Mass Violence Incidents

So first, let me quote President Lincoln who said, “that from these honored dead we take increased devotion to that cause for which they have the last full measure of devotion — that we here highly resolve that these dead shall not have died in vain.”  While Lincoln was referring to the Battle of Gettysburg, his words still hang true today with regards to law enforcement as well as fire-rescue and emergency services. However, the lines between blue team and red team responsibilities as well as the lines between the hot, warm and cold zones are being blurred beyond recognition.

The school shooting in Columbine changed things for law enforcement. Prior to that event, law enforcement was encouraged to establish a perimeter, call for a SWAT team, and attempt to negotiate with the shooter(s). Today, law enforcement proceeds in a more rapid manner. The department in which I serve has trained on responses to mass violence incidents, but the same question seems to rear its ugly head. Where and how long do we stage before law enforcement renders the scene safe? These questions are no doubt a result of our day-to-day operations.  When we respond to a domestic altercation with one of the parties injured, we stage until law enforcement arrives, separates — and perhaps detains one of — the parties, and insures the scene is safe for us to enter. That may only take a few minutes at a single-family dwelling. For those that think this is appropriate to prevent us from getting shot when we pull up to the scene, I must admit that I agree. Nevertheless, we should put ourselves in law enforcement’s shoes.  How long will it take for a handful of the blue team to render a building that is over 300,000 square feet safe? The public expects us to take risks and while none of us want to get shot, we also cannot sit in Level II staging for three days while the blue team sweeps a 300,000 square foot building completely for all potential hazards. The result is that we, too, must start moving in a more rapid manner. This puts us at a much greater risk than we have experienced in the past, but it does not have to be a Columbine or Sandy Hook shooting that almost “gets” us.

A recent International Association of Fire Chiefs’ Near Miss report outlined that an ambulance crew responded to the report of shots fired with “several people down” in the street. After staging for a few minutes, the dispatcher advised that the shooter was on an adjacent street.  The ambulance proceeded into the scene and found two victims, one obviously dead and the other critical. While treating the critical patient, the ambulance crew “failed to notice several people beginning to surround us.” The crowd turned out to be rival gang members of the critical patient. The crowd pointed guns at the ambulance crew and insisted that they leave the critical patient and go back to the deceased patient to “save” him. The ambulance crew (smartly) complied, loaded the deceased patient and immediately departed the scene. The near miss reporter — one of the ambulance crew — faulted themselves for losing situational awareness.  That’s not really fair though. When you are performing patient care, particularly on a critically injured patient, it is difficult to pay attention to your surroundings. It emphasizes the fact that the faster you can load your patient and depart the scene, the better. This will minimize your exposure time while you provide patient care. Communications between the red team and blue team are also critical. I once was responding to a shooting involving seven patients and about a minute away from the scene I heard a law enforcement officer tell the dispatcher, “Everything’s 10-4, everybody can back it down.” This was followed by my department’s battalion chief telling the dispatcher, “I don’t know how many cops you have coming to this scene, but it’s not enough.” Shortly after arriving, gunfire again erupted, but luckily no one else was hit. Common terminology is also essential. Remember that codes and signals are not uniform and can vary widely between jurisdictions and agencies. If someone from the blue team tells you to 10-17 by the Code 7 over in the Signal 86, you should politely ask him or her to speak in plain text.  Miscommunications can also occur with plain text. In a Tactical Combat Casualty Care drill, law enforcement was leading a team of firefighter/paramedics through a school building. They entered the first room, searched it, and came back to the hallway announcing, “Clear”. After the third similar action, they turned to find their firefighter/paramedics were 50 yards behind them in the hallway. They asked, “What are you doing?”  The firefighter/paramedics replied, “When you say clear, you mean there are no patients in there or do you mean there is no one in there that will shoot us?”

So, what should our operations include when dealing with incidents such as these? First, you should keep your head on a swivel. Try to minimize your scene times and limit your exposure, but while you are there, pay attention to your surroundings, particularly if the law enforcement folks are not in your immediate area. This is how we can limit the chances that the warm zone becomes the hot zone. Next, we should consider our PPE. While we want to be conspicuous so that the blue team recognizes us, we do not want to be conspicuous to anyone who wishes us harm. It is also becoming fairly commonplace to find the use of ballistic vests or body armor among many fire-rescue and emergency medical services. Although this PPE is the last line of defense, it does offer some protection to responders. 

Finally — and maybe this should be first — we should recognize that we might be working in the “warm” zone much earlier than we would like. Get comfortable with that, as it will probably only get worse in the years to come. For those that insist that they are not comfortable with that and they are not going into an active violence event, I can relate. Regrettably, the choice is not up to us. You may not have joined the fire or an emergency service to go running into a scene and get shot, and that is OK. You may suggest that you don’t get paid to get shot at, and that is also true — for the most part. If a handful of our taxpayers and their families are in a building occupied by a shooter, you can bet they will want us outside getting shot at in lieu of staging a mile down the road for an hour. I urge you to consider this wholeheartedly. The public decides what it is that we get paid to do, not us. With the increase in violence against law enforcement and the public, we will be called upon to operate inside those blurred lines. That will put us at a higher risk. These mass violence incidents are extremely complex. Despite our best possible planning, not every detail can be anticipated. We have to focus on the basics, maintain situational awareness, collaborate with law enforcement, and do everything we can to protect the lives of our citizens. As Lincoln would say, “It is altogether fitting and proper that we should do this.”

Be safe and do good!