# "New Paradigm" for Los Angeles paramedics in mass shootings



## mycrofft (Mar 20, 2014)

http://articles.latimes.com/2013/dec/22/local/la-me-ems-response-20131223
Yes, they're talking about taking steps to remove casualities out under fire or from "warm zones" near but not under fire (notice no concrete steps outlined),buit there is another aspect here, and I quote:

The new imperative, experts say, is to reach those with life-threatening wounds quickly, stem their bleeding and get them to trauma centers as fast as possible.

"They need a surgeon," said Battalion Chief Jeff Adams of the Orange County Fire Authority, which has rewritten procedures and retrained hundreds of rescuers in revised emergency response tactics being championed by the Obama administration.

Recommendations issued by the Federal Emergency Management Agency in September call for fire department medics, working with police, to enter "warm zones" — areas near active shooters where a threat might exist — before the attackers have been fully contained."

This "increasing menace" is based on 250 people shot and killed, in public by strangers  in so-called "mass shootings" nationwide over a 15 year period, or about 17 a year; very close to the number killed by snakebites in such a time frame. 29 shootings are identified.

That means , in rounded terms, eight and a fraction killed per incident, slightly over 16 killed a year in nearly two shootings a year, nationwide.

In the LAX instance, the victim took 12 rounds from a "high powered rifle" (a Smith and Wesson .223 M&P) in the chest and abdomen and there was a 15 minute delay (per the LA Times) between police being notified and responding; they removed him in a wheelchair.

My take: a politically/publicity motivated vague response in the case where the victim was beyond help once the trigger was pulled.

 And once more a case where, had the victim not been destroyed at once,  most on-scene measures (as for most abdominal and thoracic hits by big velocity hunting or war rounds) would be of a nature to keep the victim alive in the short run because it requires a surgeon to _save_** these lives. Maybe a good case for grab and treat on the go?


*Mass shootings since 1999 in the USA:

http://thinkprogress.org/justice/2012/12/14/1337221/a-timeline-of-mass-shootings-in-the-us-since-columbine/

**Let's make a distinction between _*keeping a pt alive*_, or "maintaining" them, and _*saving lives*_, meaning definitive treatment.


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## UnkiEMT (Mar 20, 2014)

mycrofft said:


> And once more a case where, had the victim not been destroyed at once,  most on-scene measures (as for most abdominal and thoracic hits by big velocity hunting or war rounds) would be of a nature to keep the victim alive in the short run because it requires a surgeon to _save_** these lives. Maybe a good case for grab and treat on the go?



Absolutely, The only definitive care for that is bright lights and cold steel, anything I'm going to do is more in the nature of buying time, and it makes no sense to spend the time I'm buying sitting on scene and buying time.

That's the way I've been trained since basic, and as a 'medic, I see no flaw in the logic.

I'm more worried about the notion of sending us into "warm zones". I've got a skin condition that keeps me out of "warm zones"...bullets pass through it. I'd rather spend the time training cops to throw a guy on a scoop and book it than training me to safely operate near a potential active shooter.


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## mycrofft (Mar 21, 2014)

UnkiEMT said:


> Absolutely, The only definitive care for that is bright lights and cold steel, anything I'm going to do is more in the nature of buying time, and it makes no sense to spend the time I'm buying sitting on scene and buying time.
> 
> That's the way I've been trained since basic, and as a 'medic, I see no flaw in the logic.
> 
> I'm more worried about the notion of sending us into "warm zones". I've got a skin condition that keeps me out of "warm zones"...bullets pass through it. I'd rather spend the time training cops to throw a guy on a scoop and book it than training me to safely operate near a potential active shooter.


Or, 
(wait for it):

_*BRING ON THE TACTICAL MED TECH !*_


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## EMDispatch (Mar 24, 2014)

Not terribly shocked that hey're discussing this, the LAPD has had Rescue 4, one of there APCs, decked out as an ambulance for several years.


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## mycrofft (Mar 24, 2014)

Geez, you need ascenders to get into the cab!


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## Mainspring (Mar 24, 2014)

bearcat!

https://www.youtube.com/watch?v=bBaWlF0ME-w

(how do you post youtube vids here properly? h34r


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## johnrsemt (Mar 27, 2014)

As a comparison:   in Boston, EMS and Fire responded to the scene where they KNEW there had been 2 bombs detonated already;   they didn't hesitate,  and who knows how many people they saved.   
Everyone that made it to the hospital survived that day.     If EMS had stayed out of the area,   or evacuated how many people would have died?


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## JP171ntx (Mar 27, 2014)

mycrofft said:


> Yes, they're talking about taking steps to remove casualities out under fire or from "warm zones" near but not under fire (notice no concrete steps outlined),buit there is another aspect here, and I quote:
> 
> The new imperative, experts say, is to reach those with life-threatening wounds quickly, stem their bleeding and get them to trauma centers as fast as possible.
> 
> ...



I agree with get em and run like the devil is chasin me, yep sure do. I want you to think about something here, the red parts are pure horse pucky, don't exist never have never will. there are no such things as HIGH POWERED nor BIG VELOCITY nor WAR ROUNDS. they DO NOT exist the 223 is a small round that moves between 2300 and 4000 fps at a max of 68 grains about the same as an aspirin out of the bottle, NOT a BIG WAR ROUND. most hunting rounds from a rifle move at between 2300 and 3000 fps at 165 grains. yes the have a large quantity of kinetic energy but they aren't magically enhanced they are NOT BIG VELOCITY nor are they HIGH POWERED, please be a good EMT and research the item before blowing Pelosi like rhetoric, it makes you less than sincere and less than you should be as a PROFESSIONAL:angry:


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## mycrofft (Mar 27, 2014)

Sure whatever. This isn't a gun column and I'm not here to correct people's deficient physics education.

PS: graduated Alpena National Combat Readiness Training Center (medical section), qualified on M-16 and M-9


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## JP171ntx (Mar 27, 2014)

johnrsemt said:


> As a comparison:   in Boston, EMS and Fire responded to the scene where they KNEW there had been 2 bombs detonated already;   they didn't hesitate,  and who knows how many people they saved.
> Everyone that made it to the hospital survived that day.     If EMS had stayed out of the area,   or evacuated how many people would have died?



hoo AHH, go gentlemen


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