It is very similar to the time-old debate in the fire service as to which hose load is best and the advantages of smooth bore nozzles or fog nozzles. In some cases, it seems like people are writing articles to just sit back and watch the debate that they have created. Many of the articles that I read create more questions and cause more confusion than provide answers.
Debates are Great, But ...
I’ve read many articles where the focus was debating the merits of the author’s beliefs against other mindsets. Debates are great but understand that what works in your jurisdiction probably will not work in another jurisdiction. Instead of debating the optimal response, explain the details of the event and allow the jurisdictions to figure out what will work best with the resources they have. Since 2012, our company has provided integrated active shooter training for more than 80,000 responders from 6,000 agencies on four continents. The one underlying key is that no one single protocol, policy or mindset will work for every agency or every event.
At this point, every fire department has most likely had discussions about their role and responsibilities at active violence incidents. We all know the acronyms, the catch phrases, and the latest statistics that creep into every article or discussion. Chief officers have probably already determined the level of risk tolerance that they are willing to accept to save lives at these events. By now, many departments have adopted the Rescue Task Force (RTF) model, or at least some variation of the concept.
It is commonly accepted that when it comes to active shooter events, Sandy Hook was a sentinel event for much of the fire service, just as Columbine was the sentinel event for much of the law enforcement world. Many fire departments began very serious active shooter response conversations after the Sandy Hook attack. For our department, those conversations began literally two hours after the attack.
However, if this is not your department, you are at least five years behind the discussion. April 20, 2019 will mark the 20th anniversary of the Columbine shooting. The shooting created sweeping changes in law enforcement response tactics to active violence incidents. However, fire and EMS were much slower to adopt change.
What’s the Next Step?
Every fire department is on the proverbial tip-of-the-spear for these events. Whether you are volunteer fire department that runs 40 calls a year, or a metropolitan department that runs 125,000 calls a year, the risk is the same for every department. The next call can be the one. Larger departments have been quicker to adopt protocols for active violence incidents. However, 98 percent of active shooter events in the United States have occurred in jurisdictions served by 100 or fewer law enforcement officers. Although this is everyone’s problem, it literally is a much bigger problem for smaller departments.
If your department has adopted active violence policies, you have most likely trained all of your department, held exercises, purchased equipment and refined your response. This is not the time to let off the gas and coast. If this is your department, what is the next step? Now is the time to think about your skills and see if they still follow current, best practices recommendations.
Think about the relationships that you have developed with other agencies. If you started this process several years ago, odds are that several of your liaisons with other departments have promoted up or retired out. Do you still have strong relationships? Have your partner agencies continued to address the problem, or are they moving on to other problems? Is the active violence training and skills that you implemented in your department reserved for the “once in a lifetime” call, or do you use and reinforce those skills on routine calls?
In most cases, organizations have failed to wholeheartedly adopt the paradigm shift of holistic public safety integration. The active violence protocol, cool tactical equipment, and hostile threat skillset usually is shelved waiting for the once-in-a-career call. If this is the case, we have failed at operationalizing the plan, failed to create muscle memory and ultimately failed the people that we serve.
Institutionalize Your Specialized Skillsets
If we really want to be ready to respond to a hostile mass violence event, then we must operate with the mindset that routine calls can quickly turn violent. Instead of buying the “active shooter” medical bag that is stowed into a special compartment, buy the right equipment and integrate it into your standard medical bag. The same skills that we use on the routine shooting, should be the muscle memory that we utilize when we have 30 people shot- or 300 people shot.
We must find a way to institutionalize our specialized skillsets so that they are practiced routinely and ingrained into muscle memory. This makes our operations at hostile mass violence event a hindbrain activity, not a forebrain activity. We will then operate seamlessly, without delays in analyzing the event to death (literally).
This first step to institutionalize tactics is to ensure that training is not a one-and-done checkbox. The tactics must be ingrained into training for all new members. There are always benefits to having a third-party contractor come in and provide specialized training. This allows your department to take advantage of the research already conducted, hear current best practices and put everyone on common ground with a basic understanding of active shooter events. This will give you a solid jump off place, instead of starting from scratch.
However, utilizing third-party vendors is not a sustainable business model to provide continual training for your department. Instead, have the specialists — or experts if you will — come in, train your department, and provide your department with train-the-trainer capabilities. This is critical for several reasons. First, it is more economical for your department. Second, it makes the training yours. Your department now has buy-in and sweat equity in the training. Third, the training is tailored to your department’s needs and the capabilities of your partner agencies.
Any time that new training is brought to your department, always consider building your own training cadre. This cadre can take the concepts taught and move forward with refining the concepts for your department. Traditionally in the fire service, tactics are more readily accepted if they are taught by members of your department. We are much more suspicious of the outsider “from the big city” who came in wearing a suit, with a briefcase, and snazzy PowerPoint. People are immediately dismissive of the ideas, thinking “That is great for them, but that’s not us.” Take ownership of the concepts; fold them into your department’s resources, culture, and abilities.
Mass Violence Response Training — Make it Fit
It is critical to make sure that all new department members have mass violence response training. If this training was mandated for your department, then include it in rookie school, new employee orientation, or EMT training. Find a place where the training fits and give it a permanent home. You can make it fit wherever you want. In rookie school, it can fit into the block of training on firefighter safety and survival. In new employee training, it fits into mandated OSHA workplace violence training. In EMT school, it fits with mass casualty training.
Make the training realistic. Hostile mass violence scenes are incredibly graphic, emotionally disturbing, and provide sights, sounds, and smells never otherwise encountered. Let the students know that there will be an overwhelming stench of gunpowder, cordite, blood and possibly other chemical irritants. Teach students how to operate with their head down, but their eyes up. While they are dealing with this situation, they also know that law enforcement force protection is right there with them, ready to immediately address any hostile threat. This is a great time to bring in new law enforcement officers and provide them with the same type of hyper-stimulus training.
Combining new firefighters, EMTs, and law enforcement officers for this training not only provides realism, but it establishes relationships for years to come. This type of training should become the new norm for fire academies, EMT training, and basic law enforcement training courses. Not only does this show the recruits the importance of integrated training, but it also shows the dedication of public safety command staff to ensure integration of agencies.
Beyond initial training, we must develop ways to make mass casualty training more realistic and relevant to real world operations. I’ve participated in hundreds of mass casualty training exercises in the last 30 years in the fire service. In many cases, it was the simulated plane crash in the parking lot on clear, sunny Saturday. This serves a purpose, if the purpose is teaching a skillset where you line up mock patients with unrealistic injuries on clean tarps, in an environment completely devoid of chaos. The checkbox was met.
I was an evaluator for one mass casualty exercise in another jurisdiction where the first 15 minutes was all about putting colored tarps out and placing triage tags on 80 victims. However, this fire/EMS agency was so focused on checking the mass casualty “boxes” that they forgot to treat the patients. For 15 minutes, patients lay on the ground literally bleeding to death, while EMS providers spent more attention on putting on the right MCI command vest. I would not have believed it if I had not observed it myself.
We must figure out a way to streamline hostile event treatment to meet to the “20-60-90 rule” for optimal trauma survivability. This rule states that within 20 minutes of injury, every critical patient will receive point-of-wounding care by a medical responder trained in Tactical Emergency Casualty Care. Within 60 minutes, all critical patients will arrive at area hospitals. Within 90 minutes, all critical patients will be in surgery. Without the continued refining of operations, we will continue to have incidents such as the Pulse Nightclub, were 33 percent (n=16) of the victims who died had potentially survivable injuries. To make this worse, Pulse Nightclub was located less than five blocks away from Orlando’s Level 1 trauma center.
Is RTF Model Relevant to Daily Operations?
If Sandy Hook was not a sentinel event for your department, then Pulse Nightclub was most likely the final straw. If your department has been training since 2012, you have most likely spent hours planning and even more hours training. We are now at a point where most departments feel like we have an operational plan that we can utilize during these events. If we feel we “perfected” the RTF model, we need to go back and reinvent the RTF model to make it relevant to daily operations.
This training should not just be about forming a team and moving downrange in hostile environments. This training needs to now focus on how to survive a non-violent scene that suddenly becomes violent. It is much different if you are an RTF organized by the command post, versus an organic RTF organized by the event — two cops standing next to a fire company. We need to understand what it looks like to transition from an everyday shooting or stabbing incident, to forming an RTF at mass violence hostile event. We need to understand the skills necessary to conduct this type of operation. By creating this type of skillset, we ensure that personnel have the knowledge and equipment necessary to react to the sudden escalation of a mass violence incident.
Please do not misunderstand the intent of this article. I am not saying that we should stage on all calls or that we should form an RTF for the next seizure call on the sidewalk. However, I am saying that the fundamental of all calls should transcend from the basic calls to the most complex of calls. Hostile event training tells us that our personnel should not stand in the proverbial “fatal funnel” when knocking on the door at a medical nature unknown call. Do not stand with your hands in your pocket on a medical call, completely unable to respond to an immediate hostile action by your patient. Use the concepts that law enforcement use when interviewing a potential suspect when we talk with patients. Be guarded, keep your hands up, watch for preattack cues, and always prepare for unexpected violence. When we have firefighters train in the academy with law enforcement recruits, they will see and learn these skills.
We must accept that we live and work in a world where people die from needless, wanton violence. In this world, innocent people will continue to die if we elect to stage blocks away until we receive absolute assurance that we will indeed survive to return to the station. If this is your department’s belief, ask if your department truly is an “all hazards” department. Until we can stop societal violence, the solution is to understand how to operate at hostile events. We must hone our skills to optimize survivability for the community and minimize the risks to the responders. The flock needs sheepdogs to protect them from danger. But every sheepdog needs a shepherd willing to continually train the sheepdog. Don’t just be a sheepdog, be a shepherd.