Unified command: EMS role in active shooter incidents
NFPA’s John M. Montes, NREMT, examines how ASHER programs help communities prepare for, respond to and recover from active shooter incidents
NEW ORLEANS — Between 2000-2017, the Federal Bureau of Investigation has recorded a total number of 250 active shooter events resulting in over 2,200 victims either killed or wounded. Active shooter incidents have a significant impact on an entire community. Establishing relationships between all available resources are essential in the preparing for, planning of, responding to and recovering from these incidents.
John M. Montes, NREMT, an emergency services specialist with the National Fire Protection Association (NFPA), kicked off the 2019 EMS World Expo in New Orleans with an early morning session titled “Active Shooter Hostile Event Response (ASHER) Programs: Unified Command and the Role of EMS,” to educate attendees on the importance of implementing and improving a community’s ability to establish a unified command with the whole community approach in mind.
Memorable quotes on ASHER programs
Here are four memorable quotes from Montes on planning for, responding to and recovering from active shooter incidents:
“No matter what your function in the community is; from the public, to responders, to healthcare, everyone has a role in these events.”
“Take care of each other ... planning for taking care of our people [first responders] is just as important as taking care of the community and their loved ones.”
“The point of a unified command is to work together to achieve shared goals. Not to tell each other what to do.”
“Figure out what works best for you based on your risk assessment, resources and capabilities. Then, put it into practice!”
Top takeaways on ASHER programs
Montes explains the importance of the NFPA 3000 standard which was designed to answer the call to create a national standard to streamline the planning, preparation, response and recovery from active shooter incidents. Here are some key takeaways captured during his presentation.
1. Why was the ASHER program created?
The NFPA serves as standards development organization that creates comprehensive national codes and standards designed to diminish hazards that may cause injury, death or property/economic loss. The NFPA has a 123-year history in forming technical committees that are balanced in category of representation (labor, consumer, special expert, etc.) of subject matter experts when requested to develop American National Standards Institute (ANSI) accredited consensus based standards for a particular item, process or subject.
The Technical Committee on Cross Functional Emergency Preparedness and Response is the largest single document technical committee in the history of the NFPA and was tasked with creating NFPA 3000 (PS) Standard for an Active Shooter/Hostile Event Response (ASHER) Program. This program provides criteria for a whole community approach working together to assess risks, plan, prepare, respond and recover from an active shooter or other hostile incident.
Information sharing from after-action reports, public viewpoints via public inputs and comments, existing laws and regulations, and preexisting local/state/federal guidance were utilized and referenced in making the standard.
2. Implementing the ASHER program using for common concepts
NFPA 3000 can help guide communities to identify risks, plan, prepare, respond and recover from active shooter incidents. Four common concepts are found within each chapter:
Whole community. First responders can build and maintain partnerships between residents, emergency mangers, hospitals, faith-based organizations and businesses to aid in the preparation for, response to and recovery from an incident within their community. First responders must reach out to key personnel outside of the normal responder community, such as non-governmental organizations, emergency management, public health, healthcare, schools and other subject matter experts to better prepare for all phases of an incident.
Unified command. According to the National Incident Management System, the standard definition and role of a unified command is:
“An authority structure in which the role of incident commander is shared by individuals from all responding organizations responsible for the incident, operating together to develop a single incident action plan. During an ASHER incident, Unified Command generally consists of law enforcement, fire, EMS and representatives of the location or organizations that are assisting with incident management at a minimum.”
Lessons learned from after-action reports have shown common trends regarding the lack of an effective unified command when active shooter incidents cross between multiple jurisdictions and involve interoperability of various resources from local/state/federal levels.
Establishing a unified command clarifies response roles and enhances open lines of communication between multiple entities. Having someone in unified command who is familiar with the location of the incident will help decision makers better understand what the plans, capabilities and actions expected of occupants are of the location.
Integrated response. Response integration is about un-like resources working in a unified manner to address their responsibilities to the response of the incident. Typically, this consists of fire, EMS and law enforcement. It can also consist of armed security, mutual aid or disported agencies that are prepared to work together to address the needs of the incident.
Threat-based care is outlined in accordance with the guidelines of “Tactical Emergency Casualty Care (TECC) Guidelines for First Responders with a Duty to Act and Tactical Emergency Casualty Care (TECC) Guidelines for BLS/ALS Medical Providers.”
The hot zone is designated for law enforcement or specialized teams to directly neutralize the known threat.
The warm zone has the potential for a threat, but may allow responders to provide threat-based care. While the standard does not dictate your local tactics, it does recommend training your personnel on the four rescue concepts (i.e., rescue task force, law enforcement rescue team, protected island operations, and protected corridor operations) as this will allow commanders flexibility on how to address warm zone care and best address the needs of the current incident with available on scene options. Fire and EMS agencies planning to have their personnel enter a warm zone with protection, must equip responders with a minimum of a level IIIA (NIJ) ballistic vest, an identifiable garment and a means of communication, with the consideration of also providing them ballistic helmets.
The cold zone is secured which allows the establishment of a command and control, triage/treatment and transport/staging area.
Montes emphasizes the importance of an effective dispatcher as the key to keep track of team activities in real-time and relying that information to additional teams within the same location.
Mutual aid between jurisdictions may be available to supplement response needs should resources become limited throughout the course of the incident. It is critical to identify the resources available and capabilities of mutual aid partners and to plan accordingly for what they can provide to the incident..
Planned recovery. Recovery of an active shooter incident starts today. It is divided into three main major categories: 1) immediate recovery, 2) early recovery and 3) continued recovery.
Montes challenged attendees to start conversations by asking some of the following questions:
What are we going to do with volunteers?
How are we going to handle spontaneous donations?
How do we vet credentials of medical volunteers?
Where are we going to locate the victim notification center?
What are our long-term plans to support victims?
Short-term to long-term recovery period should include some of the following plans:
Coordination of primary agencies
Utilization of a committee meeting protocol
Primary victim notification and reunification
Victim assistance (i.e., victim witness specialist)
Media and public information coordination
Montes explained the revised edition of the NFPA 3000 will include a change from “Reunification center”(an early recovery phase operation) to “Notification center” because it has been identified that many people head to the reunification center with the false hope of being reunified with loved ones and notification center more accurately depicts the actions of the site. “Family Assistance Center” (a continued recovery phase operation) is transitioning to “Incident Assistance Center.” This term is more inclusive of all relatives, friends and loved ones, who may be impacted by the incident. These centers will provide several short or long-term services, e.g.;
Mental health counseling
Crime victim compensation
Assistance with legal matters
3. Conducting risk assessments
Montes advised information sharing between first responders, businesses, schools, healthcare and other entities within the community are beneficial.
Identifying vulnerabilities through community risk assessments is key to knowing potential threats, response capabilities, obtaining proper resources, developing appropriate plans and conducting annual exercises to test plans.
4. First responder call to action
The NFPA 3000 roadmap was designed with the whole community approach in mind.
Montes proposed a call to action for all first responders:
Step 1. Gather more knowledge about the NFPA 3000 and what is in it.
Step 2. Start identifying which components of the standard effect your agency and community needs. Initiate conversations within your community to help them find the parts of the standards that affect them, then use the standard as a reason to build relationships, develop a customized plan, and start talking about short/long term recovery plans.
Step 3. Continue to obtain more knowledge about changes and resources available.
Step 4. Take care of fellow first responders. Any traumatic events can take a toll on everyone in the community, especially first responders. Montes encourages all first responders to “take care of each other.”
Additional resources for planning for and responding to active shooter incidents
Learn more about ASHER programs and how to plan for and respond to active shooter incidents in your community with these resources:
The NFPA 3000 Fact Sheet
You can learn more and even read NFPA 3000 for free (just create a free account) at www.NFPA.org/3000news
This article was originally posted Oct. 28, 2019. It has been updated.