Toward the Sound of Shooting
Arlington County, Va., rescue task force represents a new medical response model to active shooter incidents
* E. Reed Smith, MD, Blake Iselin, FF/EMT-III, Assistant Chief W. Scott McKay
* December 2009 JEMS Vol. 34 No. 12
* 2009 Dec 1
In November 2008, a group of 10 well-trained terrorists with good communications systems and a well-coordinated plan essentially held Mumbai, the largest city in India, paralyzed for more than 24 hours. Although the coordination and scale of the Mumbai attack went beyond what we’ve seen in the U.S., active shooter scenarios aren’t foreign to us.
An "active shooter incident" is commonly defined as an incident in which one or more people use deadly force on other people and continue to do so while having unrestricted access to additional victims. Almost every year, several of these incidents happen throughout the country, injuring and killing innocent civilians. They range in size, scale and publicity, with the most infamous being the killings at Columbine High School (12 killed, 23 wounded) and Virginia Tech University (32 killed, 17 wounded). On Nov. 5, an Army major went on a shooting rampage at Ft. Hood, Texas, killing 13 and wounding 30 others.
In the past decade, the EMS community has spent a lot of time and effort training to increase awareness, detection and response capability for weapons of mass destruction. But we’ve failed to address what could possibly be the greatest threat for mass casualty—the well-armed, well-supplied lone gunman who is willing to or intends to die in the act of killing and injuring others, including fire and EMS responders.
Other first responder groups have addressed this issue. After the Columbine High School shooting in 1999, police agencies across the country addressed what appeared to be failures in their tactical response to active shooter scenarios. They developed proactive response plans, which established a standard that’s now commonplace. Prior to Columbine, the police model was to cordon off the area and wait for the arrival of a SWAT team to engage the threat. In most circumstances, this process allowed the shooter to continue to be active inside the perimeter and led to a significant delay in getting victims to medical care.
In a paradigm shift following Columbine, police departments moved to an aggressive response in which police immediately pursue, establish contact with and neutralize the shooter; the idea is that the sooner the shooter can be contained, captured or neutralized, the fewer the casualties.
To meet this objective, first responding patrol officers organize and deploy in three- or four-person teams as soon as they arrive on scene; they move quickly through unsecured areas, bypassing the dead, wounded and panicked citizens with the goal of engaging and eliminating the active threat. They’re now trained to "move toward the sound of shooting."
