I recently saw an article talking about Responding to Mass Shootings. It read like an old worn out sneaker, comfortable but stinky and ugly. Why are we still talking about a scenario we should have pre-planned and trained on until we were blue in the face?

Kleebold and Harris changed public policy for law enforcement and schools in 1999. Where has EMS been for the last 12 years? In 12 years the best the greatest minds in EMS has come up with through pre-planning, training and exercises is “wait for police tell them it is safe, or leave”…seriously? I would be embarrassed to collect a pay check for providing public safety if that is my protocol.

Whenever I see someone use the term “safe response” and “scene safe” I wonder why they are involved in a public safety career. The call of “scene safe” is constantly uttered by new medics in their training accompanied by the throwing of their hands up in a surrender motion. The job of fire, police and EMS is interwoven with risk, training and equipment is designed to mitigate risk. Pretending it away with surrender motions is pathetic training.

Let’s look at a couple of the “tactics” offered in the article:

“Wait for law enforcement to secure the scene” — I would ask each reader to contact their police department and ask them how long it will tell them to “secure” their local high school. The honest answer will be it depends upon the number of officers, but they will likely tell you it will take “hours” to search the entire building to declare it safe and secure. Now consider this scenario, a medium-sized artery nick will bleed at about 50ml/minute, the 10 high school kids so wounded (don’t forget this may be your child or your bosses) will have lost about 500-750 ml of blood by the time the active gunfire stops (per the authors research). This is a very survivable injury, but now keep in mind the scene will not be declared “secure and safe for EMS” until say 120 minutes into the event, which is about 90 minutes longer than 10 kids will remain viable. Be sure and tell the family members and city council about the great plan you came up with in the last 12 years which lead to such great results. At that point I would offer to run a taxi and mortuary service in your community at a lot less cost than your EMS agency and have equal patient outcomes. A much better plan would be to work side by side with law enforcement to practice taking over ground within the school and establishing a forward treatment area, with law enforcement security, or training your police officers in the use of tourniquets, chest decompression and sucking chest wound care.

“If there is an active shooter on the scene, medics must try not to draw attention to themselves if treating patients” – I am guessing this means if I was dumb enough as a medic to be on scene before it was declared safe, I should play dead. My own thought would be to drag some wounded kid behind cover and do my work there. Life is hard sometimes and some days you earn that paycheck.

“If the scene is unsafe, leave” — this is the best job in the world! All I have to do is say the scene is unsafe, and it is time for me to go back and finish my sandwich in the medic unit then drive to the bank to cash my paycheck.

I would suggest medics train and train and train until they determine safe becomes a relative term and accept they are being paid to take reasonable risk to affect a positive patient outcome, not take the easy way out, or have a job with a no-risk guarantee.

My opinion only, what’s yours?