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Top-down preparedness for an active shooter

Takeaways from Dr. Tan and Chief Wylie on training and communicating to deploy rescue task forces, unified command and casualty collection points

Rescue task forces, casualty collection points, unified command – we know in theory how these tactics can guide operations, but when an active shooter event happens in your community, will your responding agencies be trained and ready to deploy them?

In a recent EMS1 webinar, sponsored by Rescue Essentials, David K. Tan, MD, EMT-T, FAEMS; and Chief Rob Wylie provided valuable insights and advice for responding to an active shooter event based on their real-world experience. According to an after-event survey, attendees appreciated the emphasis on preparation and the practical, relevant information that could be used to improve their own preparedness for an active shooter incident.

Memorable quotes on managing active violence

Following are some of the memorable quotes from Dr. Tan and Chief Wylie.

  • “Casualty collection points are a tool. I see people who say that every single time there is an active violence situation, we’ll have a casualty collection point, and that’s crazy to me. If I’ve got one person who’s injured, why am I going to have a casualty collection point?” — Rob Wylie
  • “Sometimes we have to check our ego at the door. The priority is to save lives and the way we can save lives best is to work with our law enforcement partners and we have to in this situation, work within their framework.” — Rob Wylie
  • “Both police and EMS have the exact same priority, which is to stop the bleeding – law enforcement from the lens of stopping the source of the hemorrhaging through the shooter or killer, and EMS from the lens of we need to get to the patient to stop the bleeding.” — Dr. David Tan
  • “Nothing should stop your forward progress toward definitive care except fixing something that’s going to kill them.” — Rob Wylie

Top takeaways on active shooter response

Check out the top takeaways from Dr. David Tan and Chief Rob Wylie on preparing for an active shooter response in your community.

1. What unified command should entail

When it comes to a multi-agency active shooter response, “unified command is the key,” Chief Wylie stressed. But when it comes to knowing exactly what unified command entails, not all departments are on the same page.

“I’ve been in some exercises where unified command was the fire department and the police department had their separate mobile command posts on the same city block,” Wylie recalled. “That’s not unified command.”

Unified command is having supervisory representative personnel from each agency that has a stake in the operation working together, “arm in arm in the same space, making joint decisions,” he noted. “Yes, one of them is going to be in the lead, and in this case, it’s going to be law enforcement, but you’re right there, adding to the conversation, giving them your dimensions.”

Watch a clip from the presenters explaining what unified command should look like:

2. Communicate with police

Communication with your police escorts is crucial to success, including, the priority of your patient – who needs to go first if you have multiple victims – and then how you’re going to get out.

You should never cross the threshold of a building without an exit plan – and a secondary exit plan – already in mind, Wylie stressed.

Get to the immediate needs first – then coordinate with police. The last thing you want to do is pop out of an exit with a patient, Dr. Tan noted – “That’s a good way to get shot.”

Keep informing unified command about the number and severity of casualties as well, so they can manage and obtain more resources as needed. Remember, you can’t just call for everybody and use them as needed, Dr. Tan reminded us. There are still normal citizens in that community experiencing cardiac arrests, strokes, car crashes, etc., so we can’t deplete all the ambulance resources.

Another point Wylie made: communication shouldn’t be limited to patient needs. You should be an active participant in the police operation – another set of eyes and ears – so stay alert to communicate threats to officers.

3. Leadership must be involved in training exercises

Every gold badge, from sergeant, to chief, to sheriff, should participate in or at least attend active shooter training and drills. Dr. Tan shared a real-life example in which the “boots on the ground” personnel had attended joint trainings with law enforcement and were ready to deploy the rescue task force model, but the “gold badges” never attended, and were not prepared when an active shooter incident occurred.

Chief Wylie noted he can think of at least 3 incidents in the last 10 years in the U.S. in which a ready, able and willing RTF was standing there, ready to be deployed, and wasn’t used because the officer at the time had not been trained on RTF.

Leaders are not likely to experiment with something they don’t know about during a crisis, and Wylie doesn’t blame them for that. But with his organizations, in his county, they took one of the annual trainings and made it mandatory for everyone in the law enforcement community – sergeant and up, including the chief of police. The event included tabletop, classroom and practical exercises.

“I get it, in the fire department, we have meetings to find out why we have so many meetings, but you’ve got to go to these things, because you’re going to be the one that everybody looks at when the rubber meets the road, and it’s time to deploy these tactics.”