Active Shooter Response Jim Schwartz, Chief Arlington County Fire Department

Arlington County Located directly across from Washington D.C. Highly urbanized community of 26 square miles; population if 212,900

Paradigm Shift Columbine High School Shooting – April 20, 1999 Eric Harris & Dylan Klebold Both had self-inflicted fatal wounds Occurred within 45 minutes from start of incident No significant law enforcement entry for 1 hour No medical operations inside for 4 hours 12 students & 1 teacher killed 24 wounded Coach Dave Sanders Bled for > 2hrs before dying

April 2, 2013 IAFC, IACP, FBI and DHS Host meeting to discuss medical response to active shooter IAFF, Metro Chiefs and USFA also in attendance Discussion also covered use of ICS during incidents Conclusion -“integrated and coordinated planning, policies, training and team building prior to any incident will ensure effective and successful response”

The New Fire/EMS Paradigm Initial EMS/Fire medical responders should work with Law Enforcement assets to rapidly deploy into areas that have been cleared but not secured to initiate treatment and effect rescue of injured victims NOT tactical medics but first arriving EMS assets Security and/or escort provided by LE teams Requires appropriate equipment and PPE Should utilize TECC medical principles

Rescue Task Force One answer to the issue of rapidly providing stabilizing medical care in areas that are clear but not secure NIMS compliant name Task Force: Any combination of single resources, but typically two to five, assembled to meet a specific tactical need

Rescue Task Force First arriving EMS providers (NOT tactical medics) team up with 3 patrol officers to move quickly into “warm” zone areas along cleared corridors to initiate treatment and evacuation of victims

Rescue Task Force Concept 3 patrol officers for front and rear security Readily available resource Do NOT assist medics in care Responsible for security and movement only 2 street medics in ballistic gear with supplies to treat up to 14 patients Able to initiate TECC care and rapidly evacuate

Rescue Task Force Concept RTF is the deployment of 2 firefighters/2 police moving to the location of multiple injured. There is some flexibility in the numbers, but 2 and 2 should be a minimum. Here shaded in green are the designated Areas of Responsibility for the Pointman and Rear Guard. The paramedics in this formation can assist the officers by watching opposing sides of the environment.

NYPD Active Shooter Report 2012 Comprehensive document summarizing commonalities, trends, and events Total qualifying cases from 1966-2012: 230 Some common characteristics found but also a large degree of variation across broad categories Age, Sex, Planning, Location, Relationship to victim, weapons used

Summary: Pattern of an Active Shooter Duration of event Average <10 minute duration Most as short as 3-4 minutes Average 12-15 min response by Police 93% of incidents in academic institutions were over prior to the first responding asset, police or fire/EMS, arriving on scene

Conclusions about Active Shooter/Active Killing Events After review of combat and post-incident data: The immediate threat is rapidly mitigated in almost all incidents well prior to Fire/EMS response The sooner the first responders start medical treatment, the greater the chance that victims will survive The risk from active shooter incidents is very low in areas that are clear but not secure

…Other Rationales for RTF Mumbai Attack November 26-28, 2008 10 terrorists – 6 killed / 4 arrested 171 killed Multiple attack sites Taj Mahal Palace and Tower – 50 killed Oberoi Hotel – 30 killed Naraman House – 8 killed Other incidents

How To Get Police Onboard Overcoming the ‘us vs. them’ mentality Who ‘s in charge of the scene Cost sharing concerns Emphasize the force multiplying benefit during ASEs Emphasize improved operational relationships During both ASEs and normal day to day operations Public image of collaboration between police & fire Teach TECC – Tactical Emergency Casualty Care

Tactical EMERGENCY Casualty Care Evidenced-based best practices medical guidelines for care at or near the point of wounding in high risk operations NOT Law Enforcement tactical medic specific For use by any first responder who is providing medical care whenever and wherever there is increased risk to provider and patient

Tactical EMERGENCY Casualty Care Goals: Provide principles for point of wounding management of trauma for response to ALL atypical and high risk civilian emergencies To balance appropriate medical care with the threat, the required tactics, and the civilian scope of practice, equipment, and population

Personal Protective Equipment

Equipment and Supplies

Equipment and Supplies

RTF Operations

RTF Operations Initial responding patrol officers form 2-3 contact teams that all enter building along same corridor and move quickly to engage shooter

RTF Operations

RTF Operations Contact teams essentially are clearing the primary corridor as they move to sound of shooting Identify and notifty command of threats (IEDs, etc) Do not open locked doors unless sound from behind would indicate threat Do not aide or assist injured As victims encountered, notify Command of location

RTF Operations

RTF Operations Need for RTF identified by 2nd contact team Initial RTF team formed and quickly moves into area down the corridor cleared by the contact teams Will not move into un-cleared areas or get in front of contact teams

RTF Operations RTF

RTF Operations Goal of initial RTF team is to stabilize as many victims as possible using TECC principles Will penetrate into building as far as possible until they run out of accessible victims or out of supplies “Stabilize, position, and move on”

RTF Operations

RTF Operations

RTF Operations Once RTF operational, Fire and Police Unified Command will establish: RTF re-supply near point of entry External casualty collection point for transfer of patients Warm Corridor for evacuation away from area Dedicate non-RTF assets to assist in transfer of patients from RTF assets for external evacuation

RTF Operations C P Resupply boxes

Active Shooter Questions?