POLICE Magazine

SEP 2018

Magazine for police and law enforcement

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SPECIAL REPORT H ACTIVE SHOOTER RESPONSE 9 PHOTOS: LAWRENCE HEISKELL Your incident command plan should include when and where casualties will be treated and how they will be evacuated from the point of wounding using the THREAT principles (threat suppression, hemorrhage control, rapid extrication to safety, assessment by medi- cal personnel, and transport to definitive care). is will improve survivability and should be an integral part of planning. Determine which agency or person- nel will locate victims and triage them, provide point of wounding medical stabiliza- tion, and/or remove victims to a safe location with hard cover if possible, thus estab- lishing a casualty collection point. In the first phase, you are about to enter a tactical environment and a crime scene. Your safety is para- mount and the possibility still exists that you or other officers at some point may come under hostile fire. e tactical medic must at all times be fully aware of the surroundings and any potential threats. In the second phase, you and the victim or victims you are treating are consid- ered relatively safe, and you will be able to provide emer- gency medical care based on your scope of practice, level of training, and equipment carried with you. Begin to formulate extraction deci- sions as you evaluate and treat the victim. Inform your tactical team leader of your clinical findings and when you plan to extract the victim. In the third and final phase, the victims are ex- tracted from the scene and evacuated to the location of the appropriate method of transportation for delivery to a medical treatment facility capable of treating the injury. Transporting the victim to the nearest hos- pital may or may not be in best interest of emergency care. Trauma is a surgical disease and is treated in the operating room, not in the emergency depart- ment. Make every attempt to transport the patient with penetrating trauma to an appropriate hospital with trauma services. Try to achieve the platinum half-hour. Regardless of the tactical medic's professional standing, he or she will quickly learn that providing medi- cal care in a tactical environment can be extremely challenging. Tra- ditional EMS doctrine maintains that rescuer and scene safety are first priorities, and that patient care is a secondary concern. What sets tactical EMS apart from standard EMS is the ability to render immedi- ate care in the operational area. Every active shooter incident is different in terms of the location, the weapons used, and the motives of the attacker. ese events can range from unplanned, revenge-motivat- ed, or random events to extensively planned terror-related events. e successful command and control of any active shooter inci- dent is based on multiple levels of planning and coordination, includ- ing fire and EMS response assets, public safety and private sector re- sponders, facility personnel who provide expertise regarding techni- cal and facility matters, as well as hospitals and trauma centers. Using the Incident Command System (ICS) will provide a frame- work for managing the incident and should be utilized by the respond- ers and infrastructure operators. Effective planning requires mutual goals, critical reviews, evaluation, revision, and continued practice. Planning, coordination, commu- nication, and information sharing must be common and practiced among all responders to such an incident. ere must be a commit- ment to prepare and plan for such events long before it occurs. Phased RESPONSE PLANNING for the Worst ➔ Using a tourniquet can stop hemorrhagic bleeding and save lives. Providing medical care in a tactical environment can be extremely challenging.

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