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ACTIVE-SHOOTER RESPONSE most likely types of injuries. Training with law enforcement is crit- ical to the success of an EMS response to an active-shooter incident. As one homeland security expert stated, “You don’t want to be exchanging business cards on the day of the event.” To be clear, I am not talking about being a SWAT medic or tactical medical training. Tactical medicine is a special- ized and highly discriminating endeavor. Tactical medics have the primary respon- sibility to take care of the SWAT team and are generally not well-prepared for an MCI situation. Clearly, any tactical medic attached to a law enforcement team would be an integral liaison to the EMS personnel on scene. We are talking about standard fire- based and private EMTs and paramedics who find themselves staged and are preparing to enter an MCI, active-shooter, barricaded-subject or other law enforce- ment incident. The in-house training for EMS should include a review of MCI procedures. In an active-shooter situation, there should be a balance between triage only vs. emergent treatment on scene. If there are only a few victims and EMS resources are not stretched, then more focus can be placed on treating and stabilizing the patients before extrication and transport. If victims far outnumber rescuers, then a more traditional triage approach may be preferred. There is also a school of thought regarding a revised approach to medical equipment. In this new model, each medic carries a belt pack or small back- pack with at least the following items: several changes of PPE, triage tags/tape or triage lights, trauma shears, stetho- scope, head lamp, tourniquets, Asherman (or similar) open chest wound seals, OPA/ NPA, Israeli dressings, QuikClot dressings and roller gauze, and large trauma dress- ings. This provides for a more decen- tralized medical gear approach. Each medic can operate independently and manage a trauma victim, at least initially. This gear can also be pooled according to emerging needs. Additionally, there should be one or more “mother lode” packs with additional supplies, including those already mentioned, as well as several “roll up” tactical stretchers. Other items to be considered include basic O2 advanced airway supplies, IV fluids and equipment, and even a few front- line meds/monitors. Even though the kit should be trauma-focused, some victims may have true medical problems such as stress-induced asthma attacks, chest pain or other scenarios. The emphasis should be on trauma, but medical prob- lems do occur. This new model stresses the adages “light is right” and “speed saves.” The EMERGENCY MEDICAL SCIENCE ONLINE DEGREE PROGRAM E ARN YOUR DEGREE ONLINE 6WDWH DQG 1DWLRQDO 3DUDPHGLFV HDUQ XS WR FUHGLWV WRZDUG DQ (PHUJHQF\ 0HGLFDO 6FLHQFH 'HJUHH IRU \RXU FXUUHQW FHUWL¿FDWLRQ 'HJUHH FODVVHV IRU FHUWL¿HG SDUDPHGLFV WRWDOO\ RQOLQH QR RQVLWH UHTXLUHPHQWV UHJLVWUDWLRQ DQG DGPLQLVWUDWLRQ FRPSOHWHG E\ SKRQH ID[ RU HPDLO 'HJUHH SURJUDP LV GHVLJQHG IRU GHPDQGLQJ (06 ZRUN VFKHGXOHV &RPSOHWH; WKH GHJUHH DW \RXU RZQ SDFH PARAMEDIC CERTIFICATION ONLINE (HYBRID PROGRAM) 7KLV +\EULG 3URJUDP LV RIIHUHG WR LQGLYLGXDOV ZLWKRXW DQ\ (06 WUDLQLQJ $OVR DYDLODEOH IRU FXUUHQW EDVLF RU DGYDQFHG (07V VHHNLQJ 3DUDPHGLF FHUWL¿FDWLRQ 3URJUDP RIIHUHG WKURXJK /&& &RQWLQXLQJ; (GXFDWLRQ 'HSDUWPHQW 2QO\ IRXU RQ VLWH YLVLWV IRU VNLOOV WUDLQLQJ DQG HYDOXDWLRQV DOO FODVVZRUN GRQH RQOLQH 7XLWLRQ LV RQO\ &RQWDFW; D SURJUDP VSHFLDOLVW DW H[W +Z\ 6RXWK .LQVWRQ 1& ZZZ OHQRLUFF HGX For More Information Circle 26 on Reader Service Card EMSWORLD.com | JULY 2011 47