EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.
Issue link: https://emsworld.epubxp.com/i/469414
EMSWORLD.com | MARCH 2015 19 numbered in sequential fashion. Figure 1 represents the results of that triage process. The crews triaged eight patients and cat- egorized the patients by the compromise of the ABCDE body systems. Case Discussion With the latest incidents that have occurred across the United States and around the world, emergency scenes have an ever wider range of potential threats. But the fire-EMS services have a lengthy history of managing hazards of all types using the Incident Command System, and those principles prepare emergency personnel for any type of incident. Regarding EMS victim care, they're a structured set of principles that save lives, whether a bomb has been detonated, thun- derstorm winds have just collapsed a stage onto a big crowd or someone is still shoot- ing. When the incident involves ongoing violence from gun, bombs or fire there is another set of priorities that are related to combat medicine. An active shooter event involves the man- agement of an incident where there is real or potential ongoing violence. The plan- ning for these events requires a high level of cooperation and a joint Incident Action Plan developed by local law enforcement and fire EMS leaders, and followed by train- ing for all levels of public safety personnel. There are fortunately a growing number of programs that allow school teachers, work- ers and others to "shelter and fight" to save lives as these incidents first evolve. These are also integrated with law enforcement. Scene Priorities at an Active Shooter Incident Public safety providers have a joint oppor- tunity to save all lives possible. Law enforce- ment has the primary responsibility to neu- tralize a person or persons with weapons of any type. Their responsibility and train- ing constitute the first wave of responders into the scene. All public safety personnel share a responsibility to perform rescues and operate in a way that maximizes safety for their own personnel. Active shooter incidents can, of course, have the full range of injuries and illnesses. The majority of life-threatening injuries will involve serious or lethal penetrating wounds with ongoing hemorrhage. EMS emergency care should prioritize the con- trol of hemorrhage. Relatively less spine immobilization is needed, and personnel should be equipped to move patients quickly using blankets or similar equipment and devices. Triage is simplified, without need for fancy devices. In these circum- stances, rapid BLS care is the EMS strat- egy. Airways will usually be managed after the victim is moved to a safe area in the cold zone, and after hemorrhage control has occurred using tourniquets or trauma dressings. For More Information Circle 21 on Reader Service Card