# Tactical E.M.S. Scenario For Explorer Exam



## cfuentes (Jun 7, 2013)

Hey guys, 

if you guys would help me see if this is a good explorer test question or not by answering it on the replies.

thanks,
-chris f.


You are called to a SWAT officer down at a school hostage situtation. You arrive at the Staging Area to find that no contact has been made with the hostage takers as to what the officer's medical status is. It is later decided by the on-scene cmdr. that a tactical response is given the green light. You are asked if you are willing to enter the building to assist in immediate MEDEVAC of the officer. 

Upon entering shots are fired the suspect is KIA due to suicide. The pt is 28 Y.O., suffering from shock and is going on 6 1/2 mins. of CPR by the EMT that works at the school. The pt is believed to also have been strucken in the head with a pistol, but, the suspect was carrying a M-16 therefore you suspect the real suspect is somewhere in the building. 

Answer the Following Questions:

1. If the "Suspect" is still in the building what exactly is the status of the Operation's Security?

2. Describe where the suspect might be hidden and what type of mental status he is in?

3. Should the School's EMT be able to assist in your defibrillation of the officer or not?

4. Should the School's EMT be asked to assist in any form as a "Good Samaraitan"?


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## chaz90 (Jun 7, 2013)

There have been some other threads discussing how "tactical rescues" like this really don't happen. Train for the situations you're going to come across. MCI or what-if drills can be good, but this isn't a critical thinking exercise as much as it is nonsense and unrealistic expectations. First of all, if an officer is shot, they're tossed in a squad car and driven to the nearest hospital Code 3 most of the time (in an urban setting). Also, suffering from shock? The dude has a GSW to the head and is pulseless and apneic. This isn't suffering from shock. This is suffering from death, and it's not going to change. Now for your questions.

1. Who knows? Not your business. Quite frankly, I believe in hot zone evacuations under certain circumstances. If officers on scene are requesting assistance and need help evacuating (especially an officer down), I plan on going in with them. Done the right way and with officers leading and determining the need, this can be reasonable. This is seriously such an incredibly uncommon scenario though I wouldn't get too caught up in it.

2. Again, who knows? I'm not trying to profile this guy and have zero idea of where he is. Dude is messed up and homicidal, and I'll let the cops find him and the courts or God sort out why he did what he did.

3. This is a trauma arrest. You're probably not going to be defibrillating him. Also, you're not working this patient where you are. This is a hot evac, even if the patient was viable.

4. The EMT on scene will absolutely be assisting. This is an extraordinary scenario and an MCI. All hands on deck for sure. He probably won't be transporting with me, but he'll at least be a litter carrier or babysitter.

In short, this is a pretty awful scenario for any student or "explorer." It's in no way related to anything we do and presents an inaccurate picture of what EMS is. Aim for realism, not heroism and glory. Not trying to be too harsh man, but you have to learn what real life is like before you start throwing this kind of stuff around.


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## cfuentes (Jun 7, 2013)

chaz90 said:


> There have been some other threads discussing how "tactical rescues" like this really don't happen. Train for the situations you're going to come across. MCI or what-if drills can be good, but this isn't a critical thinking exercise as much as it is nonsense and unrealistic expectations. First of all, if an officer is shot, they're tossed in a squad car and driven to the nearest hospital Code 3 most of the time (in an urban setting). Also, suffering from shock? The dude has a GSW to the head and is pulseless and apneic. This isn't suffering from shock. This is suffering from death, and it's not going to change. Now for your questions.
> 
> 1. Who knows? Not your business. Quite frankly, I believe in hot zone evacuations under certain circumstances. If officers on scene are requesting assistance and need help evacuating (especially an officer down), I plan on going in with them. Done the right way and with officers leading and determining the need, this can be reasonable. This is seriously such an incredibly uncommon scenario though I wouldn't get too caught up in it.
> 
> ...


Thanks for your concern about my explorer post in school. have a good day.


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## VA Transport EMT (Jun 7, 2013)

. If the "Suspect" is still in the building what exactly is the status of the Operation's Security?

unsafe!

2. Describe where the suspect might be hidden and what type of mental status he is in?

suspects don't hide, they kill.

3. Should the School's EMT be able to assist in your defibrillation of the officer or not?

no leave it to the adults.

4. Should the School's EMT be asked to assist in any form as a "Good Samaraitan"?

No! explain it to your explorer captain's mom how you guys wanted to be superheros and got shot and killed.


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## frdude1000 (Jun 7, 2013)

From previously being an explorer for 4 yrs, this is not a good question to ask.  Doesn't really test on EMS knowledge and asks for information that is too tactical in nature.  What is this test for?


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## DesertMedic66 (Jun 7, 2013)

There are no correct answers for the first 2.


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## CritterNurse (Jun 8, 2013)

I think the only right answer for ANY EMT (explorer or otherwise) would be:

Scene is NOT safe, stay far far away.

Only exception to that I can see is for someone with some sort of special training for that sort of scenario, and I just don't see explorers ever being allowed onto a scene that dangerous.


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## DrParasite (Jun 8, 2013)

First off, your question sucks.  your scenario sucks.  and this is not a question to be asking an explorer post.  That being said:





cfuentes said:


> Answer the Following Questions:
> 
> 1. If the "Suspect" is still in the building what exactly is the status of the Operation's Security?
> 
> ...


1. operational security?  this is a VERY unsafe scene.  If I was asked to get the suspect, the answer would be NO F**^*&^& WAY.  Ask me to get the cop?  ehh, how about you men with body armor, kevlar helmets, and fire arms go in, and drag him out, and once you clear the building doors, throw him on my cot and we will run really fast to the ER?

2.  Don't know, don't care.  the cops will be handling that.  they will search the building in an organized manner.  

3.  sure.  but more often than not you can't defib a traumatic arrest, but anything is possible.  Personally, if I was him, I would run really fast away from the shooting, but that's just me.

4.  do I know him?  do I know he's an EMT?  I should have plenty of cops (and probably firemen) standing around if I need some hands.  If he want to play rickey rescue, I probably won't stop him, but I am going to be calling for all available uniformed personnel, in EMS vehicles, who I have accountability for.  Freelancing (whether by bystanders, PD, FD, or other EMs units) happens at all these things (just listen to the radio traffic from the Aurora shootings), and you want to try to minimized freelancing personnel, despite them having good intentions.

But again, this isn't a question for a newbie EMT, or even a 1 to 3 year experienced EMT.  and definitely not an explorer question.  It's a LEO question, and cops train for years on this


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## Handsome Robb (Jun 8, 2013)

It's not realistic and I don't agree with posing this question to people :censored::censored::censored::censored::censored: learning. We all want the "cool guy" job but you can't have it without basics.

For a class situation this stops at the first question, this scene is not secure, they do not have tactical training and/or are not working in a tactical position so we do not enter. Have PD/SWAT/TEMS extricate the patient while you wait in the cold zone.

I'll answer the rest for the sake of answering your question.

2. I don't care about his mental state, this is PD's scene and PD's problem. Once they secure the scene and have the suspect in custody if they want me to evaluate him then I'll gladly do it just like he is any other patient but he's at the bottom of my list as far as triage goes. S/he goes last in whatever category they may be in (red, yellow or green). 

3. Sure, if he's employed as an EMT and isn't spinning out then use the resources you have available. Don't tie up a cop who could be helping take the suspect into custody. It'll be made very clear that if he does not do what I tell him when I tell him to do it or I feel he is physically or emotionally compromised he is finished helping me and will be treated as a patient if I see the need or as a bystander. 

4. See the answer above. *If he is willing to help and offers, I'm not going to ask someone who is under extreme duress to help me.* If I need the hands and he is doing what I say, correctly, then why not? With that said, I'm not going to ask him to put his life in jeopardy. In the hot or warm zone you're doing minimal treatment anyways, if you try to be a hero and get yourself shot what good are you? You've taken away a valuable resource (trained medical hands) and created another patient, so I'll interpret this as we are now operating in the cold zone.

Like someone said, practice like you play. The majority of medics will never be involved in treating a patient in this scenario, even as a standby unit. Why not focus on things that they'll be doing on a daily basis? I teach so I understand what you're doing. You have to mix it up and keep it fun to hold their interest. With that said, there are a ton of ways to do this with scenarios that are more realistic. 

If you want ideas or advice feel free to shoot me a PM.


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## AnthonyM83 (Jun 12, 2013)

Respectfully, gotta say it's a pretty poor question. Also, since we're not familiar with your system, we don't know how it's set-up. There's an explorer and suddenly there's students? Is the explorer program ran through the school rather than an EMS agency/department? There's also a lot of extra info, misspelling, weird words (like "strucken")...just kinda messy.




> You are called to a SWAT officer down at a school hostage situtation.


In what capacity? What's your level of training? What equipment do you have?



> You arrive at the Staging Area to find that no contact has been made with the hostage takers as to what the officer's medical status is.


Irrelevant info. No part of the question requires reader to know that he doesn't yet know the mental status at first and then know it later.



> It is later decided by the on-scene cmdr. that a tactical response is given the green light. You are asked if you are willing to enter the building to assist in immediate MEDEVAC of the officer.


Is this in any sense realistic? For an EMS Explorer to go in with the entry team? Or is it Police Explorer? Either way, wouldn't it make more sense to bring the downed officer out to a safe zone???




> Upon entering shots are fired the suspect is KIA due to suicide.


Weird way of stating this with extra acronyms. You don't really use the term KIA for this situation. It's like saying killed in the line of duty almost....for a terrorist...



> The pt is 28 Y.O., suffering from shock and is going on 6 1/2 mins. of CPR by the EMT that works at the school.


 So confirming the patient is the downed officer.... I don't really think you need to say he's suffering from shock. Once he's in cardiac arrest, you don't really describe it that way... He's past shock, he's in cardiac arrest.



> The pt is believed to also have been strucken in the head with a pistol, but, the suspect was carrying a M-16 therefore you suspect the real suspect is somewhere in the building.


Wait, you're basing the idea of two suspects on the fact he was struck with a pistol, but suspect has an M16???? Wouldn't the person who told you he was struck with a pistol just tell you there were two suspects when they talked to you? And why couldn't the suspect have two weapons? And either way, you're still going to assume there's multiple suspects until the entire school has been cleared most likely.

Answer the Following Questions:



> 1. If the "Suspect" is still in the building what exactly is the status of the Operation's Security?
> 
> 2. Describe where the suspect might be hidden and what type of mental status he is in?
> 
> ...


1. Don't capitalize Operation unless it's the name of that specific operation. 

2. That's a fine question, but is this really an EMS question or a law enforcement question? OBVIOUSLY he's bonkers.... if it were a LE explorer, that'd be a better question because they can talk about crisis mindsets.

3. Why are you using an AED on a trauma patient? EMT books usually say don't unless you get orders from medical control.

4. This is a fine question. But I think you might want to focus the whole question a bit more.


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## Melclin (Jun 23, 2013)

cfuentes said:


> Hey guys,
> 
> if you guys would help me see if this is a good explorer test question or not by answering it on the replies.
> 
> ...



Overall:
-This is not at all a scenario on which a civilian provider of any kind needs to be tested let alone an underage volunteer. It strikes me as something taken from a scene in a TV show more geared towards drama than realism.

-We all make mistakes (I make plenty), but the gramma and syntax in your question are so poor as to obscure what is actually being asked. A poorly constructed question will lead to poor answered. Students have to know what is being asked of them if they are to have a chance at answering correctly. Writing exam questions is something of an art in this way.

-The scenario has plenty of information of interest to a LEO but very little of interest or relevance to an EMS provider. What are you actually trying to test? 

Specifically:
1. What is the "operation's security"? Why is it something on which you need to test students? We are healthcare professionals, not security or paramilitary experts.

2. Firstly, what kind of training are these kids getting where they might be able to accurately predict the location of a hidden armed offender? They would never need to do this and couldn't anyway. Secondly, the subject's mental status is irrelevant. What are they going to do? Seek the offender out in their hidden location and negotiate with them? Again, this is very much a LEO issue. Nothing to do with EMS.

3. Assist in what way? Applying an AED and standing back while it does its thing is a one person job. What do you mean by "should"? Ethically? Morally? Legally? Scope of practice wise? Or do you mean that they aren't allowed and that you require an argument from the student on why that rule should be changed? More clarity required.

4. Again..clarity. Are you asking if it is right or acceptable to ask the question of the EMT or are you asking if good sumaritan laws might apply?


*To my mind, this is a poor scenario, terribly written, irrelevant to EMS providers of just about any kind let alone a volunteer youth, and not at all clear about what it requires of the student being tested.*


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## Luno (Jul 11, 2013)

*Hahaha, well, I guess if you insist... *



cfuentes said:


> Hey guys,
> 
> if you guys would help me see if this is a good explorer test question or not by answering it on the replies.
> 
> ...


 Not really my issue, if you're the responding medic, and you've decided to volunteer for this little goat rope, and you aren't in the stack, then you're a moron if you don't bring your own security, a better question is what kind of security do you want?





> 2. Describe where the suspect might be hidden and what type of mental status he is in?


 There's a lot of places to hide in a school, but that's your security's job to worry about, you should just be able to bound forward, buddy rush, however you decide to make it from point A to point B with minimal exposure, find the most bulletproof place you can, set your perimeter, then begin looking at your patient.  Because if you f this one up, there probably isn't another medic going to want to jump on this goat rope to come and get you.





> 3. Should the School's EMT be able to assist in your defibrillation of the officer or not?


Why are you defibrillating him?  BTW, if I'm just trying to clear ground, I will probably just have a drop leg bag, maybe an M9 bag, but definitely not carrying a defib at a full sprint with a weapon.[/quote]


> 4. Should the School's EMT be asked to assist in any form as a "Good Samaraitan"?
> Most definitely, why wouldn't you want all the help you can get?


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