Engine Company EMS: Active Shooter/Mass Casualty Response

By Michael Morse

If your department doesn’t have a standard operating procedure for an active shooter/mass-casualty incident (MCI) that includes joint training with law enforcement, it’s time to push for one. Try not to assume that somebody knows what to do. Probably somebody does, but what if we all think somebody else is that person?

Working together is imperative during crisis and every second spent training is one more second that need not be wasted at the scene of an MCI involving an active shooter. Uncertainty at an active scene is dangerous for responders and victims. Law enforcement needs to know what to expect from fire/EMS, just as we need to know what to expect from them. The time to figure that out is not during the incident when lives are at stake, but beforehand. The time to drill and practice is not when an incident occurs.

Things law enforcement needs to know:

1. Are there tactical medics available?

2. Where is the casualty collection point (CCP)?

3. How far away is the staging area, and exactly where is it?

4. Will there be adequate resources (mutual aid ambulances and staffing)?

Every firefighter, EMT, and officer has the ability to spearhead the process that will result in a properly trained and motivated response team should an incident occur in your area. By going through proper department channels and being persistent, even the most underfunded, understaffed, and unorganized department has the potential to get the job done right.

All fire departments were not created equally. There are progressive departments, paid departments, volunteer departments, adequate departments, departments that are stuck in tradition, underfunded and unmotivated departments, and everything in between. The one thing every department has in common is firefighters, and they are our greatest strength. It is easy to get lost in departmental red tape, apathy, and disillusionment, especially when there are simply not enough resources or interest to get the ball rolling. Those are the times when we as firefighters need to step up. The first-year firefighter and the 30-year officer are equally capable of researching proper responses to mass casualty/active shooter incidents. By learning from available resources, a plan can be assembled and proposed, following the chain of command. If that chain is broken or damaged by politics or inflated egos, the strength of the plan may be enough to overcome internal chaos. Everybody wants to do the right thing; sometimes we get overwhelmed by apathy and allow a false sense of security to undermine what should be effective planning.

Some things to consider:

–Use the tools at your disposal. FEMA has a comprehensive guide to help get your plan off the ground: www.usfa.fema.gov/downloads/pdf/publications/active_shooter_guide.pdf

–Don’t be overwhelmed. A journey of 1,000 miles begins with one step. Creating an atmosphere of cooperation is much the same. Nobody wants to drill for eight hours. Two hours of training once a week for a month equals eight hours a month. Do what you can, but do something!

–Allow your instinct to be your guide. You know if you are prepared, what is expected of you, and what is expected from the rest of the agencies responding to an incident. If you’re wondering whether they know what you know, assume they don’t. Communication is key, and training is the answer to many problems that have no business arising in the first place.

–Step back. Once you have started the process of interagency cooperation, chances are somebody higher in the chain of command will take over. Good. This is not about feathering one’s cap; it’s about staying alive, and keeping other people alive.

Sometimes the simplest things are the most effective. More often, the simple things are overlooked. Something seemingly benign like talking about mass-casualty response and active shooters to the law enforcement officers we respond with on the street level might expose dangerous holes in our respective departmental planning. Once those holes are exposed, we can figure out how best to fill them.

By talking about our expectations and respective abilities during an incident we all hope never happens anywhere, we will be better prepared to respond properly should it happen during our watch. Triaging victims, treating the injured, and transporting those who need it to the appropriate facilities may be our main objective, but being able to do so takes practice. That practice and training must come before the next MCI.

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Michael Morse is a former captain with the Providence (RI) Fire Department (PFD), an author, and a popular columnist. He served on PFD’s Engine Co. 2., Engine Co. 9, and Ladder Co. 4 for 10 years prior to becoming an EMT-C on Rescue Co 1 and Captain of Rescue Co. 5.