Active-shooter incidents: Steps to prepare, train and respond from EMS experts

EMS professionals have an obligation to learn to operate in the 'warm zone' to deliver lifesaving care to victims of lone wolf shooters

Active-shooter incidents, with alarming frequency, in communities of all sizes happen far too often. EMS1 editorial advisory board members, columnists and contributors share their thoughts on the obligation we have to operate in a warm zone, deliver lifesaving care – on or off duty, and be ever vigilant for a lone wolf attacker. Read their observations and share your thoughts in the comments.

Look for the helpers; Be a helper

By Kelly Grayson

Like everyone else, I was shocked and saddened to hear of the mass shooting at Umpqua Community College in Roseburg, Ore. Of course, 'shocked and saddened' are pale words to describe the grief and anger each of us feels after events like these.

I will not profane the memories of the victims killed by an evil man by ever mentioning his name, or by using their deaths to advance a political opinion. Most EMS1 readers already know my politics anyway.

I will instead offer prayers to the families of the killed and wounded, and hope that time brings them healing and peace. I also offer my support to the EMS and public safety personnel responding to this tragedy. No one should ever have to face such an event, but it seems that in the world we live in today, all of us must be prepared to do so.

I believe that it is past time that all EMS crews are provided body armor and training in operations inside the 'warm zone' of an active shooter incident. As yesterday's events aptly prove, there are no safe places and there are no safe scenes. We need to prepare accordingly. And if your agency has not recently focused on active-shooter incident training it is time to do so.

Small towns and sleepy rural communities are no longer a shield. Evil is not something that just visits inner cities.

In times like these, I prefer to face such horror with the wisdom of Mr. Rogers, a gentle voice from my childhood. When times seemed much simpler he said:

"When I was a boy and I would see scary things in the news, my mother would say to me, 'Look for the helpers. You will always find people who are helping.' To this day, especially in times of 'disaster,' I remember my mother's words, and I am always comforted by realizing that there are still so many helpers—so many caring people in this world."

For every senseless act of violence committed by one evil man, twenty more will rush in to defend the defenseless, tend to the wounded, and offer help to the stricken. I am proud to count myself among the community of helpers.


More sophisticated attacks are likely

By Jim Morrissey

I am in Nigeria right now with the U.S. State Department anti-terrorism assistance (ATA) program teaching active shooter, terrorist attack response for EMS and others. The focus is on coordinating with law enforcement and bomb squad to secure the scene, and then get medical assets to those who need it quickly, but safely. The threat here is, of course, Boko Haram bombings and coordinated attacks. As bad as the typical single shooter incidents we face in the U.S. are, we also need to be ready for the more sophisticated and deadly attacks that at some point we will see.


Huge opportunity to improve

By Gustavo E. Flores

No mass casualty is ever the same or run-of-the-mill. There is nothing ordinary about mass killing. But it's becoming distressingly more common. Still, most EMTs and medics are untrained on how to survive (RUN. HIDE. FIGHT.) and perhaps are not even being trained on aggressive bleeding control tactics. I think there is a large gap and a huge opportunity to improve our response capacity.


Is it time for EMS body armor?

By Chris Cebollero

We have gotten to a point where we are not safe anywhere we go. We can't go to church, the movies, or schools. What's next? That has to be the question because these copycat shooters are looking for the next big impact.

Is it time to think about body armor and arming first responders to assist our police partners?

EMS could potentially be a target. As leaders, how do we keep our workforce safe?


Profession needs to unify on preparation and response to active shooter

By Kris Kaull

We have a problem. We are not unified as a profession on preparing for an active-shooter incident and doing our job safely.

Safe used to mean staging blocks away. This simply isn’t the case anymore and hasn’t been for years. But the mentality hasn’t changed.

Unfortunately, the answer to active-shooter incident response is more than a position statement. Mike Taigman has been preaching concerns about provider safety since the 1980’s with the EMS Street Survival Seminars.

Skip Kirkwood has more recently championed the cause of critical thinking for scene assessments and has supported Kip Teitsort’s unyielding focus on protecting ourselves in violent encounters. We have passionate, skilled and experienced colleagues who are willing to teach and train, but we struggle getting this to resonate with the EMS Community.

To most effectively respond to active-shooter incidents, we need:

1. Education. This includes classroom knowledge on the profile of the active shooter, preventive measures, our roles in the response, and lessons learned from experts and previous events.

2. Hands-on training. Textbook knowledge is great, but it’s critically important to apply that knowledge into multi-jurisdictional scenario-based training.

3. Continual updates. Annual or more frequent training and review.

4. Local expert teams. EMS needs a disciplined, specialized team with more intense education, training and availability as the first response crew.

Our communities believe that we are ready for every response and expect us to be ready for an active-shooter incident. We need to take that responsibility seriously.


Thoughts to the responders

By Skip Kirkwood

We are not going to disarm American society any time soon. As a former sworn law enforcement officer and Navy hospital corpsman (USMC trained), I fully understand that the only solution for a bad guy, or crazy guy, with a gun, is a similarly-armed good guy. I suspect, without knowing, that the Umpqua Community College is probably a “gun free zone” where good guys are disarmed. I’m starting to think that these should be named something else - “easy victim zones.”

My heart goes out to those killed and injured and to the responders who had to contend with an awful situation - Roseburg Fire Dept., Douglas County Fire District, Medcom, Medic-4, and probably services well beyond that area, as well as the law enforcement agencies in the area. Don’t forget to take care of yourselves.


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