Paramedics barred from saving Orlando shooting victims because club was deemed too dangerous

MMiz

I put the M in EMTLife
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Paramedics barred from saving Orlando shooting victims because club was deemed too dangerous

Paramedics responding to the Orlando, Fla., nightclub shooting never entered the building throughout the three-hour standoff because it was considered too dangerous, officials said Wednesday.

The attack at the Pulse nightclub left 49 dead and more than 50 wounded. It’s unclear how many could have been saved had paramedics been able to enter the gay club between the time the shooting was reported at about 2 a.m. and when it ended shortly after 5 a.m..

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SandpitMedic

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I'm not sure how I feel about this one. I'll have to think about it a little more.
 

OnceAnEMT

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Train LEOs first aid, triage, and extrication skills and make patient evacuation an objective. Correct me if I am wrong, but I doubt any ALS skills would be used in that environment. The last thing we need is defenseless personnel starting IVs around the corner from the shooter's unknown location.
 

Gurby

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Correct me if I am wrong, but I doubt any ALS skills would be used in that environment. The last thing we need is defenseless personnel starting IVs around the corner from the shooter's unknown location.

I couldn't find any data from a quick Google search, but if I remember correctly, the military did a study and found that tension pneumothorax was one of the leading ways people die in combat.
 

SandpitMedic

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I'm going to have to say that given the current state of the average EMS provider, that EMS as a whole should not be allowed in active shooter scenarios.

Large picture is that most EMS providers are moderately to severely out of shape, do not carry the traits of continuous situational awareness, prone to complacency, could not handle the intensified stress to properly execute TTPs in a nonpermissive environment, couldn't be trusted with a squirt gun - let alone a firearm, not interested in learning/training adequately to perform such rare operations, and are not in this game to do such things. Generally, tacticool medicine and tactical medicine are vastly different from each other and vastly different from regular EMS calls. Not to mention- some EMS folks wouldn't walk into that building anyways with shots being fired- no matter what- it just isn't in them.

Trained tac medics train continually and are versed and reheared for such action, and even they don't get it right everytime (we're all human). Plucking a few "badass" heroes off the engine and putting a vest and helmet on them does not a tactical medic maketh.

Now if you want a few medics to rush in under a protection element (SWAT guys covering you) and put TQs on folks and needle decompress folks- that's still something that requires more than a vest and helmet, to avoid becoming a casualty yourself.

Proficiency in such operations require personnel of a higher caliber than that of your average EMS provider. Notwithstanding, sometimes it is the people who no one imagines anything of that do the most unimaginable things. But in the larger scale- tactical medicine is not our business.

Intense physical conditioning, firearms training, small team tactics training, movement under fire... Etc...

I'd suggest if you are truly interested in tactical medicine you take a TCCC course -which is a VERY minimalistic entry level view into the concepts surrounding care under fire. It's not a tactical medic cert or patch or some BS.

Anyways.

Would I volunteer to be one of those guys? Sure I would... In a damn second... But I would train like my life and my teammates lives depended on it, because it will. Not to mention, I'm not going into an active shooter environment without being armed- cut and dry, that's non-negotiable. I don't give a **** if I have a full body Ironman suit- no personal weapon, no go.

"Everyone wants to be an operator, until it's time to operate."
 

Jim37F

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In my mind, the situation was roughly analogous to a structure fire, in the sense that you don't provide much (if any) treatment to the victim where they're found. Instead you grab and drag them out of the danger zone to the safe zone where the medics are. Sending medics in to triage, treat THEN extricate and transport, with a barricaded shooter still insode the same structure would have been just as bad as doing so if the victims were down from smoke inhalation and active fire somewhere you don't know where inside.
 

SandpitMedic

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In my opinion it does not equate to that.

Not at all. Both are dangerous events, but they are not of the same danger.
Fire is dangerous, smoke is dangerous, debris is dangerous. However, none of those things are consciously and actively attempting to kill you with precision.

Additionally, some here are thinking of this one isolated incident with one shooter. Not taking into account and adding in scenarios where there are multiple shooters, explosive devices, secondary waves, and/or paramilitary state or self trained hostiles, etc etc etc.

When these things unfold, they happen fast, and details are scarce. There are ways and tactics to prepare and deal with these threats and potential threats... OODA loop, anyone?

Equating the dangers of people shooting at you and or actively attempting to blow you up (combat) and the dangers of a structure fire is short sighted and it is apples to oranges.
 

SandpitMedic

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To add, I forgot, most of EMS... Are not firefighters. So there's that too.
 

EpiEMS

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I couldn't find any data from a quick Google search, but if I remember correctly, the military did a study and found that tension pneumothorax was one of the leading ways people die in combat.

I believe the figures are:
Of preventable combat deaths, 60% are due to extremity hemorrhage, 33% from tension pneumo, and 7% from airway obstruction. See: http://archsurg.jamanetwork.com/mobile/article.aspx?articleid=1107258

Good BLS knocks most of that right out -- and good shooting all of it. The key, I think, in all this, is good solid EMR-type training for LEOs and supporting them in their all too vital suppression of the threat.
 

NysEms2117

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I honestly cant agree more with EPI and Grimes, I am in LE (granted its parole, but we still get action contrary to popular belief) and it's almost shocking how little medical training we get(you guessed it, none). However I also understand the tactics part, and while your under the stress of gearing for a warrant or to breach, you have 1 thing on your mind and it is to "get" the bad guy. However you want to define get is up to you(shoot,arrest, what have you). I understand a need for a tactical medic, but they can not be part of any breaching team IMO. The breaching team needs to do their job and complete it safely, and you can't do that 100% while having to body guard a medic. And sandpit medic is correct about one thing, most EMS i see are not physically fit enough to be doing something like that.
 

Dennhop

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Theres a big difference between our corpsmen that served with us in the Marines and the EMT/Paramedics I work with now. The first difference was that our corpsmen were armed. The second was they trained with us day in and day out. They new our tactics, they new our drills, but even then, unless we absolutely needed them, they weren't on entry teams with us. Why? Because making entry is the most dangerous part of clearing a building. Why put the one guy you're going to need if everything goes wrong in a position to also be the first casualty?
That all being said, civilian medics at BEST may get a bulletproof vest issued to them by their department. Many don't. You're not going to solve anything by sending medics in to treat victims in an active shooter incident when they are potentially going to be the next victim. It's also not going to be good if they have to be protected on the way in, and someone else goes down.
Does it suck to be the families of those victims? Absolutely. Should we potentially create more bereaved family members in a misguided attempt to save others? It doesn't make sense. Like was stated above, even armed police didn't enter the building for a while. Your typical officer isn't equipped to handle a hostage rescue situation by himself, or even with a group of patrol officers. (No offense meant to any that may be here on these forums) there's a reason why SWAT/HRT/TAC teams exist...they train together for these situations. They know exactly how each other works, and they have the skill set to perform the required tasks.
Every Marine a Rifleman. Just because that's true, even more so now, it didn't mean I as ever going to go on a HVT or hostage rescue, or even a reconnaissance mission. At most, I performed security sweeps, patrols, and a few low value/routine raids while I was in Iraq. I knew where I stood, and understood that I did not have the training to perform the higher level missions.

Between the Corps and my EMS education, one thing that's drilled into our heads from day one is Safety First. Youre no good to anyone else if you can't protect yourself. What's the point of sending in medics into a volatile scene of any sort, especially if their safety can't be guaranteed? At that point you end up creating more casualties than doing any good.

Sorry for the long rant. I'll stop now.
 

Dennhop

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My primary job was as a 2841/2862...ground repair. My second deployment to Iraq I went as the satellite comms section chief, where we would set up out terminals at remote OPs to allow them data signals. 4 of us on a team, 6 hour shift, we got bored quick, so we would end up attaching to what ever unit we were with and helping them out when we could.
 

RocketMedic

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I'm with Grimes. Short of a tank or a full body Ironman suit, I'm not entering an enclosed active shooter scene like the club without a weapon and friends with weapons. Outside, where I can move and escape to anywhere, is a different story
 

johnrsemt

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In the opposite thinking I understand that fire medics and fire crews pushed in under fire in Dallas to work on the officers shot, and get them out of the area.
 

luke_31

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In the opposite thinking I understand that fire medics and fire crews pushed in under fire in Dallas to work on the officers shot, and get them out of the area.
Totally different scenarios between the two. Inside a building you have less room to maneuver versus outside with multiple paths of egress and various cover and concealment available.
 
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