Why EMS personnel need an off-duty bailout bag

On- or off-duty EMS personnel need to be on the lookout for hazards and ready to operate in the warm zone

I went to the movies with my wife a few hours after hearing about the October 2015 shooting at Umpqua Community College in Oregon.

As we walked to the theater, I told my wife we had to sit near the back. If there was someone alone behind us, we may have to move or leave.

This wasn’t because of the events in Oregon. I routinely do that. I also watch people in the mall when I am there with my family. I maintain a heightened state of awareness.

A personal bailout bag with first-aid items for an active shooter incident
A personal bailout bag with first-aid items for an active shooter incident (Photo by Dan Limmer)

Only couples and larger groups were at the theater and we had a seat near the back. Odds were squarely in my favor that nothing would have happened, but that wasn’t the case in a theater in Aurora, Colo., a mall in Salt Lake City and a school in Sandy Hook, Conn.

I can't completely let my guard down now, and I believe I am not alone. Here are some of my top tips for on- and off-the-job safety.

Off-the-job safety

  • Keep your head about you. Everyone else will be in a panic during an active shooter incident. Much like clinical situations, you will only survive if you think clearly and critically.
  • Understand the concept of cover. The simple act of getting behind something that will stop a bullet is the easiest and most life saving thing you can do.
  • Incorporate movement into your survival plan. Dropping to the floor and covering your head makes you a sitting duck. Know where your exits are. Move from position of cover to the next position of cover until you are safe.
  • Know alternative paths to safety. Malls, theaters and other large buildings may have delivery corridors. These hallways, accessible through the rear of the store, may be your fastest exits.

Personal bailout bag
I keep a personal bailout bag, also known as an individual first-aid kit (IFAK), in my truck, so I can provide immediate and relevant care at an active shooter incident, as well as help with my personal survival. You should have your own IFAK. The following patient care items are in my bailout bag:

  1. Combat tourniquets
  2. Hemostatic dressings
  3. Israeli battle dressings
  4. Chest seals

On-the-job safety
I have two predictions that are not in favor of EMS safety.

First, EMS providers are being deployed into warm zones. This is already happening and will continue to a greater extent. Our training will prepare us for this response. Tactic and new equipment — vests and other protective devices — will be designed to be EMS specific.

Secondly, I believe we will become bigger targets. It used to be that shooters would turn the gun on themselves and die by suicide as the police approached. Now it seems that shooters are increasingly being neutralized by the police.

We have always been looked at as the "good guys" in the emergency-response business and that has prevented us from being targeted. The next iteration of this will be the active shooter/sniper who targets responding emergency personnel. It has the potential to demoralize us and causes more terror.

Response considerations
Since EMS and fire stations are within the community, it is likely that first due apparatus will be close when an active shooter incident begins. Keep the following things in mind:

  • Expand the warm and hot zone. Consider the scene to extend past the physical location where the shooting is reported. Whether it is a sniper situation or a perpetrator who may have left the scene as part of a panicked crowd, the danger zone extends much farther than you would think.
  • Practice response with law enforcement. Drill with police and fire agencies to determine roles and responsibilities at an active shooter incident.
  • Equipment for real risks. Your department should match equipment and training with the realistic role you will play in a scene.

Today is the day to make a comprehensive plan and strategy for your personal safety, as well as the plan and role of your public safety agency in the next active shooter incident.

I am very interested in hearing your experiences, the equipment you carry, and your agency’s policies in the comments below.

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