Vernon AmbulanceActive Shooter Training2016

Creating a Safe Area for Medical Triage

MEDICAL TREATMENT AT AN ACTIVE SHOOTING INCIDENT

• This training will cover medical personnel response to an active shooter incident. Over the years active shooting tactics and response has changed. In the past it focused on Police response and the need to stop the threat as fast as possible, Immediate action by police. • Today training will focus on the need for quick

medical treatment at the scene and tactics to bring medical personnel to the victims of a mass shooting as soon as possible.

MEDICAL TREATMENT AT AN ACTIVE SHOOTING INCIDENT

• Studies have shown that the quicker victims receive medical treatment the more likely they are to survive. • In the past medical personnel did not enter a

building until it was cleared and safe. That could take 30 – 90 minutes for a large building, like a high school or Mall.• Police can clear a Warn Zone in 5 – 15 minutes

and get medical personnel to the victims faster

HAZARD ZONES

• Inner Perimeter: Perimeter around the Hot Zone that contains the threat.

• Outer Perimeter: Perimeter around an incident that keeps people away and in a safe area.

• Warm Zone: Area between the hot and cold Zone

ACTIVE SHOOTER HAZARD ZONES

• Hot Zone: unsecured area where threat remains active.• Cold Zone: Secured area outside of immediate

threat. This is the personnel standby zone- Staging area• Warm Zone: Area inside the hot zone that has

been swept- cleared for immediate threats. Law Enforcement Officers provides force protection for medical personnel responding to warm zone

Cold Zone OuterPerimeter

Warm Zone InnerPerimeter

Hot Zone

Staging area

TRIAGE WARM ZONE

• An area where medical personnel can treat injured people- Casualty Collection Zone• Building has not been fully secured• Officers secure a small area in the building for medical

treatment• Officers Provide security for medical personnel in the

building• Other officers are still clearing the building and looking

for threats

TREATING THE INJURED• Active Shooter with one or two casualties• It may be easier and quicker to remove the casualties from the area and

take them to medical personnel

• Active Shooter with numerous casualties• Creating a casualty collection zone and bringing medical personnel into

the warn zone to treat the casualties is faster and better

• ASM: now has several tactical medics that will enter a hot zone with officers- as part of the entry team• The Entry Team provide security for them

• EMS personnel will enter a warm zone and treat the injured. • Officers will provide security for them

MEDICAL PERSONNEL

• You will respond to the staging area in the Cold Zone

• Officers will secure an area and set up a warm zone

• Officers will direct you where to respond• You will be given a route to take and an area to park• Do not deviate from the route- some areas are not secure

• Officers will meet you and provide security for you• Stay in the warm zone• Approach and leave as directed• If you need to Move out of the warm zone have an

officer escort you.

MASS CASUALTY TRIAGE

• Some officer are providing security and can not assist with medical treatment• Some officer can help with medical

treatment and will assist you as needed• Vernon Officers are EMR trained and can

assist with Triage, Tourniquet application, quick clot and other tasks.• Other department may not train their

officers in Triage or medical care.

MASS CASUALTY TRIAGE

• You may not be able to reach the warm zone by ambulance. In which case officers will escort you to the warm zone- victims• You may only get one ambulance into the

warm zone• You may have to fill the ambulance and

transport victims to other ambulance in the cold zone • Don’t block the route with ambulances or

cars. Vehicles must be able to get in and out

CONTACT WITH SHOOTER

• If you come under fire• Look for cover- Something that will stop a bullet• Brick -concrete wall, heavy solid object, engine of a

vehicle• Get down, make yourself a small target• Clear the area if possible• Request help• Don’t grab officers- they can not shoot if you pull

them• If an officer tells you to move- do it• Don’t touch bags and packages. Suspect may have

left an explosive device. If you see something suspicious tell an officer

POLICE- RAPID DEPLOYMENT BAG

• Vernon Cruisers are equipped with medical bags in the trunk and Rapid Deployment Bags in the front seat

• Officer will carry their black- Rapid Deployment bags over their shoulder

• Rapid Deployment bags contain some medical supplies• Tourniquet • Quick Clot• Chest Seals• Nasal Airway• Dressings• Scissors and light

HOW IT WORKSSCENARIO –ACTIVE SHOOTER

• Active Shooting Northeast School

• Officers will respond to the school• Officers will make entry and start clearing the school• Clearing the entire building could take 30-90 minutes• A warm zone can be cleared in 5-15 minutes

• Vernon Ambulance- Fire Department• Will respond to the staging area• Beni’s 1280 Hartford Turnpike

Staging Area

entrance

Reported area of active shooter

OFFICERS ARE TOLD THAT THE SHOOTER IS IN A ROOM ON THE NORTH SIDE OF THE BUILDING.

OFFICERS WILL MAKE ENTRY THROUGH DOOR # 7

OFFICERS CLEARS FIRST 4 ROOMS AND FINDS 13 VICTIMS. NO SHOOTER FOUND

POLICE DON’T KNOW WHERE THE SHOOTER IS. POLICE WILL CONTINUE CLEARING THE

BUILDING

MORE POLICE ARRIVES AND START TRIAGE.THEY MOVES VICTIMS INTO FIRST TWO

ROOMS AND SETS UP WARM ZONE

WARM ZONE IS CREATED AND SECURED BY OFFICERS . OFFICER WILL MAINTAIN SECURITY ON WARM ZONE

OFFICERS WILL DIRECTED MEDICAL PERSONNEL INTO THE WARM ZONE- FOLLOW OFFICERS DIRECTIONS-

GROVE ST TO KING ST PARK IN FRONT OF DOOR 7

MEDICAL PERSONNEL AND OFFICERS WILL TRIAGE VICTIMS AND MAKE A PLAN TO CARE AND MOVE VICTIMS FROM THE

SCENE.

TRIAGE

• Medical personnel must coordinate movement with the police. • If more equipment or staffing is needed the police may

have to increase the size of the Warm Zone or escort medical staffing into the warm zone

• Medical staffing should not direct others into the warm zone without clearing it with the police. • The area around the warm zone is still hot, and there could

be threats.• Bringing other people in or stacking ambulances could put

people in danger

QUESTIONS