Dealing With Major Trauma: Paramedic Matthew Pepper


Published: 20 November 2019

Content warning: this article discusses a traumatic event in which three lives were lost. Some readers might find the content in this article distressing.

Ambulance officer, Matthew Pepper, recalls the moment his team began to lose their patient on the drive from Martin Place.

In the following days of the 2014 Lindt Cafe siege, findings would reveal a police bullet ricocheting off the cafe wall was the cause of Ms Dawson’s death.


Before becoming a paramedic, Matt Pepper served seven years in the Australian army. Matt has 13 years of experience as a paramedic across multiple ambulance services. He works as a Special Operations / Intensive Care Paramedic in Sydney.

Matt is a member of the first full-time Tactical Paramedic Team in Australia. He is the first-ever dedicated Tactical Medicine Clinical Training Officer in Australia.

Among Matt’s responsibilities is to teach tactical medicine to government agencies, the ADF, and emergency services.

In 2015 Matt was the recipient of a Churchill Fellowship in 2015 to study technical medicine and prehospital response with agencies through the USA, UK and Canada. He was also the Ian O’Rourke Scholarship recipient in 2018, looking into collaboration and interagency cooperation in large-threat medical response.

Matt has a Masters in Philosophy researching defining elements of the prehospital response to terrorism. He is on the editorial board of the Journal of High Treat and Austere Medicine and works for multiple universities as a lecturer, tutor and curriculum developer.

Matthew Pepper will be presenting at this year’s Major Trauma Conference on 12 - 13 December in Sydney with his talk ‘When Terrorism Causes Trauma’.

Paramedic standing in front of an emergency vehicle | Image

The Lindt Cafe Siege

On a seemingly normal Monday morning in the midst of the 9:00 am rush at the Lindt Cafe in Martin Place, cafe patron Man Haron Moris drew a gun, holding-up 18 hostages.

In the duration of the terrifying 16-hour siege that took place on 15 December 2014, 12 of the 18 hostages were able to escape in four separate instances.

Shortly after 2:00 am on 16 December, a heavily armed police squad burst into the cafe bearing flash grenades and heavy ammunition.

The gunfight lasted roughly 30 seconds. From the cafe, police and emergency officers emerged carrying injured hostages. Three of the hostages were on stretchers and a fourth was carried out in the arms of two officers.

Matthew Pepper was one of the ambulance officers on the scene.

Major Trauma Conference

For further details and to register click below:

Book Online Now!

Ambulance officers worked without hesitation following the shooting. They administered CPR on the sidewalk to barrister Katrina Dawson who had been hit by a bullet.

Matt reports when they put her in the ambulance, Ms Dawson was still semi-conscious. They started to lose her as they drove to the hospital.

Findings would reveal a police bullet ricocheting off the cafe wall was the cause of Ms Dawson’s death.

In an interview with the Saturday Telegraph about the siege, Ambulance Inspector Alex Peters is quoted saying:

‘The harder bit is in the days following when you start to learn about the people you looked after.’

Katrina Dawson was a mother, wife, sister, daughter and lawyer.

Unfortunately, there wasn’t anything more paramedics could have done to save Ms Dawson or 34-year-old cafe manager Tori Jonhson, who was shot dead by Monis.

At the siege’s end, the death toll was three: two hostages and the gunman himself.

What to expect from Matt’s presentation...

As a nurse, there’s a high chance you will be confronted by a sudden natural or premeditated disaster at some point in your career, which will impact the provision of patient care, requiring you to make difficult decisions and use available resources in situations not entirely in your control. This session will highlight vital issues for all nurses to consider.

The presentation will include:

  • Emergency response to disasters, ‘at work’ v ‘at the scene’ as an incidental responder.
  • The facts and fiction of disaster management, influences on triage and impact of short-term v long-term events.
  • Characteristics of intentional mass violence incidents including wounding profiles and dynamic threat profiles.
  • The impact of premeditated events on medical response and outcomes in today’s world.

Major Trauma Conference

Major trauma incidents can happen without any warning.

Are you prepared for when a major trauma patient comes your way? Since no two major trauma incidents are the same, education is essential to ensure you are confident and always ready to act. Attend this conference to improve outcomes for major trauma patients.

Topics will include:

  • How to treat penetrating injuries.
  • Catastrophic haemorrhage management.
  • Where to start with paediatric and obstetric trauma.
  • Prehospital management of suspected spinal injury.
  • A look at delayed accident symptoms and much, much more…

Don’t miss out on an opportunity to attend this new event. Book now!

Listen to this Australian Tactical Medical Association podcast episode in which Matt speaks with Adam Davis, a Paramedic of 10 years who works in the Tactical Response Unit with London Ambulance Service:

Major Trauma Conference

For further details and to register click below:

Book Online Now!