There is a difference between prehospital providers' ability and willingness to respond to terrorist, public health emergencies, and disaster incidents.

A nationally representative sample of the 203,465 basic and paramedic emergency medical service providers in the United States was surveyed to assess their ability and willingness to respond to terrorist incidents.

Emergency medical technicians were appreciably (10–20%) less willing than able to respond to such potential terrorist-related incidents as smallpox outbreaks, chemical attacks, or radioactive dirty bombs (p <0.0001). Emergency medical technicians who received terrorism-related continuing medical education within the previous two years were nearly twice as likely (OR = 1.9, 95% CI 1.8, 2.0) to be willing to respond to a potential terrorist incident as those who indicated that they had not received such training.

Timely and appropriate training, attention to interpersonal concerns, and instilling a sense of duty may increase first medical provider response rates.