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Clinical scenario: A report of shots fired with multiple injuries

You are dispatched to a law office for multiple shooting victims

“Medic 7, respond and stage two blocks south of 578 Northwest Circle, Suite 210. Law enforcement is en route for a report of shots fired. The County Rescue Task Force is being deployed for a possible active shooter event.”

You pull up to the designated corner and park behind the engine. You advise dispatch that you are staged at the requested location and receive the following update:

“Medic 7, law enforcement is on scene and has made entry into the building. Officers are reporting multiple casualties on scene, possibly 10 to 15 with a range of injuries.”

You request that dispatch activate your system’s MCI protocol and are advised that four additional ambulances are responding.

After approximately five minutes dispatch provides another update:

“Medic 7, officers report that one suspect exchanged gunfire with them and is down. They are indicating that you and Engine 5 are clear to proceed in using the south driveway. Medic 2 will be your next arriving ambulance and is approximately five minutes away.”

With the limited information provided by dispatch and the officers on scene, think about these questions as you decide what steps to take next:

  • How may this call differ from a standard shooting call?
  • What role do tactical paramedics play in such an incident? What about on-duty crews?
  • What are the triage priorities in an active shooter scenario?
  • What about treatment priorities?
  • What care should be provided on scene versus en route to the hospital?
  • Does your agency’s MCI plan adequately address active shooter scenarios?

Post your answers below in the comments and view the clinical solution for this patient.

An EMS practitioner for nearly 15 years, Patrick Lickiss is currently located in Grand Rapids, MI. He is interested in education and research and hopes to further the expansion of evidence-based practice in EMS. He is also an avid homebrewer and runner.

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