Leadership and Followership


  • In a sudden emergency there is a ‘leadership void’ that needs to be filled if the situation is to be well managed.
  • A good leader steps back to survey the whole scene.
  • Being a good follower is a skill: be supportive and communicate actively and thoughtfully.


Accident scenes can be chaotic. In the seconds following a crash, people are often too stunned to move. Then suddenly, everyone rushes into life, all with different ideas and priorities. Some will want to take over, some will want to run and hide but fundamentally, everyone is looking for a leader and a task. We all need to feel like we are doing something useful in a crisis.

Stepping up to fill the leadership void is a difficult thing, particularly amongst a group of friends. It can feel exposed and some worry about being thought of as pushy or arrogant. Actually, most groups are utterly relieved when one person volunteers to be the leader.

A leader does not have to be the one with the most medical knowledge. Indeed, often it is best that those with medical experience don’t take overall charge. They will be most useful applying all their energy to looking after the casualty.

We prefer to use the word ‘coordinator’ rather than leader. It carries less emotional charge and is a more accurate description of the role. We would encourage you to be brave. If you are faced with an accident, then step up and say ‘I will coordinate this situation’. It will make the world of difference to how the rest of the day unfolds.

Trauma course participants managing the accident scene. Two teams of carers look after each casualty. The leader (green hat) stands back, talking to the scribe (red hat), but keeps physical contact with a casualty carer (left hand).

When you are coordinating, please try to stand back. Your job is not to be hands-on, it is to take a global view and delegate wherever possible. This too can be very hard. Even though it feels the opposite, the less you are physically doing, the better a coordinator you are.

Don’t forget to think out loud. During stressful situations, we often internalise – however, thinking out loud will help marshal your own thoughts, as well as giving your group a sense of direction.

If someone else has volunteered to coordinate, then try to fall in behind them. Recognise their courage in putting themselves forward and do your best to support them. Clearly, that does not mean unquestioning obedience – of course you should speak up if you think events are moving in the wrong direction. However, if you are given a sensible task then do your best to get on with it.

Be conscious that the coordinator will be being bombarded with information and questions. This is called decision fatigue and is a recognised problem. As a follower, tell the leader only what is necessary when you speak to them. Try to pose a solution along with your question. If you are given a task, verbally confirm that you have understood and report back when it is completed. Finally, give the leader plenty of encouragement during and after the event.