As all new vogue terminology and tactics enter our world, we have to ask if we truly have an in depth understanding of what it is, how it does and does not work in our organization, and finally how do we most effectively utilize it. In this article we will discuss the basics of what a Rescue Task Force is, what the RTF mission and tactics consist of, and finally how it adapts to your agency at other types of incidents.
Basics of the Rescue Task Force
To understand the basic principles of a Rescue Task Force, lets first look at what is a task force? A task force is defined as a group of people, or equipment, that has different capabilities but is grouped together for a common task. In this case we are pairing EMS/fire with law enforcement (LE), for a common goal of treating and extracting patients. The next most common question regarding RTFs, is the number of personnel required to create an RTF. As many of the questions regarding active shooter incidents are, the answer is, it depends. In the fire/EMS world we love specific guidelines because it takes the guesswork out of it, however, rarely do hardened guidelines align with dynamic incidents. In this case we really need to evaluate current incident resources, expected resources, and most importantly a threat assessment. With that being said, if resources were plentiful four police officers and three fire/EMS personal are ideal. This configuration allows two officers to search rooms, while the remaining two hold front and rear security, sandwiching in the fire/EMS responders.
This configuration would be the best-case scenario when the RTF is making entry into the warm zone early in the incident, before there is a strong LE presence in the building. As more LE officers go into the building and the threat assessment lessens, RTFs with two law enforcement officers become a more reasonable use of resources. The Personal Protective Equipment we discussed in last quarter’s article, needs to utilized by all responders entering the warm zone per NFPA 3000. This includes the level IIIA ballistic vest at minimum, with a ballistic helmet as a recommendation. The RTF also needs to have an appropriate medical kit for the operation at hand.
Rescue Task Force Mission and Tactics
This mission of the RTF simply stated, is to save lives that would otherwise be lost. A major component of building your active shooter program is making sure that your law enforcement counterparts agree in the scope of the mission. A highly critical component is agreeing that once the shooter is captured, killed, or contained, the incident priority changes to rescue, not to securing the building with a traditional LE search. The LE officers assigned to the RTF have to understand their mission is RTF security, not building search. Though officers not assigned to RTFs can be actively clearing the building for secondary threats, this should not inhibit RTF staffing. Completely searched and secured buildings pose the least risks for fire and EMS, but pose the most risk for our victims. This is why the national standards have reflected a shift in thinking, prioritizing early fire/EMS entry into a warm zone, once the initial threat is mitigated, but prior to a time-consuming complete building search.
The most important job of the IC, is early establishment of unified command or joint operations. This allows for the Rescue Task Force to launch as soon as possible. The RTF should be launched from staging and should travel to the warm zone in a patrol vehicle or ambulance. RTFs should make access to the building based on LE intel on where the most patients are located. The job of the RTF is to stop the bleeding, and keep patients breathing. This is accomplished by systematically searching the building and treating as many patients as fast as possible. The Rescue Task Force has the ability to make the most difference in patient survivability. At this point in the operation we are not focused on triage or victim removal, we want to focus all efforts on treating victims with life sustaining interventions. Subsequent RTFs should be launched based on number of victims, and geographical considerations. If victims are present in more than one building, or in different areas of a large building, more RTFs should be launched.
An example of this would be a large school with three corridors, or a college campus with numerous buildings with injured victims; RTFs should be systematically searching each wing or building looking for patients to treat. Once the patients in each room are treated, command should be given a patient count and location. These treated patients will now be left behind for another team to extract. Responders should be re-assuring these victims that other teams are coming to get them out. Consideration should be given to un-injured people helping extricate these victims, as the RTF continues to move forward, if this is safe and communicated through command, this can be the fastest way to get victims out, and diminish the load of the teams removing patients. Some programs have implemented a tactic where the RTF treats and then immediately removes victims. The challenge with this strategy is that the first patient you find might be easily stabilized with a quick tourniquet, and while removing this patient another victim one room further, could be exsanguinating waiting for the next team, or for the RTF to return. This is why we strongly advocate for treating and moving, and passing extraction duties on to another team.
Once the appropriate number of resources are assigned to treatment, the incident commander’s next priority should be to focus on extracting victims. These next teams inside can be called Rescue Task Forces, with a mission of extracting victims. However, I prefer and teach the NFPA terminology of Extraction Task Force (ETF). This team is a similar make up of law enforcement and fire/EMS responders. Having this team identified as the Extraction Task Force clearly identifies each team’s mission; RTFs are treating, ETFs are extracting. The extraction teams may also be best suited with more responders due to the demanding nature of carrying patients out of a building. Extraction supplies like soft stretchers, patient movers etc. should be brought in by the team performing extraction. Once the Rescue Task Forces have completed all the treatment in their division, they can be re-purposed as extraction teams once coordinated though command.
The critical concepts of RTF tactics are making sure all responders understand the mission of the RTF, the RTF stays focused on rapid treatment of all patients, and that building movements are performed systematically by clearing rooms for patients, not leap-frogging from patient to patient, un-systematically. Following these components will ensure patients are not missed, time is not wasted, and all victims get life saving treatment as quickly as tactically feasible.
Utilizing the Rescue Task Force Concept in Day to Day Operations
As we have learned from the Phoenix Fire Department Rapid Intervention Team studies, introducing new, unpracticed tactics in “once in a career scenario,” is a recipe for disaster. In these instances, we will not rise to the occasion, but fall to what we have trained on, and have utilized in real world incidents. Though active shooter-type incidents continue to increase in the United States, we are far more likely to be exposed to risk in a routine law enforcement assist. “Routine” domestic assault calls continue to be one of most dangerous calls police officers respond to. These calls represent one of the highest causes of injury and death to police officers year after year.
This is important to fire and EMS because we very commonly are called to assist in these incidents. These calls as well as officer involved shootings, and all other traumatic violence calls, create an ample opportunity to utilize some of the terminology and tactics we will use in an Active Shooter or Hostile Incident Response. Though we may not use a seven-person Rescue Task Force, we can still utilize the terminology and practices of pairing fire/EMS with a dedicated officer for force protection. This challenges us to communicate with law enforcement and not rush into scenes that are still chaotic and truly unsecured. It also forces the officer dedicated to the RTF, to recognize his change in mission from patrol officer to RTF security. The more incidents we utilize our RTF skills with our brother and sisters of law enforcement, the better we will be prepared to respond to that once in a career incident.
In next quarter’s article, we will take a deep dive into the specific medical treatment modalities best suited for an active shooter or hostile incident. We will discuss lessons learned from combat medicine applied overseas, and how we can implement these concepts into our active shooter responses; and more importantly, into our everyday trauma calls.