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ON THE JOB NEWS DISCIPLINE JUST HANDED DOWN ATHENA REPORT RANGEMASTER MISSION CRITICAL SYSTEMS Latest Active Shooter Tactics Paramedics enter with patrol officers. By Sgt. Ed Sanow I Editorial Director P esanow@hendonpub.com Sgt. Ed Sanow aradigm shifts—major changes in the way things operate—happen slowly, especially in law enforcement. Only on the rarest occasion will police operations suddenly change to adapt to anything. The best tactical example of a rapid paradigm shift is Columbine. The transition from "Isolate, Contain, Wait for SWAT" to an immediate entry of patrol offcers seemed to happen overnight. Virtually every department in the U.S. conducted in-service Active Shooter training using some sort of four-offcer, diamond or Y-formation. Most police academies began to teach this same Active Shooter patrol response. The reason for this almost immediate change in technique was simple math. The average response time for a SWAT team is 50 minutes. The timeline of violence in Active Shooter scenarios is less than fve minutes. To stop the Active Shooter, the police have to engage him. By the time SWAT arrives, the killing is long over. Patrol offcers made entry as soon as the diamond formation was formed. Very slowly, that same simple math, that same short timeline of violence, began to take hold again. Even in well-staffed urban departments, and especially in under-staffed rural areas where most school shootings occur, it could take too long to assemble four patrol offcers. Over a 10-year period, no four-offcer patrol formation actually stopped the ongoing killings. It was all over just too quickly. Again, slowly, four-offcer formations gave way to an immediate entry by the frst offcer on the scene. Again, it is simple math. If it is all over in less than fve minutes and someone gets shot every 15 seconds, the frst offcer simply must enter. We are now seeing another time-based, time-forced change in our Active Shooter response. The reality is that the shooting may have stopped, but the victim bleeding has not. Since the ultimate mission has always been to save lives, the latest paradigm shift is working with Fire/Rescue to quickly stop the bleeding. That means rapidly transitioning the hot zone into a warm zone and getting paramedics into the scene as soon as possible. Not the SWAT teams' TEMS offcers, but Fire/Rescue's medics. These are not just any paramedics. Instead, those who have trained with the police, have been equipped with body armor and helmets, and have their load-bearing vest specifcally ftted for the mass-casualty incident response, i.e., dozens of tourniquets and numerous bags of homeostatic agents. The SWAT teams TEMS cannot fll this role. SWAT is not there in time and the frst responsibility for TEMS is the SWAT team. The paramedics are on the scene as fast as the patrol offcers. Use who is already there. Properly trained and equipped paramedics entering a warm zone is the paradigm shift. This is entry into a declared warm zone, meaning known perpetrators are either dead or in-custody. However, the structure has not been searched and secured; unknown perpetrators may exist; other threats may exist. The rapid bleed-out time is the simple math compared to the time to declare a structure safe. Most departments are up to speed on buddy-care or self-care. The very essence of buddy-care is the short bleed-out time from an arterial injury. It depends on a number of factors relating to the injury, but fve minutes keeps popping up in lethality timelines: "…within fve minutes…" and "… more than fve minutes…" Yes, this next life-saving step in the Active Shooter response requires inter-agency coordination. However, a number of police and fre departments have already got this all sorted out. Arlington County, Va. Police and Fire is one example. The Hillsboro, Ore. Police and Fire is another example. Protocols differ, but typically two offcers (front, rear) escort two paramedics. The paramedics decide where they want to go. The patrol offcers decide how to get there and when to move. This is indeed a medical mission. We just pull the security detail. They do triage, not us. We don't have the time to move the wounded to the paramedics—we need to escort the paramedics to the wounded. And that fve-minute countdown? It started when the frst person was shot, not when the police/fre arrive. LaO Post your comments on this story by visiting www.lawandordermag.com "Surround yourself with the best people you can find, delegate authority, and don't interfere as long as the policy you've decided upon is being carried out." — Ronald Reagan 6 LAW and ORDER I October 2013