In September, FEMA released a guideline for EMS and fire response to active killer events, which it terms AS/MCI’s. Quoted here are the salient operational points, emphasis added:
Considerations should be made for all potential first responders, including LE patrol officers, to be trained to the basic tenets of TECC. Training, equipment and protocols around use of TECC for medical first responders should be explored, considered and implemented when feasible. The survival benefit of TECC is based on rapid application of point-of-wounding care, thus the equipment must be forward deployed for care to be immediately implemented. This requires that TECC equipment and supplies be carried with all other medical aid and equipment. In short, TECC equipment could become a valuable part of the standardized equipment for fire/EMS response assets…
Tactical EMS support personnel are not a typical resource because they are usually very limited in number, not immediately available, and committed to their tactical team’s assignment. This will preclude them from casualty care activities until the tactical team’s objective is met. Considerations, planning and interagency training should occur around the concept of properly trained, armored medical personnel who are escorted into areas of mitigated risk, which are clear but not secure areas, to execute triage, medical stabilization at the point of wounding, and provide for evacuation or sheltering-in-place. Some jurisdictions accomplish this through the deployment of Rescue Task Forces (RTFs). Were this an ongoing ballistic or explosive threat, under the protection of LE officers these teams treat, stabilize and remove the injured rapidly while wearing ballistic protective equipment. An RTF team should include at least one advanced life support (ALS) provider. A few agencies are even exploring the use of LE for rapid patient removal. When possible, agencies should plan for warm zone, indirect threat-area medical operations to provide TECC-driven point-of-wounding care according to their resources and capabilities.
SpecMed 