POLICE Magazine

SEP 2018

Magazine for police and law enforcement

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8 SPECIAL REPORT H ACTIVE SHOOTER RESPONSE Significant efforts on the part of fire and EMS agencies, along with pre-planned coordination with law enforcement, are necessary during active shooter response in order to effect prompt rescue and save hu- man lives. erefore it is essential that local agencies have policies in place before an event occurs to en- sure cooperative and coordinated re- sponse and emergency medical care. Historically, active shooter in- cidents usually end a few minutes from the time they begin. However, the response actions typically play forcement units on the periphery of the event. is creates a diversion and can delay emergency medical personnel responding to victims who are significantly wounded. is problem doesn't only affect medical personnel at the scene. Victims with minor injuries may self-transport to nearby hospitals and create emer- gency department overcrowding before the arrival of the more se- verely injured. is is known as the "reverse tri- age effect," where the least injured enter the emergency medical sys- tem first and can significantly im- pede response operations both on- scene and in the receiving medical facilities. out over a longer period of time. e scene may include a "hot zone" or an area of "direct threat" with an ongoing active shooter or shooters. Inside this hot zone, it is common to find multiple casualties requiring extensive triage, emer- gency medical care, and treatment. Extraction and evacuation efforts as well as transport to trauma cen- ters and hospitals may include large numbers of response personnel, by- standers, and volunteers. Clinical data collected from prior active shooter incidents has dem- onstrated that victims who sustain only minor injuries will self-evac- uate and seek additional care from responding fire, EMS, and law en- TACTICAL MEDICS IN ACTIVE SHOOTER RESPONSE D uring an active shooter event, law enforcement will often stage fire and EMS personnel remotely for their personal safety. e tradi- tional fire and EMS crew is reluctant to enter the scene until they are convinced that the area is absolutely safe because they are not tactically equipped or trained. Unfortunately, while these responders wait for the "all clear," wounded officers and/or victims could bleed to death. And fire and EMS not having di- rect communication chan- nels with the command post can also create even more delays, preventing pre-hospital care providers from being able to perform effectively. e need to get immedi- ate care to people during police response to mass casualty incidents led to the development of tactical emergency medical support (TEMS) for law enforce- ment. Today, more and more police tactical teams have added emergency medical personnel. Some have trained full-time SWAT officers as EMTs or paramedics. Others have trained medical personnel such as rescue task force personnel in police tactical operations. Few events present more challenges for law enforce- ment tactical medical response than the active shooter incidents. Properly trained officers and medical personnel can enter an active threat area and save lives. TRIAGE and Reverse Triage LAWRENCE HEISKELL

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