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CASE REVIEW 16 MARCH 2015 | EMSWORLD.com The officers are requested to provide ongo- ing security for the crew, and at least one to accompany the paramedic transport unit. Command is notified by the paramedic. The Attack One crew is to remain on the scene with the officers, and let the trans- port unit proceed quickly to the trauma center with its own crew. Command has been advised that two more LEOs have been shot inside the courthouse, and the Attack One crew will be responsible for tri- age and initial care until further law enforce- ment work can provide a safe environment for the remaining rescue crews to work. The mortally wounded LEO is carried to the ambulance, loaded quickly inside, a report is given to that crew, and an armed law officer jumps in the ambulance to pro- vide information, guidance and any neces- sary protection to that vehicle and its EMTs. The Attack One crew returns to their vehicle, replenishes their rapid care equip- ment, cleans up the blood from the two law enforcement officers who are with them and readies themselves for their next tri- age duties. The remaining EMS resources are staged several blocks away, ready to proceed in when there is sufficient control of the scene. The Attack One crew is led to the front door of the courthouse, and then into the front lobby. There they find two patients, both LEOs with wounds to their legs. They were shot, but both had protective vests in place. One complains of chest pain, and other officers have determined he was shot in the right chest, but the bullet did not penetrate the body armor. But both have injuries in the thigh, and both have a trauma tourniquet in place on the involved leg. There are no other obvious wounds, and both are speaking and trying to give necessary information to the officers who will be attempting to locate the shooter. Command is notified that two transport ambulances will be needed immediately and a rendezvous point is established near the front of the courthouse, where a large num- ber of armed LEOs are clearing the area and preparing a safe zone for EMS operations. The paramedic quickly identifies that the injured officers have no further wounds, but both have holes that are close to the arter- ies in the upper leg so there is no reason to remove the tourniquets in place on each officer. They are reassured the ambulances will have pain medication for them, as the placement of the tourniquet has now result- ed in significant pain for both. They are loaded onto sheets and carried outside to the ambulances. The paramedic is advised by the lead law enforcement official that the area directly in front of the courthouse is now a safe zone, and requests that fire and EMS resources, and the battalion chief, be put in place as rapidly as possible. Since there are ongo - ing life threats, the battalion chief will be incident command, and law enforcement • Tactical Combat Casualty Care: only TCCC course endorsed by the American College of Surgeons; uses PHTLS military textbook. 16 hours of CECBEMS credit. • NEW – available June 2015! Tactical Emergency Casualty Care: endorsed by the American College of Surgeons; meets TECC guidelines; uses PHTLS military textbook. Teaches civilian tactical EMS. 16 hours of CECBEMS credit. • Law Enforcement and First Response Tactical Casualty Care: 8 hours of CECBEMS credit. • Bleeding Control for the Injured: teaches basic life-saving recommendations of the Hartford Consensus. 2.5 hours. Learn more at www.naemt.org/education. NAEMT Sets The Standard In Tactical Casualty Care Training For More Information Circle 18 on Reader Service Card