Response Priorities for Mass Violence Incidents

BY AUGUST VERNON

Crisis situations such as school shootings, workplace violence, domestic violence spillover attacks, and other threatening situations appear to be occurring with alarming frequency. First response agencies may also find themselves being exposed to these types of situations more frequently.

According to the Department of Homeland Security (DHS), an active shooter is “an individual actively engaged in killing or attempting to kill people in a confined and populated area, typically through the use of firearms.” There is no single national or recognized template for the effective response to these types of incidents, but strong leadership, preparation, and training provide the emergency response community with an excellent foundation for responding to these types of incidents.

Active shooters may have detailed plans of attack and lists of targets and may be prepared for a sustained confrontation with law enforcement. The length of a mass shooting incident depends on law enforcement response times, the number of shooters on site, their level of aggression, and the types of weapons involved. These incidents are usually very fast paced and may be over in four to eight minutes. The active shooter’s intent is to engage multiple targets, killing as many people as possible in the shortest time. Escape and survival are usually not the shooter’s objectives.

A rapid, safe, and successful response to a mass violence incident requires preparation. No jurisdiction is immune from these types of incidents. Today’s criminals and terrorists appear to be more determined, violent, and heavily armed than ever before. Responders are faced not only with the possibility of large numbers of victims during these incidents but also with serious threat of harm and death to response personnel. First responders at all levels must learn to work together to deter mass violence incidents from occurring in their jurisdictions and to safely respond if an attack occurs.

The lack of a properly coordinated and planned response can lead to confusion, bad publicity, and even death and injury to responders and citizens. The more our public safety agencies prepare, the greater the chance that they will be able to effectively manage any type of situation that might arise. If and when a major mass violence incident occurs in the United States, trained and educated first responders can help lessen the impact with a safe and effective response.

SCENE SIZE-UP

On arrival at any mass shooting/active shooter incident, it is important to conduct a quick “windshield survey” even when a scene is believed to be secure. It is always important to gain as much prearrival information as possible and to listen for key verbal indicators and intelligence that may come across as indicators for a large-scale incident such as victim numbers and types of injuries: It is a high-violence area, you have been to the location before (a bar or a club), shooting or alcohol abuse is involved, or there are large crowds. Large crowds and fire/EMS may not always be a good combination. At times, these crowds can be hostile. Alcohol may be present in large groups, and there are almost always individuals who believe that the responders are moving too slowly or are not doing enough for the victims.

In these situations, the crowd may end up being a significant threat to the safety of emergency responders. Also, recognize that protests/civil unrest events can occur for a variety of reasons and are not just limited to large urban areas. These events can take the forms of peaceful demonstrations/protests that turn confrontational, violence related to major sporting events, concerts and “block parties” that turn violent, planned political conventions disrupted by activists, confrontations at “hot spots” such as abortion clinics or research labs, and riots related to racial tensions.

Dispatched information is not always correct or will be very vague because of the information the communications center is receiving. When dispatched to a mass violence incident, be fully aware of what is occurring prior to and during your response.

Law Enforcement

For fire/EMS agencies, typical procedures require that law enforcement be dispatched to an incident that has the potential for violence, but you may find yourself on the scene of such an incident alone because of a wrong address, victims coming to you, or suddenly coming on an incident. Should you find yourself alone on a potentially violent scene for any reason, never hesitate to call for law enforcement assistance if you think you may need it.

In today’s environment, first response agencies may find that they are requested to assist or “stand by” at law enforcement “special operations” such as the tactical team call-outs, dignitary visits, planned events, or a bomb squad response in dealing with suspicious persons, packages, or devices. Unless otherwise specified, agencies should initially have a small response, which allows for better command and control of resources. The supervising fire/EMS officer should report to the law enforcement IC for an exchange of details/information and initiate a unified command organization. If a bomb squad operation or search for suspicious devices is taking place, response personnel must be briefed on their roles and be staged in a safe area where they will be out of harm’s way if a device detonates.

Command System

The incident command system (ICS) is one of the best tools agencies can use when responding to mass violence incidents. During the initial size-up, the incident commander (IC) will need to notify dispatch of the command post (CP) location and assess the situation as best as possible by quickly gathering information from witnesses and other responders. The IC must also direct arriving units, designate at least one or more staging areas, and immediately request that partner agency representatives go the CP to start building unified command. It would be counterproductive to have more than one CP.

EDUCATION AND TRAINING

In preparation for these incidents, local responders should talk to experienced military medics and those with experience in Iraq and Afghanistan and review Tactical Combat Casualty Care (TCCC). A typical bus crash or plane crash mass casualty incident (MCI) is different from the “terrorism or mass violence” MCI. The shooters, both criminal and terrorist, are training on head shots and double shots to the chests. Additionally, they may be using devastating heavy and automatic weapons. Responders should train on hasty rescue-removal techniques and equipment. They should practice rapidly moving multiple victims to safe areas; casualty collection points (CCP); triage; and evacuating from structures, down hallways, through windows, down stairwells, over traffic/highway barriers; and so on. You may not have access to or be able to use normal emergency medical services such as wheeled stretchers; therefore, you should have other types of rescue devices and litters you can use.

INITIAL ACTIONS ON SCENE

Following are some of the immediate considerations/actions of firefighters once on scene:

• Approach the scene cautiously. Stop and look/listen before entering a suspicious or dangerous situation, residence, or structure. There could be the potential of vehicle and structural fires from explosive or incendiary devices used during the attack or planted in the area as secondary devices. Stop, look, and size up suspicious buildings, vehicles, occupants/contents, and activities.

• The IC must decide whether fire operations should be offensive or defensive if a fire (vehicle or structural) is present.

• The fire department may be the lead EMS agency or may need to assist EMS operations with triage, medical care, victim extractions, scene safety, and CCP.

• Quickly conduct the initial scene size-up or windshield survey, and provide that intelligence to communications and other responding units.

• Anticipate that law enforcement will assume the lead position in the unified command structure during the tactical response phase of the incident until the scene is secured.

• Rapidly establish a unified command post with the other responding agencies and determine staging areas outside of the hazard area. The presence of fire and EMS agencies will still be required in the CP. Fire and EMS may need to be ready to go with law enforcement escorts as soon as possible in a coordinated fashion: First Wave of fire and EMS responders: “grab bags”/small handheld trauma and shooting kits and Second Wave of fire and EMS responders: stretchers, trauma bags, oxygen bags. During a rapid deployment (active shooter or terrorism) incident, law enforcement will most likely bypass the wounded.

• Law enforcement may need immediate access to portable breaching tools and equipment such as ladders, tools, skeds, and fire extinguishers.

• You may need to establish helicopter landing zones for medical evacuations.

• Fire and EMS may need to implement the local MCI system such as the disaster procedures triage, triage tags, CCPs, medical command, hospital coordination, and field treatment areas for minor injuries. Keep in mind that perpetrators could be among the fleeing victims, the wounded, or the deceased.

• If responding to high-risk areas or situations, wear body armor. Body armor has been a topic for debate among the fire and EMS communities. Used “hand-me-down” body armor/ballistic protection from the military and law enforcement agencies may not always be the best choice, as the armor may be severely damaged/worn out. Also, this practice could open your agency up to legal actions.

Some jurisdictions provide no armor; some provide all staff with armor; and others provide armor to only those units that routinely respond to a large number of shootings, stabbings, and other types of critical incidents. On the other hand, the cost of body armor is very restrictive; typical cost starts around $500-$800 per unit. If your agency is looking to purchase armor, carefully research the topic: You must consider “ballistic protection” guidelines and the various types and levels of body armor available.

• Operate in a minimum of two-person or “buddy” teams when possible. Wear basic bloodborne/splash personal protective equipment (PPE) at the minimum. You may have to search beyond the immediate scene for victims who are not able to call for help or may have fled the area.

• Be aware that there is a difference between “law enforcement on scene” and “the scene is secure.” All responders on the scene must wear appropriate high-visibility identification such as department or command position vests for ease of identification and scene security. Volunteer/combination department firefighters responding in plain clothes must be properly identified. EMS and fire personnel should wear helmets and jackets clearly marked “EMS” or “Fire.”

• Be aware of improvised explosives devices and incendiary devices in questionable surroundings. These incidents will be large-scale, multiagency, multialarm responses.

NIOSH RECOMMENDATIONS

The National Institute for Occupational Safety and Health (NIOSH) Fire Fighter Fatality Investigation and Prevention Program conducts investigations of firefighter line-of-duty deaths to formulate recommendations for preventing future deaths and injuries. For additional information on the program, see www.cdc.gov/niosh/firehome.html. NIOSH recently released report FACE-F2004-11, which lists the following recommendations for fire departments responding to scenes of violence:

• Develop standard operating procedures for responding to potentially violent situations.

• Develop integrated emergency communication systems that include the ability to directly relay real-time information among the caller, dispatch, and all responding emergency personnel.

• Provide body armor or bullet-resistant PPE; train with it on, and consistently enforce its use when responding to potentially violent situations.

• Ensure all emergency response personnel have the capability for continuous radio contact; consider providing portable communication equipment that has integrated hands-free capabilities.

• Consider requiring emergency dispatch centers to incorporate the ability to archive location or individual historical data and provide pertinent information to responding fire and EMS personnel.

• Develop coordinated response guidelines for violent situations, and hold joint training sessions with law enforcement, mutual aid, and emergency response departments.

•••

This article is intended for basic information only and to spur further discussion and planning within response and planning agencies. Follow your local guidelines and procedures, and update those plans if they are two, five, or 10 years old—they are out of date. Each community and organization should have a plan in place to address these events. The more our public safety agencies at the local, state, and federal levels prepare, the more they will be able to safely respond and effectively manage any type of mass violence situation that might arise. The community has entrusted us with their safety, so let’s prepare now!

AUGUST VERNON is the operation officer for the Forsyth County (NC) Office of Emergency Management. He returned to this position in 2005, after a year in Iraq as a security contractor conducting long-range convoy security operations involved in several improvised explosives devices (IEDs) and combative engagements. He has been a member of emergency management since 2000 and of the fire service since 1990. Vernon served in the U.S. Army as a nuclear, biological, and chemical (NBC) operations specialist. He teaches courses in IED response, incident management, OPSEC for public safety, hazmat operations, and terrorism/WMD response. He has been published in several national publications. He has given more than 160 multiagency presentations over the past 11 years. He teaches courses in incident management, mass violence/mass shootings, emergency management, crisis planning, and terrorism planning-response. He is a member of the IFSTA WMD/Terrorism Committee and the author of the First Responders Critical Incident Field Guide (Red Hat Publishing).

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