Shooters Cause Paramedics and Police to Blend for Victim Survival

This past week in brutal heat and an empty unairconditioned downtown office building, the Raleigh Police Department and Wake EMS were spending valuable time both sweating and learning new skills that may benefit you.

The talented Raleigh Police Department didn’t need to practice on how to deal with a shooter who kills people. It’s something they’ve trained for and are skillfully prepared to handle.

In fact watching the Raleigh officers in action made me personally feel safer if anything like that happened in Raleigh. Those randomly selected officers in the drill had the skills of how to enter a hostile environment and find an active shooter, down pat.

What was new in this blistering hot training was the integration of trained paramedics from Wake EMS into the hostile environment to help provide medical care to shooting victims as quickly as possible.

Historically when there is a shooter on the loose in a building or school the scene is secured first with a planned and coordinated law enforcement response. Police officers would secure the wider perimeter of the event and SWAT would plan their insertion and sweep the place for all threats. There is only one problem with that approach, victims bleed to death while waiting for all that to happen.

The statistics of these unfortunate and tragic mass casualty shooter events tells us the majority of time the shooter is Actually neutralized quickly. About 85 percent of these incidents are over in six minutes with the majority over in three minutes, and 98 percent are carried out by a single attacker. Law enforcement data says the shooters predominately commit suicide on site.

While an active shooter scene is not 100 percent secure until every nook and cranny is searched by law enforcement, there is certainly a tremendous benefit that can be offered to victims by providing emergency medical care as quickly as possible when the risk has been reduced. Even law enforcement officers are now being trained to apply tourniquets in the field to stop massive blood loss by victims. The earliest medical intervention possible for some.

In the training I was embedded in I was able to move with the initial Raleigh Police Department entry team of first officers on the scene as they entered the building and looked for a shooter. Shots rang out and echoed in office halls, stand-in victims were calling out for help, and the shooter was hunted down by laser focused street cops.

The moment the shooter was located and was controlled the officers on the initial team were already applying tourniquets to start saving victims right away.

You see there are many people who could be saved even from a crazed shooter that are probably dying now by a delay in even basic medical intervention. Studies show that 42 percent of deaths could be avoided if care begins within five to 30 minutes of the injury. In military combat situations only 10 percent of combat deaths occur after care is initiated. So the speed which care can be reasonably and safely initiated is critical.

And speaking of the military and combat we have a lot to thank the military for in the development of effective battlefield medicine and active shooter urgent care. In World War II the survivability from wounds was 60 percent. In the latest military conflicts it is around 98 percent because combat troops have been trained in these same skills and already implement a similar strategy.

The role of Wake EMS in the new skills being taught is to enter a hostile environment once the majority of the shooter risk has been managed by law enforcement. That doesn’t mean the scene is 100 percent safe yet but it also doesn’t mean it is still as dangerous as it initially was.

In the training, Raleigh Police and Wake EMS conducted, the paramedics and police might have been from two different departments but they operated as a larger seamless team.

There is only so much I can share without giving away tactics taught, but what I can say is with this new approach, paramedics entered the hostile environment with trained police protection and engaged in cooperative communication with their police protectors to save victim lives that would have otherwise been lost.

The emphasis was on saving people, period. That meant all victims needed to be assessed and appropriate treatment initiated in the proper order. Sometimes that means to stop bleeding right away and sometimes that means victims need to be dragged to a central safe secured area where more medical care could be delivered before moving the victims out of the building.

Dr. William Fabbri, FBI Medical Officer and Director of FBI Emergency Medical Support visited Raleigh this past week and observed the training. He said, “I was very impressed with the interaction between individual officers and paramedics and their training and skills. The exercise in Raleigh was really significant and showed tremendous positive capabilities. It was exemplary.”

Dr. Fabbri said the big push for moving these battlefields lifesaving skills to hometown streets was because of the Sandy Hook tragedy in Connecticut. Sandy Hook was a traumatic event which launched a public safety emphasis on both shooter neutralization and victim survivability skills.

Based on gathered statistics and increasing victim survivability it seems that anyone considering doing something crazy with a gun could save everyone a lot of time if they just got right to the suicide ending and left the innocent people out of their grand plan. But that’s not going to happen all the time, is it?

Instead what we have to be prepared for is that there will be future shooter events. And they will happen at:

• Schools – 24%
• Open Commercial – 24%
• Factory/Warehouse – 12%
• Office Building – 11%
• Other Assorted Places – 29% – Source

But if one of those cruel, grotesque, and nasty events happens in Wake County at least victims here will have a greater chance of survival. That’s a good thing.

By the way, I understand the Wake County Sheriff’s Office and Wake EMS will be conducting a future training session as well to help spread these skills and capabilities to more departments.