Shooting Prep.

Milla3P

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This week my small municipal department started the first phase of planning for a shooting event by walking through the place that has the most people in it at any given time, our high school.

Most of the time we were in the school we spent astounded about how complicated the floor plan was, that there are 400 people 3 times a day in the cafeteria and how most of the doors are glass. We realize that any incident that involves firearms, children and Mayberry’s finest is going to be an absolute nightmare.

My question is have any of your limited resource services (2/3 rescues and PD) started planning? What challenges have you faced? What left field solutions has anybody come up with? The best idea we have right now is practicing our NIMS and putting a duffle bag full of TQs on each truck.

I spent most of the time just flabbergasted that this is something we have to do now.
 

Lo2w

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We have 25 trucks on day shift. I couldn't imagine only having 2-3 squads.

We have a folder on our trucks laptop that has a PDF for every school and I believe some other public spaces that gives you an aerial map view, floor plans etc., contact info and so on for that building.

I'd consider incorporating some school busses for your green tagged pts.

What hospitals do you have access to? Would you have to consider flying out the most critical? Might invite the local flight services out to scout landing areas.
 

MMiz

I put the M in EMTLife
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I've been part of an active shooter drill with police, fire, and EMS (no students). They were obviously firing blanks, but we had assigned injuries and a tactical EMS response.

Wake County EMS has an active shooter EMS bag and response protocols that I find progressive.

Their active shooter bag has:
  • OLEAS Bandages
  • CAT Tourniquets
  • Megamover
  • Child/Adult BVM
  • Trauma Shears
  • Penlight
  • 4x4's
  • A variety of bandages
  • A chem stick
  • Whistle
  • IV supplies
  • Nasal airway
  • Triage tags
  • Ace bandages
I'd work with the school/district on what they already have established, they likely have a plan that incorporates transportation/buses.

Good luck!
 

StCEMT

Forum Deputy Chief
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We don't have any formal drills with schools and other resources like that, at least nothing that has trickled down to us that I am aware of. We get the gang related shootings almost daily and sometimes more than once a day. Just had one like 3 days ago myself, so at least when it comes to hands on assess/treat/move on aspects of it we are fairly comfortable with handling GSW's.
 

DrParasite

The fire extinguisher is not just for show
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This week my small municipal department started the first phase of planning for a shooting event by walking through the place that has the most people in it at any given time, our high school.
first off, I applaud you and your agency for actually being proactive in trying to preplan how you are going to respond to these types of calls.
Most of the time we were in the school we spent astounded about how complicated the floor plan was, that there are 400 people 3 times a day in the cafeteria and how most of the doors are glass. We realize that any incident that involves firearms, children and Mayberry’s finest is going to be an absolute nightmare.
glass doors (which most of the exterior doors in the HS I attended back in the day) are great for letting light in, and (realistically) are more for show than anything else (kind of like tempered glass windows on your car). You can lock the doors all you want, but if someone really wants to get in, they are going to get in.

One thing you should remember: active shooting incidents are extremely low frequency highly visible incidents, so many AHJs are not thinking about it happening in their school when they initially built the builds. and telling them they should change when (statistically speaking) the chances of it occurring are very slow will likely fall on deaf ears.

My question is have any of your limited resource services (2/3 rescues and PD) started planning? What challenges have you faced? What left field solutions has anybody come up with? The best idea we have right now is practicing our NIMS and putting a duffle bag full of TQs on each truck.

I spent most of the time just flabbergasted that this is something we have to do now.
Wake's Shooting/Stabbing kit is a good start.

We don't have any formal drills with schools and other resources like that, at least nothing that has trickled down to us that I am aware of. We get the gang related shootings almost daily and sometimes more than once a day. Just had one like 3 days ago myself, so at least when it comes to hands on assess/treat/move on aspects of it we are fairly comfortable with handling GSW's.
There is a huge difference between an active shooter and a gang related shooting.

Gang related shooting: homie from gang A shoots at homie from gang B. he either hits homie from gang B, hits some of his friends, hits an innocent bystander, or hits a solitary object. Than homie from gang A flees the scene, because he doesn't want the cops to catch him. it's a simply GSW, ABC, contol bleeding, and take person (or persons, occasionally two people get shot) to the trauma center. requires 1, maybe 2, ambulances for a "routine" shooting.

Active shooter: person is shooting everyone, often at random. multiple victims in a localized area. shooter often commits suicide, or doesn't care if the cops get him. There are no routine active shooter calls. And they don't only occur in school; they can occur in libraries, offices, malls, and any place where you have large amounts of people in relatively open areas that are confined by walls.

You really can't compare the two, other than they both involve firearms.

@Milla3P, with 2 or 3 ambulances available to you, I would focus on what you want those two crews to do, and how much mutual aid you have available to you, and what you want them to do. Your first ambulance will have two people, with one doing Incident command (scene size up, calling for additional ambulance resources, calling for state mutual aid disaster resources and trying to come up with a plan), and the other person doing triage. Your second ambulance will be the "rescue task force" and treatment.

Preplan your closest landing zones (note I said zones, since you might want to land more than one helicopter). Where do you want your mutual aid staging area to be? Do you want some units to respond directly to the scene to assist the in town crews, and if so, where do you want them to respond to? where will your command post be? how will you deal with the mentally damaged people who aren't physically injured? Will you recall off duty staff? do you have additional radios and vehicles for them to take? Does your FD do EMS? if they don't, you might want to utilize them as additional manpower and laborers to carry people and equipment around. If they do, utilize them as EMS providers. What radio frequency will all the EMS people be operating on? will you need more than one?

Also remember, there are law enforcement scenes. So make sure they know your plan, you know their plan, and neither of your plans are conflicting. But once the threat is neutralized, than it's an EMS MCI (unless you agree with the EMS going in while the gunfire is still going on, I'm not a fan). Once it's a confirmed incident, start your EMS MCI plan, and start resources from all over the county to the scene. it's going to take them a while to get there, so having staging areas already designated can make things easier, vs having everyone going to the scene and freelancing on what they are doing.
 

FrostbiteMedic

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To build on what Dr. Parasite said, another thing you need to plan for with your service is how you are gonna handle other emergencies. Being prepped and ready for the MCI is great, but all too often with the smaller services (I work for a smaller service, I understand how much of a pain in the *** it can be to plan with limited resources) we focus on what to do it the SHTF with one MCI, but we forget that this is real life. People are still gonna have MIs and CVAs and MVCs and etc, etc. My service has planned out that if an MCI occurs, we call in two crews that will be here to ONLY focus on other non MCI related 911 calls for service. Everyone else will be tasked to the MCI, in addition to our mutual aid resources. We have 4 high schools that we cover as well as a power plant.
 

DrParasite

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Just to add to what Boomsticksmile said, just because an MCI is happening, you still need to cover your "routine" calls. So you can't just pull every ambulance in the county into the MCI, because the "routine" calls will still come in and need to be handled.

One of my former agencies was in a large city, that was grossly under EMS deployed, and our rule was never commit more than half of your available resources to any one incident. So if we had a building collapse with reports of 50 injuries, our initial dispatch was 1 ALS ambulance, 1 BLS ambulance, 1 supervisor in an SUV, and our heavy rescue. That's it. once EMS resources get on scene, if they confirm 50 injuries, we would send 3 more BLS ambulances and an additional ALS unit (we had 4 ALS and up to 8 BLS on duty during peak hours); the rest of the resources would be provided by mutual aid.

With only 2 ambulances, it's hard to do that, and I would make sure your emergency management personnel knew how many ambulances you could get if you pushed the panic button (at both 10am and 10pm), because they will help in back-filling everyone to make sure some level of coverage is maintained.

But that's that's basic MCI operations, not active shooter specific, which is why I didn't go into that before.
 

Lo2w

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Are there policies in place to recall off duty personnel? Might be another area to look into.
 

RocketMedic

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See if you can wrangle up a few buses for Mass transport. Not everyone, regardless of wounds, needs an ambulance.
 

FrostbiteMedic

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See if you can wrangle up a few buses for Mass transport. Not everyone, regardless of wounds, needs an ambulance.
This is important. But another thing to consider when it comes to busses is that you're figuring that you have an MCI, right? Each EMS region in TN (And this is if I remember correctly. I know for a fact it applies to Region 2) has an AMBUS. Essentially it is a classic schoolboys that has been converted to carry 15 or 20 stretcher patients. Well, litters but you get the idea. If you don't have one, see if there is one local to you. If not, see if you can get a bus donated/cheap and make your own. Then you have a resource to help others
 

RocketMedic

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I was thinking more like a medic/EMT and a few conscripts pack a school bus with a Duffel Bag of Magic (TM), a police escort, and a few dozen sorta-stable casualties and move the triage-and-evacuation party from the scene to a friendly local ED, where there's more people, more resources and your yellows-trending-to-reds can receive more stabilizing care. One of the lessons from a lot of mass shootings is that we don't necessarily need ALS and amazing medications for the vast majority of gunshots, we need good, fundamental first aid like effective hemorrhage control and timely transport to people with things like blood, chest tubes and sutures. I'm not saying paramedics are superfluous- they're very much important for seriously-wounded patients who need interventions- but tossing a stable extremity GSW with bleeding well-controlled by a pressure dressing or whatnot into a bus with their twenty injured new best friends and a medical person for 'oversight' and a fifteen-minute trip to an ED that can at least watch her more is not a terrible proposition if you're without resources. Beats shuttling people to the ED 3-4 at a time in a rig...
 

StCEMT

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@DrParasite, different situations, yes, but same treatments. My point was we run enough shootings, frequently with multiple patients, that we could comfortably split up and work on the essentials because those injuries are common here.

Not only that, we have the staffing to run larger incidents. Where shootings generally happen, we are close to mutual aid, and even in odd places it is still easy to get. Plenty of busses in the city are available to use for a mass transport method. We might not actively drill it with a school situation , but we know our resources and are familiar with the treatment.
 

RocketMedic

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"Ok Gladys, I need you and three of your school buses, and two short buses for litter patients, to the high school, then the cops are going to escort you through to University ED. You'll be taking thirty casualties per bus and two of my EMTs as clinical staff. Just drive inside the escort."
 

Jim37F

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Our FD has an actual full sized bus that's an apparatus. Department color scheme, same gold leaf font as on the engines...complete with a light bar on the front and back.
It's funny, no one has really talked about it, even when we did drivers training, we didn't touch it. But I can only presume that that's ots function, mass minor patients transport.
 

Bullets

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Each of our 2 ambulances have a small shoulder bag with wound care stuff in it and we also have 2 M9 backpacks. If we activate, the M9s come inside with the RTF and usually get dropped in a casualty collection point unless we know of a large group of casualties elsewhere. The little bags stay outside for exterior TTT. We also cut seatbelts out of wrecked cars and have distributed them as drag straps to our staff and cops. We also like megamovers in general and carry one on the back of our vests. Every EMT carries at least one tourniquet on their person when on duty. We also have a single blowout set up in each jump bag on every response vehicle.Every cop has a blowout kit that fits inside the front trauma plate pocket of their vests. Most carry another TQ on their belt. Every Long guns and shotgun has a TQ either on the stock or on the sling.

Premake blowout kits. all you need is a TQ, chest seal, izzy bandage, hemostatic gauze and an NPA. Stuff them in ziploc bags or vacuum seal them for easy deployments.

Stock multiple kinds of TQs. CATs and SOFFTs are great, but due to their design the USAF PJs found they were less effective on small children. SWATT worked better on them. SWATTs also work better on K9s. If you have a dog cop, make sure he tailors a BOK for his partner, there are some different things that hell need to treat.

We have planned our mutual aid response, identified our MCI resources, planned ahead with the schools so we all have total school access on our ID cards. Every teacher has taken B-Con and CPR at the beginning of every year and there are public access bleeding control points next to the AED cabinets throughout the buildings. Preidentify staging areas, helibases and helispots. Talk to your local hospital and get them on the same page. Do they have a surge plan? Identify psychological counseling services who can provide emergency response. Not just for the school population but for the responders.

You need to consider some respiratory protection. If the assailant or PD deploy smoke or gas, how are you going to deal with it? Each of our operators carries an MSA Millenium mask with the law enforcement canister. Talk to your FD. If they use Scott, there is an adapter to accept the NATO threaded canisters. The shooter in Parkland deployed smoke. You can make smoke grenades and gas grenades at Home Depot.

Lighting, something small, 2AA sized. If power goes it, youd be surprised how many parts of a school are dark even during the day.

Comms. Do you have enough portables for everyone. Do you have a channel that isnt your main operations channel you can work on? Does your mutual aid have that channel? Time and again, communications is always an issue at major incidents
 

EpiEMS

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Premake blowout kits. all you need is a TQ, chest seal, izzy bandage, hemostatic gauze and an NPA. Stuff them in ziploc bags or vacuum seal them for easy deployments.

It's in a ziploc bag! That's a chest seal, right there ;)

But serious note - expired defib pads work nicely.
 

Bullets

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It's in a ziploc bag! That's a chest seal, right there ;)

But serious note - expired defib pads work nicely.

But the bag isnt adhesive...and yeah, we use expired defib pads in our personal kits or give them to the cops cause DOH cant ding them for having expired medical supplies
 

DrParasite

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hahaha. your funny. Cops in NJ usually have CPR, but that's it (and that's agency specific, I don't think there is a statewide mandate). and they a basic trauma class in the academy (i think it's called crash incident management, or something like that), and very few, if any, agencies require EMT (and NJ doesn't have an EMR program at the state level).

Some are EMTs, because they were EMTs because they were EMTs before getting hired with the PD, but I don't know of any LEO agency that mandated that their officers obtain and maintain EMT certifications as a condition of their employment.
 

EpiEMS

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hahaha. your funny. Cops in NJ usually have CPR, but that's it (and that's agency specific, I don't think there is a statewide mandate). and they a basic trauma class in the academy (i think it's called crash incident management, or something like that), and very few, if any, agencies require EMT (and NJ doesn't have an EMR program at the state level).

Pretty surprising. CT has EMR as part of the police academy. (People often denigrate EMRs, but there's a purpose to it...)
Interesting historical note: "Crash Injury Management for the Law Enforcement Officer" was the precursor to the 1979 First Responder (and today's EMR).
 
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