Facilitating the medical response into an active shooter hot zone

The response to active shooter attacks is not as effective as it could be. People die before receiving care because most jurisdictions have a policy in place that stipulates emergency medical services (EMS) wait to enter a scene until law enforcement (LE) announces that the scene is clear or secure. Since this can take some time, life-saving care is not immediately available to the people who most need it, and consequently, there can be a greater loss of life. How can a combined LE and EMS response, based on combat medical care, be effective in saving lives during an active shooter incident? Utilizing 10 historic active shooter cases ranging from the Texas tower shooting in 1966 and concluding with the Sandy Hook school shooting in 2012, I analyzed the responses to consider the response times of the responders, time of access to the victims, and transport time to medical facilities. The basis for the responses utilized data collected by the U.S. military from combat injuries sustained from World War II through the current conflicts in the Middle East. From these analyses, I am able to show that fast field intervention based on training, policy, and operational planning with the Incident Command System component, which includes both law enforcement and fire/EMS entry teams, will provide better patient viability prior to hospital care. This will not be a critique of right and wrong, as the responders did what was needed at the time; however, in current-day hindsight, there are points that can be noted for future response growth.http://archive.org/details/facilitatingmedi1094549402Captain (Retired), West Palm Beach Police Department, West Palm Beach, FloridaApproved for public release; distribution is unlimited