Madison Fire Training Division 6/21/17

YOUR INSTRUCTORS: Division Chief Scott Bavery… EMS Operations

Division Chief Paul Ripp… EMS Training

OUR CONTACT INFORMATION: sbavery@cityofmadison.com

pripp@cityofmadison.com

WHAT WILL YOU LEARN?

WHAT WILL YOU LEARN?

Objectives: Facilitate direction during an active threat incident involving Police, Fire, and EMS

Integrate Police, Fire, and EMS during Warm Zone Operations

Focus on the highest level of service to those we protect and serve

Establish “Unified Command” utilizing the Incident Command System

Madison Fire Department S.O.G. 7.4

BACKGROUND AND DATA

• Howard Unruh of Camden NJ was first widely publicized active shooter in 1949

• Shooters are statistically 98% male

• 98% of attacks are carried out by a single person

• Average number of deaths 3.5

• Average number of wounded 5.8

• Predominately commit suicide on site

BACKGROUND AND DATA

• 98% occur during daytime

• Offenders are preoccupied with obtaining a high body count before police arrive

• They almost never take hostages and do not negotiate

• 85% incident over in under 6 minutes

• 2007–2012 majority of incidents occurred under 3 minutes

THE NEED FOR CHANGE • 1999 Columbine High School

• Mass shooting by two students that left 13 dead and 21 injured. • Active shooter response focused on police containing the shooters in

the school and waiting for SWAT to arrive. Both students committed suicide 32 minutes after the shooting began.

• This approach allowed the shooters to walk through the school uninterrupted and failed to get medical attention to victims soon enough.

• One of the victims, a teacher, bled to death on scene 3 hours after being shot as the SWAT team was clearing the entire school.

THE NEED FOR CHANGE • 2012 Aurora Theater

• Mass shooting where 12 people were killed and 70 wounded. • Suspect surrendered once police arrived less than 3 minutes after

the initial call. • Poor communication and a lack of coordination between Police, Fire

and EMS resulted in lengthy delay of medical care; resulting in increased casualties.

• Events in Paris, London, San Bernardino and Orlando reinforce the need for a:

•Coordinated response of Law Enforcement, Fire and EMS.

THE NEED FOR CHANGE

2016 The Pulse Nightclub, Orlando FL… More later in the presentation

VIDEO

Columbine Security Camera Reenactment

Break… …and then Discussion

KEY TERMS: •Hot / Warm / Cold Zone

•Unified Command/Command Post •Communication •Common terminology

•Recue Team

•Casualty Collection Point (CCP)

•Rally Point

•Interior Division Supervisor (at the FOB)

RAPID TREATMENT MODEL (INCEASED SURVIVABILITY)

• Get EMS care to patients early. • Golden Hour

• Shift from tactical teams (SWAT and TEMS) to an immediate Police and EMS response.

• As early as possible, police stop the threat to allow EMS to stop the bleeding.

• Establishing a Unified Command is the key to successfully integrating Police/Fire/EMS.

• Allow Police, Fire and EMS to do what they each do best

Active Shooter Response: The Rapid Treatment Model

http://www.fireengineering.com/articles/2013/09/active-shooter-response-the-rapid-treatment-model.html

PRIORITIES- “RESPONSE GUIDELINES”

1. First priority – Police contain the threat. Assemble entry team(s) to locate and neutralize threat(s) if needed.

ESTABLISH UNIFIED COMMAND and SAFE STAGING AREA

2. Second priority – Create perimeter to provide a level of security for victims, first responders, rescue teams and bystanders.

3. Third Priority – Establish warm zones (exterior and/or interior) with available entry teams and other law enforcement officers.

4. Fourth Priority - Assemble Rescue Teams of Police/Fire/EMS personnel to rapidly triage, treat and transport victims.

5. Fifth Priority – Search and Evacuate Building.

6. Sixth Priority – Reunification of Occupants.

POLICE WILL ESTABLISH THE WARM ZONE IF…

• Initial Police Entry Team engages the shooter/threat AND • You have communications or contact with the entry team AND • The shooter/threat is no longer active or is contained AND • No immediately known tactical needs (other threats) and victims have been

identified

• 2nd Team establishes the warm zone if… • If the 2nd Team did not start to establish the WARM Zone AND • The shooter/threat(s) are no longer active or are contained AND • No immediately known tactical needs and victims have been identified

• The process continues until the warm zone is established.

A Police Officer must be joined with a Fire Officer in Unified Command before Fire/EMS can enter the Warm Zone with Rescue Teams!!

WHERE SHOULD POLICE ESTABLISH THE WARM ZONE?

Guidelines:

• Have the ability to secure a corridor to an EMS Transportation Area

• Near the most victims if possible, and an area where victims can be gathered - known as the Casualty Collection Point (CCP)

• The CCP may be in the Cold Zone if victims are too spread out and/or no large area can be secured in the Warm Zone.

• Must be an area you can secure and hold

• Multiple floors or large buildings may require more than one Casualty Collection Point.

POLICE: HOW THEY ESTABLISH THE WARM ZONE

• Cover the exterior of the entrance side with at least one long gun

• Secure an entrance and hold it

• Assign an Interior Division Supervisor

• Establish Unified Command

• Clear and secure a hallway and hold it

• Clear and secure more territory around victims and hold it

IMPORTANT!

• Identify and establish the Casualty Collection Point (CCP) as early as possible.

POLICE: HOW THEY ESTABLISH THE WARM ZONE • Once an area is secured, the LE Interior Division Supervisor notifies Unified Command

that a warm zone has been established and request that fire/EMS units move forward.

• Fire/EMS units move to the “Secured Entrance” rally point.

• Fire/EMS assign an Assistant Interior Div. Supervisor and stay together with Rescue Team.

• If not done already, identify and establish the Casualty Collection Point (CCP).

• Unified Command shall also assign the following Division Supervisors :

• Triage • Treatment • Transport

Two Rescue Formation . . . POINT / SCOUT

TEAM LEADER

Fire/ EMS

Slide used with the permission of Doug Anderson Blackhawk Technical College

Four (4) Rescue Formation . . . POINT / SCOUT

SUPPORT OFFICER

TEAM LEADER

REAR GUARD

Fire/ EMS

Slide used with the permission of Doug Anderson Blackhawk Technical College

HOW TO OPERATE IN THE WARM ZONE • Fire/EMS Units move to the “Secured Entrance” as assigned by Command

• Fire/EMS Units ALWAYS stay with their police Rescue Team escort in the Warm Zone. • When moving tactically, Police are in charge; when stopping to assess victims,

fire/EMS decide when to move (practice this during combat drills).

• Rescue Team’s first priority is to quickly treat, triage and move patients to the CCP.

• Rescue Team’s second priority is to move patients to the Treatment Area along the “Secure Corridor”. • Assigned personnel re-triage at the CCP and at the Treatment Area. • Do a quick assessment. Dead (Triaged Black) stay. Viable victims are quickly triaged,

treated and moved.

• Be prepared to deal with the chaos of bystanders and walking wounded. • Walking wounded and bystanders should be directed through the secure corridor out

to the Cold Zone treatment areas.

Shooter

Victims

Entry Team

Police Officer

Interior Division Sup.

CCP/ Triage

WARM Zone

EMS-RT 1

Shooter

Victims

Entry Team

Police Officer

Interior Division Sup.

CCP/ Triage

WARM Zone

EMS-RT 1

Shooter

Victims

Entry Team

Police Officer

Interior Division Sup.

CCP/ Triage

WARM Zone

EMS-RT 1

Shooter

Victims

Entry Team

Police Officer

Interior Division Sup.

CCP/ Triage

WARM Zone

EMS-RT 1

Shooter

Victims

Entry Team

Police Officer

Interior Division Sup.

CCP/ Triage

WARM Zone

EMS-RT 1

Shooter

Victims

Entry Team

Police Officer

Interior Division Sup.

CCP/ Triage

WARM Zone

EMS-RT 1

Shooter

Victims

Entry Team

Police Officer

Interior Division Sup.

CCP/ Triage

WARM Zone

EMS-RT 1

Shooter

Victims

Entry Team

Police Officer

Interior Division Sup.

CCP/ Triage

WARM Zone

EMS-RT 1

Shooter

Victims

Entry Team

Police Officer

Interior Division Sup.

CCP/ Triage

WARM Zone

EMS-RT 1

Shooter

Victims

Entry Team

Police Officer

Interior Division Sup.

CCP/ Triage

WARM Zone

EMS-RT 1

Shooter

Victims

Entry Team

Police Officer

Interior Division Sup.

CCP/ Triage

WARM Zone

EMS-RT 1

WARM ZONE PPE

WARM ZONE PPE

CASE STUDY • 2016 The Pulse Nightclub

• June 12, 2016, the club gained international attention as it was the scene of the deadliest shooting by a single gunman in U.S. history.

• The deadliest terrorist attack on U.S. soil since the events of September 11th, 2001. Forty-nine people were killed and 53 were injured.

THE PULSE NIGHTCLUB

TRAINING VIDEO

MFD and MPD Warm Zone Training

RECAP

• Police Entry Team still does everything the same as before

• Police, as soon as possible, designate an Interior Div. Supervisor

• Police cover the entrance side of the building exterior and secure an entrance

• As soon as possible establish Unified Command

• Police secure a hallway

• Police secure Warm Zone and an area for the CCP

• Fire/EMS assign a Assistant Interior Div. Supervisor, find the Police Interior Div. Supervisor and stay together.

• Fire/EMS Establish Treatment and Transport Area/ Staff CCP

• Rescue Teams- Police provide escort and Fire/EMS move victims

• Rescue Teams move victims to CCP and from the CCP to Treatment /Transport Area

TAKE HOME POINTS:

“SUCCESS IS THE RESULT OF PERFECTIONS, HARD WORK, LEARNING FROM FAILURE, LOYALTY, AND PERSISTENCE”. COLIN POWEL