Volunteer EMS: How to prepare for active-shooters

Keeping fire and EMS personnel safe in low-probability, high-risk situations like those involving active shooters takes preparation — and a lot of it; here's what the experts say volunteer chiefs can do to be ready


Three to five minutes.

That’s the average duration of most active-shooter incidents.

The damage that can occur in just a matter of minutes is shocking and reinforces the need to remain vigilant regarding fire and EMS training and prevention efforts.

These incidents, especially those in public places, don’t always happen in major cities. They often happen in towns covered by combination or volunteer fire and EMS departments.

And almost every year, these incidents occur somewhere in the country, leaving innocent civilians severely injured or killed and putting responders in harm's way. 

Lessons from Columbine
The most infamous active-shooter incident occurred almost 16 years ago on April 20, 1999, at Columbine (Colo.) High School. Thirteen people were killed and 24 others were wounded. First-arriving units with the Littleton (Colo.) Fire Department thought they were dealing with a drive-by shooting by the way it was dispatched and were unprepared when they arrived on scene.

"At Columbine, everyone stood outside and waited for the SWAT team," Cottleville (Mo.) Fire Protection District Fire Chief Rob Wylie said. "And to their credit, they addressed the failures in their response and changed their tactics."

Chief Wylie is a tactical medic who has been researching and speaking at national events on sending fire and EMS personnel into the hot zone at active-shooter incidents as a way to save more victims.

There was no significant law enforcement entry for 47 minutes after the shootings started, and it took a total of four hours before the last victim was removed from the school building, according to a report by Dr. David K. Tan, a medical director at St. Charles County (Mo.) Regional SWAT, ER doctor, and Board Certified EMS physician in St. Louis.

"When Dr. Tan and I did a literature review on 84 active-shooter and violence incidents, the average time for the onset of the incident to the time of medical care delivered to victims was 1.75 hours," Chief Wylie said. "That’s unacceptable. We now know that if we work in the wake of the incident with dedicated security elements, we can get in there now in a 5- to 10-minute window and start to provide aid to the victims of these assaults."

How volunteers can prepare
In order to prepare for active shooter incidents, volunteer fire and EMS agencies must do extensive training and preparation ahead of time.

And although most rural departments are low in numbers, this doesn’t mean they cannot respond to such emergencies.

With lessons from Columbine in mind, Arlington County (Va.) Fire Department, with the Arlington County Police Department, developed a new active shooter method that deployed three- or four-person teams on scene for quicker response.

"It really comes down to small unit tactics," Chief Wylie said. "If you take three or four officers and two or three medical providers, you can have them attack the problem as a small unit at the appropriate time."

This method, called MACTAC (Multi-Assault Counter Terrorism Action Capability), is designed to allow officers from different agencies who have never trained together to mitigate threats using common vocabulary and tactics.

Chief Wylie and Dr. Tan piggybacked on the MACTAC training and developed RACTAC (Rapid Access Casualty Treatment and Clearance) that allows fire and EMS agencies to work together with law enforcement to save lives using the same vocabulary and tactics.

"Planning is great, but the planning process is much more important than the plan," Chief Wylie said. "Medium and small departments need to set up some cross training with their local law enforcement agencies. That way, when we all show up on the scene at a high-stress situation, you can skip the tail-sniffing phase and get to work."

Collaborating with law enforcement
Fifteen years ago, fire and EMS departments would "stage and wait" for police and SWAT teams to arrive on scene.

Now, regardless of size or capacity, it is imperative that police, fire and EMS agencies find a way to train and practice these tactics and SOPs together.

"You need to have an established relationship with local law enforcement so you can understand what the expectations are for police and so that they can also understand what fire and EMS is able to do and what our strengths are," said Fire Chief Kevin McGee, a 27-year veteran of the Prince William (Va.) Fire and Rescue Department.

Crews with volunteer and rural departments will often not be able to respond to these incidents by themselves and will require mutual aid. It’s important for rural areas with a number of small departments to train together and prepare in advance for a large-scale incident.

"A common theme from after-action analysis reports where the incident had gone well is the importance of the relationships that were built prior to the incident and how that relationship building contributed to good communication and a better outcome than otherwise would have occurred," Chief McGee said.

Once this relationship is established, fire, EMS and police officers can speak the same language and know what tactics need to be deployed on an active scene.

"We emphasize unified command for our response to active-shooter or active-violence incidents," he said. "The more integrated we are, the more effective we’re going to be. Operating in a silo kind of fashion doesn’t lend itself to actually taking care of the people we’re responding to help."

Everyone’s role on scene may be different, but the overall goal is still the same: saving as many lives as possible.

Training doesn’t come free
The growing issue for volunteer fire and EMS departments is how they can train firefighters and medics for these types of scenarios without a big budget — or sometimes no budget at all.

Other issues include how to continue training beyond the basics, and for some volunteers it’s about finding the time and place to train that’s convenient for their work schedule.

Chief Wylie mentioned that there are free online resources on Arlington County’s website and also on TECC’s (Tactical Emergency Casualty Care) website.

"Those free resources are excellent and the websites are always being updated," Chief Wylie said. "No matter how small your department is, there will always be some kind of contingency plan on what the response to this type of incident might be. Depending on the rural area, it may take a little longer to muster the resources, but the key is to be ready to integrate with those resources at whatever level you can do."

Another suggestion is to check with the emergency manager in your area and also what neighboring regions are doing.

"A lot of counties are willing to help neighboring regions and there’s a lot of information sharing within the fire service," Chief McGee said. "Don’t be afraid to reach out to your network."

Chief McGee also recommended looking at public forums for information sharing between fire departments.

"Something that’s great for volunteer fire chiefs to check out on the International Association of Fire Chief’s website is a forum digest that members of the IAFC can go on, ask questions and learn how other departments are training," Chief McGee said.

Both Chiefs Wylie and McGee agreed that training and preparing for active-shooter incidents is not limited to the size of your department.

"I don’t think anyone should say, ‘Hey, we’re only a little 12-person volunteer fire department and there’s nothing we can do,’" Chief Wylie said. "Volunteer departments with even the smallest amount of training can still sweep into these types of situations and help save lives."

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