RTF Flashcards
RTF Premise
Borne from high-threat situations with police and fire interaction (Active Shooter/Mass Casualty)
The immediate threat is already mitigated/isolated in most incidents prior to EMS/Fire arrival.
Identified the need to compress time between police clearing and patient treatment by EMS.
The sooner the first responders start medical treatment and triage, the greater the chance that victims would survive.
Communication with TPD (CICOII)
- Communication will be biggest issue between TFD and TPD on incidents
- ID team leaders/establish communication between TFD/TPD leaders prior to deployment
- Confirm correct radio channel (each agency has their own)
- Only plain English used, no 10 codes allowed
- If you want access to specific location/patient, say something to TPD leader
- If you are unsure of the plan, stop and clarify with TPD team leader before proceeding
A specific location where casualties are assembled to be moved to the medical treatment area or transported to a medical facility:
(PATT)
Casualty Collection Point (CCP)
- Patient location will often dictate CCP’s: place CCP close to high concentrations of patients
- Any change in CCP location needs to be communicated TPD/TFD Command
- There can be more than one CCP (They can be in warm zone or cold zone)
- The location of the CCP can be fluid: predetermined CCP’s often abandoned for more advantageous location
Hyfin Vented Chest Seal
Used for penetrating trauma to the thoracic cavity
Can be applied over blood and perspiration
Built-in vents prevent tension pneumothorax
Be sure and evaluate the patient for both entrance & exit wounds
TECC Treatment
- Uninjured/ Able to self- extricate
- Deceased/ expectant
- All others treat using MARCH Principles:
Major Hemorrhage Airway Respiratory Circulation Head/hypothermia
Combat Gauze
Hemostatic gauze for bleeding control
Used on junctional injuries. Requires a minimum of 3 minutes of direct pressure
Gauze must make contact with bleeding artery to be effective
Pack wound completely
Excess gauze can be used to apply pressure to the wound
RTF Deployment
First arriving TFD units will team up with first available TPD officers to create the RTF element. TFD members will be equipped with ballistic helmets and vests found in the BC truck.
The RTF element will consist of 4 TFD members and 4 TPD members (This is standard deployment but could change depending on resources).
4 TPD officers for security– ALL RTF OFFICERS WILL DEPLOY WITH THEIR IFAK
- Do NOT assist TFD in care
- Responsible for security and movement only
4 TFD members in ballistic gear with supplies to treat 15 patients or more
-Able to initiate TECC care and rapidly evacuate, could also use IFAK from rigs if RTF gear is not readily available
Accountability Officer must be established early and placed where TFD and TPD resources are being blended into RTF’s
Incident Command Communications
TFD and TPD will have a joint command post
TFD units will be assigned an RTF designation, for example “RTF1”
TFD units will report to Command or Logistics
Additional RTF Teams
Role of additional RTFs will vary:
- May begin evacuating victims already stabilized
- May leapfrog first RTF to stabilize victims if first RTF has changed to evacuation
RTF Zones
Hot zone: The location where the shooter is still active, and a direct and immediate threat exists.
-Firefighters will not work in this zone!
Warm zone: An area that police have initially cleared but security is required because the threat could return.
-TFD can work in this zone if accompanied by TPD
Cold zone: The safe area, generally outside, where no significant danger or threat can be reasonably anticipated.
- This is where Command and Treatment will be located
- CCP’s will often be established in this zone
*THESE ZONES ARE FLUID AND CAN CHANGE THROUGHOUT THE INCIDENT.
Olaes Pressure Dressing (PUCC)
Pressure cup on top of wound
Used to pressure treat wounds
Can be used with hemostatic gauze
Can be used to create occlusive seal
RTF Command Structure
RTF is under TPD COMMAND due to it being an active police situation
TPD & TFD will operate on separate frequencies, will each maintain own separate Command officer as unified command under TPD
RTF Formation
First TPD officers will go direct to threat.
Officers not going to threat will gather information on victims and form RTF.
Unifying command with TPD may be challenging, lack of communication could delay RTF so early communication is imperative.
Gather RTF equipment, may take place in staging.
Establish Cold Zone, transport cordon & prepare to deploy.
RTF Equipment (based on MARCH)
Massive Hemorrhage (CAT Tourniquets) Airway (NPA) Respiration (Hyfin Chest Seals) Circulation (Quick Clot, Olaes Bandage) Head/Hypothermia
CAT Tourniquet (UCAM)
- Used for bleeding control in extremities
- Can be applied 2-handed or 1-handed
- Apply high and tight, with 2” minimum from wound
- More than one tourniquet may be needed
Goal of initial RTF team is to stabilize as many victims as possible using TECC principles:
(POWM)
- Penetrate into building as far as possible until they run out of victims/supplies: “Stabilize, position, and move on”
- One TFD member per patient (60 seconds max)
- When RTF teams have to resupply, notify command of last victims location/evacuate with easily moveable victims
- Maintain awareness for secondary devices/hostiles amongst victims, let team leader know of anything suspicious
RTF Operations
Tactics will direct medical care:
- TFD personnel will not direct tactics
- TFD RTF will provide estimated victims to Command
- If established, confirm location of CCPs within warm zone
- Relay additional resources needed, this will generally be request for secondary RTF/patient extraction teams
RTF Movement
Once TPD clears an area of the active threat it will bedeclared a warm zone and safe for RTF.
-These areas are cleared but not secured.
RTF teams should use movement as directed by TPD
-Fire/EMS should remain within the “protective bubble” provided by TPD
If a potential threat is encountered by the RTF, emergency actions to be taken will be verbalized and
directed by TPD
RTF Definition
“The Rescue Task Force (RTF) is a set of Fire fighters and law enforcement sent to provide medical care in the warm zone of an active threat.”
TFD will provide treatment
TPD will provide security
Utilizes TECC Principles
Which treatment should I use?
Extremities = tourniquet
Junctions = wound packing
Chest/back = chest seals
Early Intervention
90% of deaths occurred prior to definitive care
42% immediately
26% within 5 minutes
16% between 5 and 30 minutes
8-10% between 30 minutes and 2 hours
The biggest time frame for us to save an injured person in this scenario is from 5-30 minutes
Once RTF operational, Fire Command will establish:
RIT
- RTF re‐supply near point of entry
- Internal/External casualty collection point
- Triage, Treatment, Transportation areas
