it may take longer to check if a patient has penetrating injuries and such.
'You shouldn't stop at 10 seconds, you should carry on until the lifesaving interventions are done, but on average when looking at a large number of patients … it takes on average 10 seconds per patient to triage,' Dr Cowburn told the court. Joel Cauchi stabbed 16 people, killing six, on April 13, 2024. Supplied. Credit: Supplied
The tool includes triaging patients as a 'category silver' rather than 'deceased'.
Dr Cowburn explained that a patient may have been declared dead under previous triage tools; however, it was a 'very quick decision to make under a lot of stress'.
'It felt inappropriate to us that we were putting our responders under that level of pressure to make that decision quickly,' Dr Cowburn told the inquest.
A category silver allows the chance for resuscitation to be given if felt appropriate and for any responder – not just healthcare professionals – to make that decision.
Dr Cowburn also said bystanders would not be stopped from applying aid to someone triaged as a category silver.
'No patient would inadvertently be declared deceased if that was perhaps not appropriate,' Dr Cowburn said.
The first responding paramedic and forward commander on the day of the attack, Brett Simpson, earlier agreed that TST could have been useful in responding to the Bondi attack, particularly the use of category silver.
Counsel assisting the coroner Peggy Dwyer SC earlier said one reason for the category silver was to combat the adverse impact on first responders in having to make the declaration of deceased.
While Inspector Simpson said this wasn't a 'problem' on the day of the fatal attack, it was 'definitely a factor'.
'Our crews are very well trained, but in a situation like that when their bandwidth is completely and wholly exceeded by the environment that they're in, some of them potentially may not have felt comfortable in making that declaration,' he said. Counsel assisting the coroner Peggy Dwyer SC. NewsWire / Monique Harmer Credit: News Corp Australia
'That's a role that I ended up performing as I approached some of the crews that were treating some of the victims that did not survive … being able to take that burden off of those crews meant that they were able to regain some of their bandwidth, effectively conserve some of their supplies, and move on and treat other patients.'
It is not suggested paramedics did not adequately perform their duties, nor that any lives could have been saved. The inquest is a learning exercise for any future mass tragedy.
Police officers on scene at the Bondi attack may have been able to help paramedics identify patients who were a priority and of silver category quicker, improving situational awareness on the day of the Bondi attack, the court was told on Friday.
Emergency physician Stefan Mazur said 'the current triage system, whilst works OK – even in exercise it kind of works OK – but under pressure it does tend to not work as well as you like'.
The inclusion of lifesaving interventions, and giving other responders such as police the language to communicate what resources are needed for the patients in front of them, were some benefits highlighted by NSW Ambulance acting executive director of medical services and research Thomas Evens.
'Collectively … the TST package I think would have a significant impact on the capability of the NSW government's response to patients in an incident such as (Bondi),' Dr Evens said.
However, he noted it would be 'quite a fundamental change in the way emergency services undertake their activity' and would need to be implemented across all emergency services with joint emergency services interoperability principles.
Inspector Simpson earlier told the court that it was an impressive tool and 'takes the clinical aspect out of it'.
'You could effectively train anyone in this room on how to then triage a patient and then provide that information to a clinician as they approach,' he said.
Police are generally on scene first and were at the shopping centre in large numbers on April 13, 2024.
Inspector Simpson said giving police the tools to notify paramedics what category of patients were inside the centre may have been able to help with resource allocation.
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ABC News
7 days ago
- ABC News
Key failings revealed by coronial inquest into Bondi Junction Westfield stabbing attack
For five weeks the coronial inquest into the Bondi Junction Westfield attack tried to comprehend what could have been done to prevent the tragedy and how to better respond to similar acts. Testimony was shared, tears wept and uncomfortable truths acknowledged. On April 13, 2024, Joel Cauchi murdered six people and injured another 10 during a stabbing rampage. Over one year on, here are some of the key failings uncovered during the inquest's hearings. The profound impact of media reporting on the day of the attack and in the aftermath was examined at the request of the bereaved. Sue Chrysanthou SC, who represents some of the victims' families, said her clients asked media companies to "take extreme care to address sensitivities". Counsel assisting the coroner Peggy Dwyer SC said "the media will have to reflect deeply" on graphic footage shown in reports. Julie Singleton, the mother of Dawn Singleton, provided a statement to the inquest, where she described the personal toll. "Very soon after Dawn's death was first reported in the media, reporters appeared and took up position outside my house," she wrote. "Reporters rang my doorbell and left notes in my mailbox seeking comment and/or information for a story. My family and I found this intrusive." Many of Dawn's loved ones were informed of her death via media reports, with Ms Singleton saying their family's privacy was "violated". Dawn's fiancé, Ashley Wildey, also criticised how Dawn's identity as one of the victims of the attack was revealed on talkback radio, Mr Wildey saying it was "extremely upsetting" for this to be done without consent. In his statement to the inquest, he noted several printed inaccuracies in reporting of Dawn, as well as criticising unsolicited communication from journalists. "The cumulative effect of the reporting has caused me and members of Dawn's family immense and immeasurable pain," he said. Elizabeth Young, the mother of 47-year-old victim Jade Young, said of the media: "Our current world has lost site of decency. "Images of Jade's lifeless body being worked on were cast around the world. At the exact minute Cauchi stabbed his first victim, the sole security guard in the Westfield control room, referred to trhoughout the hearings as CR1, happened to be in the bathroom, leaving the CCTV screens unmonitored. CR1's capability was reflected upon in the inquest, as well as the liability of her employer. An independent security expert deemed CR1 to be incompetent as a control room operator due to her limited "skill set" for the role. "You need to have good decision-making skills. You need to be able to multitask. You need to be able to give direction. You need to coordinate," the expert said of security guards reviewing CCTV. "She wasn't obviously up to speed with her competence." Glad Group, a subcontractor for security staff, and Scentre, the parent company of Westfield, were asked about their level of responsibility. A former training manager from Glad Group, who trained CR1, was asked why some induction process documents pertaining to CR1 were not signed off. "There was pressure for recruitment. I hope that didn't affect my training," said the manager, who cannot be identified for legal reasons. A security manager from Scentre, whose name also remains under a non-publication order, acknowledged the pressure on guards to be informed, comfortable and confident in responding to extreme crisis events. Scentre has since implemented stab resistant vests, made training more rigorous, and strengthened policies and procedures. There were clear signs Cauchi had chronic schizophrenia. Despite this, his long-term psychiatrist in Queensland, Andrea Boros-Lavack, weaned Cauchi off his anti-psychotic medication entirely by 2019. "There was no evidence that he heard voices," Dr Boros-Lavack said during her evidence, to which Ms Chrysanthou acknowledged an email from Cauchi's mother to Dr Boros-Lavack's clinic in 2019. Ms Cauchi had reported concerns her son was "now hearing voices" and writing notes he was "under satanic control". A panel of five psychiatrists later told the inquest Cauchi's worsening mental health was "not taken seriously enough" by Dr Boros-Lavack. They agreed Cauchi was experiencing psychosis during the 2024 attack — contradicting Dr Boros-Lavack's claim he was not. A senior Queensland Police officer conceded the state's current mental health legislation was too confusing for officers to interpret. Two officers who attended Cauchi's family home in Queensland in 2023 did not believe his mental health reached the threshold to detain him. Currently, the legislation only provides a risk of suicide as an example for police to force someone to seek mental health support. Acting Deputy Commissioner Mark Kelly said: "Our police are attending incidents every day. They maintain their professionalism, they're very considered, balanced, but they've got to operate within the legislation and our values, and also in terms of human rights." Formal findings from the inquest will be released in months to come. Regardless, for those directly affected by the events of April 13, 2024, their grief will remain "truly unfathomable", as Ms Dwyer noted.
Perth Now
23-05-2025
- Perth Now
Push to change system after Bondi attack
Paramedics responding to the fatal Westfield Bondi Junction stabbing rampage were so committed to their patients they found it difficult to move on, with an inquest told an international tool to triage patients could have been significantly beneficial on the day of the attack. Dawn Singleton, Yixuan Cheng, Faraz Ahmed Tahir, Ashlee Good, Jade Young and Pikria Darchia were all killed by Joel Cauchi at Westfield Bondi Junction on April 13, 2024, before he was then shot dead by police. A coronial inquest into the attack was told some paramedics were hesitant to move on as they were so committed to treating their patients on the day of the fatal attack, with experts convening on Friday to discuss the benefits of implementing a UK innovation coined the ten second triage (TST) tool in NSW. Bondi stabbing victims (top l-r) Jade Young, Ashlee Good, Dawn Singleton, (bottom l-r) Cheng Yixuan, Faraz Tahir and Pikria Darchia. Credit: Supplied The TST allows first responders to triage patients within 10 seconds. First responders walk through a series of rapid steps to triage a patient, with prompts including is the person walking, talking or breathing. Patients are then quickly assessed as priority one or priority two, and lifesaving interventions are carried out. Emergency medicine expert Phil Cowburn told the court that seconds was simply a guideline: for instance, patients who are walking can be triaged in less than 10 seconds, while it may take longer to check if a patient has penetrating injuries and such. 'You shouldn't stop at 10 seconds, you should carry on until the lifesaving interventions are done, but on average when looking at a large number of patients … it takes on average 10 seconds per patient to triage,' Dr Cowburn told the court. Joel Cauchi stabbed 16 people, killing six, on April 13, 2024. Supplied. Credit: Supplied The tool includes triaging patients as a 'category silver' rather than 'deceased'. Dr Cowburn explained that a patient may have been declared dead under previous triage tools; however, it was a 'very quick decision to make under a lot of stress'. 'It felt inappropriate to us that we were putting our responders under that level of pressure to make that decision quickly,' Dr Cowburn told the inquest. A category silver allows the chance for resuscitation to be given if felt appropriate and for any responder – not just healthcare professionals – to make that decision. Dr Cowburn also said bystanders would not be stopped from applying aid to someone triaged as a category silver. 'No patient would inadvertently be declared deceased if that was perhaps not appropriate,' Dr Cowburn said. The first responding paramedic and forward commander on the day of the attack, Brett Simpson, earlier agreed that TST could have been useful in responding to the Bondi attack, particularly the use of category silver. Counsel assisting the coroner Peggy Dwyer SC earlier said one reason for the category silver was to combat the adverse impact on first responders in having to make the declaration of deceased. While Inspector Simpson said this wasn't a 'problem' on the day of the fatal attack, it was 'definitely a factor'. 'Our crews are very well trained, but in a situation like that when their bandwidth is completely and wholly exceeded by the environment that they're in, some of them potentially may not have felt comfortable in making that declaration,' he said. Counsel assisting the coroner Peggy Dwyer SC. NewsWire / Monique Harmer Credit: News Corp Australia 'That's a role that I ended up performing as I approached some of the crews that were treating some of the victims that did not survive … being able to take that burden off of those crews meant that they were able to regain some of their bandwidth, effectively conserve some of their supplies, and move on and treat other patients.' It is not suggested paramedics did not adequately perform their duties, nor that any lives could have been saved. The inquest is a learning exercise for any future mass tragedy. Police officers on scene at the Bondi attack may have been able to help paramedics identify patients who were a priority and of silver category quicker, improving situational awareness on the day of the Bondi attack, the court was told on Friday. Emergency physician Stefan Mazur said 'the current triage system, whilst works OK – even in exercise it kind of works OK – but under pressure it does tend to not work as well as you like'. The inclusion of lifesaving interventions, and giving other responders such as police the language to communicate what resources are needed for the patients in front of them, were some benefits highlighted by NSW Ambulance acting executive director of medical services and research Thomas Evens. 'Collectively … the TST package I think would have a significant impact on the capability of the NSW government's response to patients in an incident such as (Bondi),' Dr Evens said. However, he noted it would be 'quite a fundamental change in the way emergency services undertake their activity' and would need to be implemented across all emergency services with joint emergency services interoperability principles. Inspector Simpson earlier told the court that it was an impressive tool and 'takes the clinical aspect out of it'. 'You could effectively train anyone in this room on how to then triage a patient and then provide that information to a clinician as they approach,' he said. Police are generally on scene first and were at the shopping centre in large numbers on April 13, 2024. Inspector Simpson said giving police the tools to notify paramedics what category of patients were inside the centre may have been able to help with resource allocation. mental health support
News.com.au
23-05-2025
- News.com.au
Major push to change how patients are triaged after Westfield Bondi Junction attack
Paramedics responding to the fatal Westfield Bondi Junction stabbing rampage were so committed to their patients they found it difficult to move on, with an inquest told an international tool to triage patients could have been significantly beneficial on the day of the attack. Dawn Singleton, Yixuan Cheng, Faraz Ahmed Tahir, Ashlee Good, Jade Young and Pikria Darchia were all killed by Joel Cauchi at Westfield Bondi Junction on April 13, 2024, before he was then shot dead by police. A coronial inquest into the attack was told some paramedics were hesitant to move on as they were so committed to treating their patients on the day of the fatal attack, with experts convening on Friday to discuss the benefits of implementing a UK innovation coined the ten second triage (TST) tool in NSW. The TST allows first responders to triage patients within 10 seconds. First responders walk through a series of rapid steps to triage a patient, with prompts including is the person walking, talking or breathing. Patients are then quickly assessed as priority one or priority two, and lifesaving interventions are carried out. Emergency medicine expert Phil Cowburn told the court that seconds was simply a guideline: for instance, patients who are walking can be triaged in less than 10 seconds, while it may take longer to check if a patient has penetrating injuries and such. 'You shouldn't stop at 10 seconds, you should carry on until the lifesaving interventions are done, but on average when looking at a large number of patients … it takes on average 10 seconds per patient to triage,' Dr Cowburn told the court. The tool includes triaging patients as a 'category silver' rather than 'deceased'. Dr Cowburn explained that a patient may have been declared dead under previous triage tools; however, it was a 'very quick decision to make under a lot of stress'. 'It felt inappropriate to us that we were putting our responders under that level of pressure to make that decision quickly,' Dr Cowburn told the inquest. A category silver allows the chance for resuscitation to be given if felt appropriate and for any responder – not just healthcare professionals – to make that decision. Dr Cowburn also said bystanders would not be stopped from applying aid to someone triaged as a category silver. 'No patient would inadvertently be declared deceased if that was perhaps not appropriate,' Dr Cowburn said. The first responding paramedic and forward commander on the day of the attack, Brett Simpson, earlier agreed that TST could have been useful in responding to the Bondi attack, particularly the use of category silver. Counsel assisting the coroner Peggy Dwyer SC earlier said one reason for the category silver was to combat the adverse impact on first responders in having to make the declaration of deceased. While Inspector Simpson said this wasn't a 'problem' on the day of the fatal attack, it was 'definitely a factor'. 'Our crews are very well trained, but in a situation like that when their bandwidth is completely and wholly exceeded by the environment that they're in, some of them potentially may not have felt comfortable in making that declaration,' he said. 'That's a role that I ended up performing as I approached some of the crews that were treating some of the victims that did not survive … being able to take that burden off of those crews meant that they were able to regain some of their bandwidth, effectively conserve some of their supplies, and move on and treat other patients.' It is not suggested paramedics did not adequately perform their duties, nor that any lives could have been saved. The inquest is a learning exercise for any future mass tragedy. Police officers on scene at the Bondi attack may have been able to help paramedics identify patients who were a priority and of silver category quicker, improving situational awareness on the day of the Bondi attack, the court was told on Friday. Emergency physician Stefan Mazur said 'the current triage system, whilst works OK – even in exercise it kind of works OK – but under pressure it does tend to not work as well as you like'. The inclusion of lifesaving interventions, and giving other responders such as police the language to communicate what resources are needed for the patients in front of them, were some benefits highlighted by NSW Ambulance acting executive director of medical services and research Thomas Evens. 'Collectively … the TST package I think would have a significant impact on the capability of the NSW government's response to patients in an incident such as (Bondi),' Dr Evens said. However, he noted it would be 'quite a fundamental change in the way emergency services undertake their activity' and would need to be implemented across all emergency services with joint emergency services interoperability principles. Inspector Simpson earlier told the court that it was an impressive tool and 'takes the clinical aspect out of it'. 'You could effectively train anyone in this room on how to then triage a patient and then provide that information to a clinician as they approach,' he said. Police are generally on scene first and were at the shopping centre in large numbers on April 13, 2024. Inspector Simpson said giving police the tools to notify paramedics what category of patients were inside the centre may have been able to help with resource allocation.
