July 31, 2019 | View as webpage

The Gilroy Garlic Festival in Santa Clara County, California, was the latest mass gathering to become a mass casualty incident. Many were wounded, and three people – two of them children – were killed when a gunman broke through a safety perimeter and opened fire on families enjoying live music on the final day of the popular event. In this briefing, Dan White details why small communities, in particular, need to pre-plan these events, and practice their MCI response before festivals, fairs and gatherings.

Additionally, the 2019 EMS Trend Report survey found recruitment and retention are still the top concern for paramedic chiefs and EMS managers and the providers they lead. Download the report and send your top takeaways to greg.friese@ems1.com.

Also in this briefing, Allina Health EMS Chaplain Russ Myers provides a low-cost, high-impact approach to engaging employees that can boost morale, create lasting workplace relationships and ultimately, retain personnel.


Greg Friese, MS, NRP
Editor-in-Chief, EMS1

Rapid Response: Is MCI response part of your community celebration planning?
By Dan White

The popular Gilroy Garlic Festival in Santa Clara County California was coming to a close Sunday evening when a gunman opened fire. The festival brings thousands of people every year to the small town of 58,000.

There are reportedly three dead, including two young children, and 15 injured. 

What happened. Todd Jones, a sound engineer, told the Associated Press that he was at the front of the festival's Vineyard stage when he heard what sounded like a firework. "But then it started to increase, more rapidly, which sounded more like gunfire, and at that point, people realized what was happening," Jones said.

From the videos posted on social media, it was chaos. Evenny Reyes (13), of Gilroy, told the press, “We were just leaving and we saw a guy with a bandana wrapped around his leg because he got shot. And there were people on the ground, crying, There was a little kid hurt on the ground. People were throwing tables and cutting fences to get out."

Why it’s significant. This is a modest-sized town with a small fire department. Resources early on must have been scant, while first responders were faced with trying to create order in this situation.

Think for a minute what it would be like. CPR in progress on a kid and more than a dozen wounded. Patients being transported in private vehicles. They didn’t even know if there might be multiple shooters, with one still running around with a rifle.

Top takeaways on the Gilroy Garlic Festival shooting

Here are two takeaways EMS agencies should learn from this incident.

1. Any mass gathering is a target for violence

We can only imagine being the first EMS crew on the scene. But we all better learn how to respond to a mass gathering, because this is the new normal.

We need to come to grips with the situation. Any large group of people carries a risk for mass violence. No place is too safe, too sleepy or too rural to avoid being at risk anymore. I have worked and lived in a few rural communities. It’s easy to feel safe to the point of perceived immunity.

Thousands of small towns across America have summer events. They celebrate a season or a local specialty and are important to a community’s economy. The whole point is to draw large groups of people carrying wallets.

In recent years, mass murderers have often attacked large groups, including those in schools, houses of religious worship and nightclubs. Organized events are another target. The Las Vegas shooter targeted attendees at the  Route 91 Harvest Festival, killing 58 people and wounding hundreds.  

2. Pre-plan and practice MCI response for mass gatherings

Anytime you will have hundreds of people in one place you need to be prepared. Practice setting up a command structure and triage station. Practice setting up transport stations and ensuring access and egress of responding units. Be ready by being well trained and regularly drilled.

Because if we can learn anything from this horrifying event, it is that this can happen anywhere large groups gather.

Additional resources:
Enhancing wellbeing, engagement, patient care in EMS with weak ties
By Russell Myers, D.Min., BCC

Think about an EMS provider’s typical work day, apart from the clinical aspects. Our medic gets to the base, where he sees a coworker, and asks about their weekend. Crews are coming and going; they chat for a few minutes and wish each other well. Our medic has a brief exchange with a supervisor, manager or administrative support person. Heading out, he makes his regular stop for coffee and a snack at the convenience store, and shoots the breeze with the clerk. He then responds to a call, where he exchanges greetings with the police officers, and the fire and rescue team on scene. He may not know any of these people well, but their paths cross occasionally, and they engage in some light conversation.

It appears that these “weak ties” have a greater impact on our wellbeing than we realize. A 2014 study found that “daily interactions with casual acquaintances ... can contribute to day-to-day well-being.”

Tracking interactions with family and friends (strong ties) and with acquaintances (weak ties), participants in the research reported a greater sense of belonging and happiness on the days when they had more weak tie conversations. “Evidence suggests that weak ties such as these – relationships involving less frequent contact, low emotional intensity and limited intimacy – confer some important benefits,” the authors noted.

Social relationships, with weak ties or strong ties, are an essential part of being human. Our brains are hard-wired to seek connection with other people. It’s in all of our best interests to cultivate the fine art of making small talk with people we don’t know very well.

Patient care implications

For our EMS providers, this has implications for both their inter-personal relationships and in the patient care they deliver. First, weak ties with those providers encounter throughout the day benefits their own sense of well-being. Having casual contact with peers, public safety colleagues, hospital staff and others deepens their sense of connectedness. Another study reports that “feeling socially connected increases happiness and health, whereas feeling disconnected is depressing and unhealthy.” Small talk aids in our ability to see others as fellow human beings, beyond the uniform.

Volpe observes that “Instead of considering these minor brushes of socialization throwaway interactions, cultivating low-stakes relationships can pay dividends.” Our intentional efforts to nurture weak ties with those around us also extends to our patients. Making small talk with patients and their loved ones invites providers to look beyond the illness, beyond the circumstances that bring EMS to their aid, and see them as fellow human beings. The same benefits of social connection that we enjoy – an increase in our happiness and health – also benefit the patient.

Encouraging empathy and engagement

The practice of cultivating weak ties has potential leadership, business and institutional implications as well. Wallace notes, “Chitchat is also an important social lubricant, helping to build empathy and a sense of community. It is much harder to snap at a [coworker] ... if you have just exchanged pleasantries.”

I believe that managers who have an intentional, weak-tie relationship with their direct reports are more likely to have employees who are more engaged, resulting in lower rates of employee turnover. Those employees are also more likely to be more empathetic toward their patients, which leads to increased patient satisfaction.  Weak ties can be nurtured by the occasional social event, manager-provided food, and EMS Week activities. Work relationships have some natural boundaries, but that doesn’t preclude being friendly and showing an interest in your employees. 

It’s clear that making small talk has surprising benefits. The challenge, and the opportunity, for EMS clinicians and leaders is to approach those interactions deliberately. It’s a win-win.          

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