Active Shooters – Changing the Paradigm for EMS Care

active shooter responseIn this episode of the Disaster Podcast, hosts Jamie Davis, the Podmedic and Sam Bradley are joined again by paramedic Jim Logan and Dr. Joe Holley from Paragon Medical Education Group. The four of them kick off a discussion on the changing view of standard of care for victims in active shooter situations.

While for years the standard of care for EMS and other medical responders was to stage in a safe area and only enter the scene when if was fully secured by the responding police agencies. Analyzing injury patterns and autopsy data from recent incidents of violence around the country has led responders to a paradigm shift to allow for rapid care of victims soon after responders arrive.

The plan is to bring EMS in to “warm” zones, areas cleared by police as they enter the building. The EMS providers will have their own security team of police to watch over them while they begin immediate, lifesaving treatment for victims and then removing them from the scene for more definitive care and transport in a safer area.

Got a question for the Disaster Podcast Team? Why don’t you leave a comment below here on the site and we’ll get right back to you both in the comments area and by email, too! We look forward to hearing from you.

Again, a special thank-you to Paragon Medical Education Group for their continued support of this podcast as our partners in this endeavor to bring disaster medicine to you. Check out their page and educational resources that can help your system be more prepared for what happens in your area.


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4 Replies to “Active Shooters – Changing the Paradigm for EMS Care”

  1. Mike

    In an active shooter situation, who supplies the ballistic PPE, for EMS? EMS/FD/local security do not have access to that type of equipment (1033) through MMRS, HRSA, ASPR the costs can be prohibitive with smaller jurisdictions,and agencies.

    • jamie

      The goal would be to not have EMS need ballistic protection. Police would sweep the initial area clear, creating a “warm zone” (to use HazMat terms) where EMS would have their own police security to allow them to rapidly treat life threats and evac casualties to triage area in safer areas outside incident zone.

  2. joe

    Hi Mike, and thank you for your question. As Jamie described, these events tend to be linear, with the shooter moving forward looking for additional victims or being pursued by law enforcement. In tactical situations, where webmay be exposed to active shooting, ballistic PPE is appropriate. But in active shooter situations, where the majority of responses are performed by frontline units and not tactical units, law enforcement provides the protective shield for EMS to perform its function in the warm zone. this new approach is necessary if we are to save more victims. Waiting for tactical teams to arrive and handle the situation leads to a higher mortality rate.

  3. Sam Bradley

    Mike, here’s another perspective. My fire department has joined forces with our city PDs to create a Rescue Task Force. It’s much less intense than the longer Tactical Medic training. It’s one day and taught by our own people (PD and Fire). Mostly what they learn is how cops can move firefighters with force protection into a warm zone. I attended an excellent training just the other day. To answer your question, we got an SHSGP grant through Homeland security to outfit four engines with Kevlar helmets, class IV vests, eye protection etc. I know EMS is more limited on grants but there has to be something out there. I would connect with your local PDs and see if they would be interested in training together. Whether EMS would go into the warm zone would depend on the agreement with local public safety. In our model, the firefighters do immediate care in the warm zone then move the patient to the edge of the warm/cold zone where EMS would retrieve the patient. Joe is right. Most of these incidents last about 12 minutes and a new model is critical is we’re going to save lives.. Hope that helps and thanks for listening. Sam

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