ABSTRACT
Resilience has always been a critical property of all human systems, but its use in the safety literature has brought an old term to a new understanding. Despite the use of the term resilience engineering (RE) in more recent safety literature, it is nonetheless used in conflicting ways with different industries using it in dissimilar contexts. RE emphasizes examples of the positive, whereas the focus is with how systems succeed by adapting their performance to the demands within the environment. The management of any system such as prehospital emergency medical services (EMS) entails achieving a balance between brittleness and resilience. Most operations in the prehospital EMS recognize the challenges and provide both training and procedures to match when recognized by on-scene personnel. Complex sociotechnical systems such as prehospital EMS are like a living organism. The individuals in any social–technical system are able to adapt to challenges and surprise, but the very nature of the system changes with the choices.
