December 14 will mark the sad anniversary of the Newtown school shootings in which 26 students and adults died in an active shooter incident. In the year since the shooting, EMS has begun to re-examine its operational role in this type of situation. As this related article suggests, the prior practice of staging for such incidents will likely be revised.
For those of us who have been in the business for a while, this is more of a return to prior practices, which had EMS providers entering unsecured scenes. In hindsight, it was a bit crazy; I recall feeling like a fish in a barrel when police were busy securing the scene. Everyone was wearing body armor and had a variety of weapons; meanwhile my partner and I had only needles and syringes to throw at the bad guys if the need ever arose. Not a fun situation, but that was the expectation back then.
Staging until the entire scene is secure is probably not helpful either. As we saw in the recent active shooter incident at LAX where the TSA agent who died waited 33 minutes for medical attention, we know that time is of the essence in trauma where the airway, breathing or circulatory status is actively decompensating. Moreover, when the fix is relatively easy — secure the airway, provide artificial ventilations, or stop the bleeding — early intervention becomes that much more critical.
With tactical changes comes a bit of uncertainty. Hopefully for most of us, we won’t have to put ourselves in the harm’s way that our EMS brothers and sisters did in Newtown, Aurora and other active shooter scenes. But when the call goes out, we’ll need to be ready to help despite the danger.
