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attempting to hold the perimeter. The media is gathering and may not acquiesce to requests to congregate at the CP. SWAT formally clears and the building is evacuated, sometimes taking hours to complete. The investigation begins. The Police Focus The police focus to date has generally been to mass a number of offcers—generally four or fve—with the intent of moving in formation to interrupt the suspect's killing. Once the suspect is confrmed to be down, law enforcement then conducts a sweep for possible additional suspects. When the SWAT team deploys, a more thorough search is then conducted. Missing from this law enforcement centered approach is what to do with the wounded. Fire personnel currently play little part in law enforcement's view of Active Shooter response. The overall event is a wider problem, something that a policecentric solution cannot solve. By viewing Within 15 minutes of the first responding officer's entry, a police officer it as a public safety event, the dramatic escorts the first team of firefighter-medics into the secured CCP. benefts of an integrated response with police and fre working synergistically call and the frst offcer to arrive. It is extremely rare for police can be achieved. to interrupt the wounding cycle. There are two simultaneous and time-competitive processes Offcers tend to arrive singly at frst, often arriving many sec- at work: 1) the suspect continues to infict wounds as long as he/ onds or even minutes apart. Within 10–15 minutes, police re- she perceives he/she is free to do so and 2) the wounded are in sources begin to pour in as available offcers from surrounding the process of dying. Once the shooting stops, the emergency agencies respond. Within 30 minutes, offcers from surround- is not yet resolved. The wounded are in a time-critical race for ing counties begin to arrive. SWAT teams become available survival. within one hour. Literally hundreds of patrol cars clog the arThe triage protocol lists four categories. Expectant—the victeries leading to the location, freezing traffc for blocks. Sepa- tim is dead or is unlikely to survive. Typically, one-quarter rate police and fre Command Posts (CP) are set up. Fire stages to one-third of those who are shot eventually perish. Immedisome distance away from the scene, awaiting permission to ate—the victim requires immediate medical attention, and is begin its Mass Casualty Incident protocols (MCI). likely to survive if treated within 60 minutes, or the so-called Inside, the police begin to realize the wounded are un- "Golden Hour." Delayed—the victim's injuries are severe and tended and bleeding out. As search operations are conducted may be life-threatening, but are not expected to deteriorate to ensure the entire structure is clear of threat, some offcers signifcantly over several hours. Minor—the victim's injuries now focus on the wounded. Frustrated calls for ambulances are not expected to deteriorate over several days given basic are radioed. Offcers eventually begin dragging the wounded frst aid. out of the structure, sometimes as far as one-quarter mile to Patients in the "Immediate" category are critical and can anxiously awaiting frefghter medics. Others will self-dispatch tolerate very little delay. They must have advanced trauma with wounded in patrol cars. care within one hour of suffering their wound—not within one Fire begins making multiple requests to enter. Radio in- hour of the police arriving, the so-called Platinum 15 minutes. teroperability problems prevent police and fre from com- For example, U.S. Representative Gabrielle Giffords was on municating with each other. Firefghters tend to hold back for the operating table within 53 minutes of being shot, something approximately a half-hour before they attempt to self-deploy, her neurosurgeon credited with saving her life. Stabilizing and causing confusion at the CP. At some point, fre is eventually rapidly transporting the "Immediate" patients is where the cleared to enter the structure. The wounded and the dead are life-saving continues. transported. Stopping both processes—the wounding and the subsequent Crowds begin to form early. If this is a school, frantic and dying of those who can be saved—must be nearly simultanehighly emotional parents arrive. Some attempt to enter the ous priorities, i.e., the police rapidly interdicting the suspect is school. Many angrily demand information from the offcers Priority 1 and the police facilitating fre personnel instituting www.lawandordermag.com 35