In a recent EMS1 webinar, sponsored by Rescue Essentials, David K. Tan, MD, EMT-T, FAEMS; and Chief Rob Wylie discussed establishing unified command, what we need to know to enter the warm zone, the fundamentals of trauma priorities in an active shooter event and overcoming the barriers to establishing an RTF program. One attendee noted, “The speakers were very direct, their message simple and clear.” Watch the on-demand version now: “Trauma tenets: Evolving active shooter response”.
When working in high stress, high consequence environments with other teams you may not work with on a regular basis, the use of preparatory commands can help ensure smoother operations and a margin of safety for all involved.
This form of communication is nothing new; in the fire service, we learned the use of preparatory commands in ladder training in the academy.
Terms such as, “prepare to lift; lift,” get everyone on the same page and working together to provide safe and effective operation, especially when you may not have visual contact with all your team members.
The same thing applies when you are part of a rescue task force entering into a potentially hostile environment. You may work with the police on a daily basis, but rarely are we working with them in this type of operation.
While each group has their jobs in an active shooter response, everyone must be on the same page as to movement and action.
Police officers are concentrating on moving to your patients while scanning for threats. They will not always have direct eye contact with you, so a good communication system is imperative.
Watch for more:
On-demand webinar: Trauma tenets – Evolving active shooter response
Saving lives with coordinated trauma care through pre-planning, training and relationship building
Wait for confirmation
In general, speak in plain terms: no codes, no jargon. To enhance that communication, let people know what you are going to do before you do it and then wait for confirmation that the whole group understands what’s going to happen next before it happens so they can adjust and there are no surprises.
Examples of these preparatory commands include:
- “Ready to move.” “Move.”
- “Medics coming out.” “Come out.”
- “Ready to stop.” “Stop.”
In each example, the person or group wanting to initiate the action gives a warning about what’s going to happen next. They then wait for acknowledgement from the group and then proceed with the action.
Allow law enforcement to concentrate on the task at hand
Imagine the potential problem if you are in a room, treating a patient, while the law enforcement element stand guard outside protecting your actions, and you suddenly come through the door without warning. The officers would be surprised, which is not a good thing!
Instead, a good preparatory communication, such as, “medics are ready to come out,” from inside the room would give the officers a heads up and allow them to make adjustments on their end for you to come out safely. Or, conversely, if there was a potential or actual threat in that hallway, your preparatory communication gives them the opportunity to say “No, stay in the room until I call you out.” All this can be accomplished without the officer taking their attention off their task.
Like in almost everything we do, good, effective communication is the key to a safe operation.
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