Washington Post article on Paramedics in Active Shooter incident

[dutemplar]

Written by a former Atlanta paramedic, who is now a staff writer...

I think he went a little too Hollywood...

https://www.washingtonpost.com/post...shootings-they-should/?utm_term=.5e6120321d0c

 

[RocketMedic]

He went past the point of stupid.

 

[ExpatMedic0]

I literally thought this was the Onion at first

 

[akflightmedic]

I posted a comment when I saw it the other day....got a lot of likes and comments. LOL

The guy is a DOUCHE.

 

[NomadicMedic]

Yeah. This guy is a douche. "I was a paramedic for nearly 10 years. In that time, my job certainly put me in danger’s way; like many of my co-workers, I believed that saving a patient’s life was worth losing my own."

Sorry, no patient is worth me losing my life. My job is to get home to my family at the end of the shift.

 

[EpiEMS]

"I believed that saving a patient’s life was worth losing my own."

That doesn't pass the cost/benefit test...

 

[Summit]

The guy is tarded...

That's OK...

 

[VentMonkey]

Sorry, no patient is worth me losing my life. My job is to get home to my family at the end of the shift.[/QUOTE]

This! 100% agreed.

 

[Bullets]

So while his introduction is perhaps a bit hyperbolic, i think he does make some good point. The way he illustrates the illusion of "Scene safe, BSI" that we drill into every EMT is effective and a nessecary one. The understanding that there is no safe scene is important for the modern responder.

I also support the rescue task force model and would like to see more agencies move that way. My agency is currently the only one in my county who has started implementing it

 

[RocketMedic]

I wholly disagree with this.

I am a medical professional. I am also a veteran, a former combat medic and a paramedic. I am also a husband and dogfather. None of those things obligate me to place myself into personal danger and risk my life. Yes, there are situations where I take calculated risks in order to do my job and care for people. Those risks do not raise to the level that is required to meet an active shooter. Frankly, I don't care about the victims of an active shooter inside a scene. Their fates are out of my hands.

The best use of medics in an active shooter situation is to triage and treat people, outside the scene, and transport people rapidly to appropriate facilities.

 

[VentMonkey]

I nervously await the days one of our fire crews are assaulted beyond what they may be able to handle, because they're tired, impatient, cocky, whatever the case may be.

It seems as though some of the guys, while good natured I am sure, are so cavalier about calls that have read flags written all over them.

Brave? Perhaps to them. Foolish? Perhaps to me.

 

[OnceAnEMT]

The best use of medics in an active shooter situation is to triage and treat people, outside the scene, and transport people rapidly to appropriate facilities.

This.

Transportation of patients in pickup trucks and patrol cars is secondary to a breakdown in ICS. The Aurora incident has come up in almost every ICS class I've taken because it is a great example of how things didn't go so well. There is an hour or so of Fire radio traffic on youtube that is a heck of a learning experience if you listen to it with the map up. Granted, hindsight is 20/20 and my desk is more comfortable than an active shooter incident.

Personally I'd like to hear what LEOs think. It's always Rickys wanting to go in. Does LEO agree?

 

[dutemplar]

Yes and no. I've heard the audio a few times, including in an ICS review. It's also a breakdown of resources and a sufficiency on immediate hand, as well as trying to herd 1000 terrified people into your planned channels. It's one thing to pre-plan and to effect "these are casualty collection points" "this is my triage area" "this is treatment area" but when you have bodies being dragged around and people still running/ limping away...

As far as police transport of high acuity trauma patients, in Philadelphia (and occasionally in DC) that works very well and has saved lives compared to waiting for EMS. At least for normal day-to-day shootings and stabbings as compared to the big events. But that's a whole different matter...

I understand the Rescue Task Force concept. I also agree far more with the "groups of police, as they arrive, team up in four man elements and make an immediate dynamic entry to clear the damned building." The military side in me has a theory that I heard from Al Brunacini on the fire side a long time ago. When at a fire - "if you put the fire out, the problems go away. Now it doesn't completely transfer the same to an active shooter situation since: You can have multiple shooters, secondary devices, etc... But the theory does seem valid that if you shoot the shooters they stop shooting. Trained, geared up people who are well guarded and accompanied can certainly help perform critical interventions and help drag people out. Of course, those people who are guarding the trained medics can be better used to, say, go shoot the bad guys first. Then scene becomes immediately safer and the medics don't need armed guards on ready overwatch.

On the articles comments, I loved the one person pushing the tactical medics on every argument. Sweetheart, if I'm assigned as a tactical medic... I'm there for the team. Not to go in and start freelancing every civilian down. We're doing Breach BANG Clear until the final CLEAR! I'm not stopping and using my entire kit on everyone we pass for one of my team to get whapped and I'm not there...

 

[Jim37F]

Yes and no. I've heard the audio a few times, including in an ICS review. It's also a breakdown of resources and a sufficiency on immediate hand, as well as trying to herd 1000 terrified people into your planned channels. It's one thing to pre-plan and to effect "these are casualty collection points" "this is my triage area" "this is treatment area" but when you have bodies being dragged around and people still running/ limping away...

As far as police transport of high acuity trauma patients, in Philadelphia (and occasionally in DC) that works very well and has saved lives compared to waiting for EMS. At least for normal day-to-day shootings and stabbings as compared to the big events. But that's a whole different matter...

I understand the Rescue Task Force concept. I also agree far more with the "groups of police, as they arrive, team up in four man elements and make an immediate dynamic entry to clear the damned building." The military side in me has a theory that I heard from Al Brunacini on the fire side a long time ago. When at a fire - "if you put the fire out, the problems go away. Now it doesn't completely transfer the same to an active shooter situation since: You can have multiple shooters, secondary devices, etc... But the theory does seem valid that if you shoot the shooters they stop shooting. Trained, geared up people who are well guarded and accompanied can certainly help perform critical interventions and help drag people out. Of course, those people who are guarding the trained medics can be better used to, say, go shoot the bad guys first. Then scene becomes immediately safer and the medics don't need armed guards on ready overwatch.

On the articles comments, I loved the one person pushing the tactical medics on every argument. Sweetheart, if I'm assigned as a tactical medic... I'm there for the team. Not to go in and start freelancing every civilian down. We're doing Breach BANG Clear until the final CLEAR! I'm not stopping and using my entire kit on everyone we pass for one of my team to get whapped and I'm not there...

Well said.

Local fire and PD have been training on the Rescue Task Force concept for active shooters. Basically as the first PD/LEO's areive, they'll self organize into 4 man teams to make entry with the single purpose of finding and stopping the shooter. Meanwhile, once enough fire and police arrive, at the discretion of the IC, based on METT-TC (Mission, Enemy, Troops, Terrain, Time, and Civilian considerations, the fancy Army way of saying "based on the specific situation") they'll start sending in 6-8 man teams of fire and police basically the police are over watch for fire to put on TQs and pull victims out of the warm zone to the triage/treatment areas in the cold zone.

That's the basic idea at least. A few months back there was a murder-suicide at UCLA that got dispatched as an active shooter incident. You could see on the news foreign medics staged wearing body armor and ballistic helmets waiting to go in whole the initial PD entry teams were still clearing the building and figuring out what was going on

 

[NysEms2117]

Im confused as to what this guy is trying to say... If he wants medics to go in, wouldn't we just train a LEO paramedic stuff? He/She can be a law enforcement officer first then go to paramedic mode, for the 1 minute difference it would take. + I don't mean to be crude(inexperienced in the EMS aspect is more like it), but as a "tactical" medic or EMT, wouldn't you just TQ and asses breathing fast and move on?? I mean I do shooting simulators and things along that line for work. But we also host live drills, which has everybody show up, and I personally don't see a need for a "combat medic" unless your in a combat zone. Anybody that knows anything about an active shooter, or shooter(threat to your life) at all, knows you neutralize the threat first... I just fail to see the point of "tactical medics". Anybody who has EMS info for me that i don't have feel free to correct me, but it just seems like nonsense to have a medic go in the hot zone, or warm zone for that matter, As a LEO protecting myself/the team(or partner) im with is HARD ENOUGH, i personally do not want to be responsible for an unarmed medic(more liabilities). And no, i dont want the medic to be armed either .

 

[dutemplar]

Yeah, IMO it would be far easier to give cops TECC (distinctly under TCCC, but geared to a down and dirty level) and bringing them up to speed on basic lifesaving and extrication... not to mention the fact that TECC helps them take care of themselves and each other in a live fire environment. Regardless of whether it is a Direct Fire or Indirect Fire (hot or warm) zone.

Most of the teams I have seen plan to have the accompanying officers enter with the paramedics, the officers are at a "ready to engage" position with active weapon sweeps and actively looking to identify and engage threats. Which in training classes I have witnessed, has led to blue on blue engagement a few times when a cop rounded a corner but the "defender" was at ready rock looking to engage any threat.

Yeah, tactically my general concerns are: TQ life-threatening bleeding, applying large hemostatic pressure bandages or similar treatment (the new injectable sponges have a place), and getting people out. The two guys with weapons hot on overwatch are the safety mechanism to let this happen faster, and to multiply the number of responders actively dragging still-living and saveable people out. Four cops doing combat first aid and drag can "babysit" several medics doing the same...

It's a risk/benefit analysis, required major training, good communications and command/control skills and is definitely venue specific. It "could" have been useful.

I still stick with the theory of if those four cops team up and make an aggressive entry and make the bad guy go away, the entire scene immediately becomes MUCH safer (barring secondary shooters, secondary devices, etc.) and lets everyone work in a much faster manner. The traditional method of securing the perimeter, letting multiple SWATs assemble and clear, ... it's a great defensive strategy but has a definite human cost as people tend not to cooperate and don't wait to bleed out.