Active Shooter Case Study

With recent events such as the shooting at the Pulse Nightclub in Orlando, there has been an increased focus on the role of EMS providers in an active shooter situation. Should EMS wait until the scene is deemed "safe" by law enforcement, or should providers be expected to enter a potentially dangerous scene where the shooter may still be active? It is an issue that has been debated on public forums all over the internet, with plenty of people of both sides of the argument. And while both sides of the argument have merits, I believe there is a solution that may allow victims of a shooting to receive quick and effective medical care without compromising the safety of those who provide it. Currently, the first thing we are taught as brand new
Adding a possible active shooter into the mix complicates the situation. While we are waiting for a scene to be cleared for our entrance, there are victims in the warm zone that potentially could have had treatment, thus increasing their odds of survival. There has been evidence that victims that have been injured in an active shooter situation have increased survival rates with the application of "quick and easy maneuvers such as hemorrhage control, tourniquet application, basic airway management and other rapid interventions." (Bulloss, 2014) After Sandy Hook, the FBI and the American College of Surgeons collaberated to come up with a solution to prevent a similar loss of life from happening again. They came up with the "Hartford Consensus". The bottom line of the Hartford Consensus is that "nobody should die from uncontrolled bleeding". While it is known that those with immediately fatal injuries do not survive, the surgeons determined that being able to stop uncontrolled bleeding would have been enough to save many lives. With regards to making an entrace into the warm zone , in 2013 FEMA issued a new guideline for EMS concerning response to active shootings. Within this document, FEMA states that providers should be prepared to retrieve or treat patients in the "warm zone". The warm zone is an area of indirect threat where law enforcement
Along with that, we would continue to make sure that responders are approaching these situations in a way that will minimize risk. The idea of training EMTs and Paramedics in tactical positions has been around since the 1980s. There have been a number of law enforcement agencies nationally that have worked with tactical EMTs already. Many of these teams use Counter Narcotics and Terrorism Operational Medical Support(CONTOMS), to certify their providers as EMT-Ts or SWAT Medics. Furthermore, there are several national agencies, such as the International Association of Fire Chiefs that have recommended the concept of a rescue task force (RTF). With this concept, highly specialized and trained paramedics would travel behind law enforcement as they clear areas. Victims would be rapidly extracted back out to a safe zone for further treatment. In Blacksburg, Virginia, the Blacksburg Volunteer Rescue Squad has such a system. With their system, medics and law enforcement are provided with ballistic protection as a precaution against any threats that may be in the warm zone. Each team is comprised of two medics and two law enforcement officers. During the 2007 Virginia Tech shooting, their squad was instrumental in the life-saving and recovery of several