Law and Order

JUL 2013

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Within 15-20 minutes, there will be a large number of responding officers— far more than is needed in the interior. Officers will assist in transferring the wounded from the CCP to awaiting ambulances. the corner. As the number of offcers inside the structure grows and within minutes of the frst offcer's entry, a supervisor (or offcer) selects and broadcasts a location for a Casualty Collection Point, detailing two to four offcers, as needed, to secure it. A Joint Command Post for both fre and police is established. Offcers arriving at this point act as fre escorts or external ingress/egress security. Offcers may ride in the fre units or lead with a patrol car. As some offcers continue to locate the suspect(s), others begin transporting the wounded to the CCP. Offcers apply a tourniquet to anyone with uncontrolled extremity bleeding prior to moving them. The obviously dead are transported last. Once the CCP is declared to be suffciently secure, fre personnel make entry and set up their MCI protocol. A fre offcer and police offcer (Hall Bosses) link up inside. This is an interior branch communicating each others' needs, e.g., body counts, security, etc. Offcers secure the perimeter. As the number of offcers from outlying allied agencies increases, the security of the perimeter improves. Ambulances begin to receive multiple wounded, generally transporting two immediate and one delayed. Minor patients are held until the severely wounded have been transported. Implementing the Integrated Response The City of Hillsboro has conducted 10 large-scale scenarios over a year-long period, including six scenarios run in a multi-story Middle School and four scenarios in an unoccupied new fve-story hospital. These realistic exercises tested and validated the potential success of the integrated Active Shooter Model. Here are the exercise results. Offcers located the suspect in under six minutes of the frst shooting, with 25 victims requiring varying levels of immediate medical aid. The CCP was established within 10 minutes of the shooting. Fire entered the CCP four minutes later, beginning their MCI protocol. The 16 wounded (including six immediate, six delayed, and four minor patients) were transported within 40 minutes of the shooting. By compari- son, it is not unusual for fre to make formal entry into a structure more than one hour following initial dispatch. Some fexibility is required by both disciplines to integrate the response. The challenge for police—especially supervisors and mid-level command offcers—is to facilitate the early introduction of fre's lifesaving MCI protocols through training. This instruction emphasizes medical reality: the sooner the wounded are delivered to fre personnel, the greater the chance of saving the injured. The challenge for fre command, especially at the executive level, is to accept the concept of introducing their personnel into a reasonably secure but not pristinely safe environment (although police offcers would argue most police activities are safer than entering a burning structure). Audio recordings of events where police offcers, in frustration and anger, are repeatedly pleading over the radio for ambulances to somehow appear through the sea of police units choking the streets can be a thing of the past. Instead, it is possible for the worst of the wounded to already be on their way to the trauma centers, medically stabilized by paramedics, well within 30 minutes of the initial police entry. This is accomplished through an integrated public safety response meeting the mutual goals of interrupting the wounding process and gaining rapid treatment for the wounded. In Part Two, we will cover the priorities in the response and whether TEMS or TCCC are the right answer. George T. Williams is the Director of Training for Cutting Edge Training in Bellingham, Wash. He has been a Police Training Specialist for more than three decades, as well as an expert witness in federal and state courts nationwide and a widely published author for more than two decades. Mr. Williams develops and presents revolutionary concepts within integrated force training solutions through a problem-solving format, functionalizing police skills and tactical training. He may be contacted at gtwilliams@ cuttingedgetraining.org. LaO Post your comments on this story by visiting www.lawandordermag.com www.lawandordermag.com 37

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