TB 135 - Active Shooter Flashcards
Tactical law enforcement incidents may include the following:
• Any incident where the subject of an actual or potential violent crime is believed to still be on scene and not in police custody
• Active shooter
• Hostage taker
• Perimeter search for an individual suspected in a violent crime
• Barricaded suspect
• Multiple-coordinated assault by suspected terrorists (i.e. Mumbai-style attack)
• Any incident where a subject threatens to detonate explosives or set fire to an occupied building
The American College of Surgeons and the Federal Bureau of Investigation in Hartford, Connecticut, developed a concept document for the purpose of increasing survivability in mass casualty shootings.
The Hartford Consensus, as a core requirement in response to Active Shooter(AS)/MCIs, identifies the importance of ______ as an INITIAL ACTION to improve survivability.
hemorrhage control
(Experience has shown that the NUMBER ONE CAUSE of preventable death in victims of penetrating trauma is HEMORRHAGE.)
The Hartford Consensus’ practical recommendations include the actions contained in the acronym THREAT.
THREAT stands for:
T – Threat suppression
H – Hemorrhage control
RE – Rapid Extraction to safety
A – Assessment by medical providers
T – Transport to definitive care
- The Hartford Consensus points out that life-threatening bleeding from extremity wounds are best controlled by the use of _____________.
- Internal bleeding resulting from penetrating wounds to the chest and trunk are best addressed through ___________.
- tourniquets and direct pressure.
- expedited transportation to a hospital.
When arriving at the scene of a tactical law enforcement incident, it is important for fire department personnel to ascertain if the incident is still ___________.
This information should be communicated to responding resources IMMEDIATELY.
Request law enforcement if not on scene yet.
dynamic
(i.e., subject(s) still on scene and not in police custody).
Fire department personnel should not enter the immediate area where a direct threat is believed to exist.
However, if there is a basis to believe that the threat is no longer present, it may be appropriate for fire department personnel to render aid or take other appropriate action, even prior to the arrival of __________.
law enforcement
When MFC receives a call for a shooting, and determines that shooting is ongoing (i.e., an active shooter incident) the following resources will be dispatched:
• 2 Battalion Chiefs
• 2 EMS Captains
• 1 Command Post Company
• 1 Light Force
• 2 Engines
• 4 ALS RAs
• 2 BLS RAs
The first arriving fire department unit on scene of an active shooter incident should:
• Confirm the NATURE of the incident (i.e., shooting vs. active shooter).
• Provide a SIZE-UP to MFC and responding units.
• Designate a STAGING AREA.
(Consider an area not in direct line of sight or immediately proximate to the incident, with a clear approach to the incident, or possibly a predetermined area developed from preplanning.)
Rescue Task Forces (RTFs) are small groups of fire department personnel together with force protection configured to treat or extract the injured from within the _____ Zone.
RTFs may also take the injured to a Casualty Collection Point (CCP) within the _____ Zone prior to further movement to the treatment area.
Warm Zone (for both)
Who will normally be assigned rescue group supervisor?
The second arriving battalion chief
The first arriving EMS Supervisor should normally be assigned as __________, unless this member is unnecessarily delayed, then this should be initiated by another resource.
The second arriving EMS Supervisor should normally be assigned as the ___________.
1st EMS Captain: Medical Communications
2nd EMS Captain: Medical Group Supervisor.
First arriving __________ should prepare personnel and secure equipment for deployment as Rescue Task Force.
Company Officers and RA personnel
For complex incidents that involve a significant commitment of LAFD resources, a _____ Command shall be employed and an ________ shall be developed.
-Unified Command
-Incident Action Plan (IAP)
(This will need to take place quickly and may be INFORMAL.)
The elements of the Incident Action Plan (IAP) for an Active Shooter may vary based on the situation, but key components that the FIRE DEPARTMENT will be RESPONSIBLE FOR include the following:
- Rescue Group
- Medical Group
- Fire Group
- Communications Plan
During an Active Shooter, the ______ Group is configured to extract viable patients from the Warm Zone or Casualty Collection Point to the treatment areas.
(This is where the Rescue Task Forces are assigned and report to).
Rescue Group
If no Warm Zone or Casualty Collection Point (CCP) exists, the ________ will have the responsibility of coordinating the movement of patients TO the treatment areas.
Triage Unit Leader
The ______ Group is configured to manage the triage, treatment, transportation, and tracking of casualties.
Medical Group
When large numbers of patients are encountered, or when they are separated by a distance that makes it impractical to have one treatment area, a Medical Branch may need to be established.
The ______ Group is configured to suppress fires and coordinate the non-EMS operational fire discipline needs of the incident.
Fire Group
Incident Command:
Identifying specific incident boundaries and locations are important as additional fire dept command officers arrive and RTFs are configured to search for victims.
Consider designating the following locations on a map:
-Location of the threat(s) (Hot Zone)
-Perimeter established by law enforcement (Warm Zone)
-Casualty Collection Point(s) (Warm Zone)
-Treatment Area(s) (Cold Zone)
-Incident Command Post (Cold Zone)
-Staging Area(s) (Cold Zone)
-Tactical Operations Center (TOC). Location from which SWAT Command coordinates SWAT operations. The TOC is routinely not collocated with the CP. It is beneficial to assign a fire command officer to this location to enhance situational awareness.
-Family Assistance Center (Cold Zone)
Example 1, groups are organized by function:
In Example 2, two of the branches are designated based on geographic locations:
When a barricaded suspect threatens to set fire to a building, it is vital that the Incident Commander develop a Fire Plan.
If a fire occurs and the suspect’s location cannot be determined, firefighters will need to PROTECT EXPOSURES to the extent possible and attempt to extinguish the fire from PROTECTED LOCATIONS.
Under no circumstances should firefighters enter or move through a _____ Zone to deploy ladders, hose lines, or other equipment.
Hot Zone
When no other options are available, water drops via helicopter can be made
Rescue Task Force (RTF) is a team deployed to provide point of wound care to victims where there is an ongoing ballistic or ______ threat.
These teams treat, stabilize, and remove the injured from the ______ Zone to an area where they can receive definitive care and/or transport to the hospital while wearing ballistic protective equipment with force protection.
explosive threat
Warm
As a minimum, an RTF shall have ____ fire department medical personnel and _____ force protection officers. When possible, RTFs SHOULD incorporate a paramedic.
The circumstances and available personnel will dictate the number and size of RTFs
-2 LAFD members
-2 Force protection officers
Possible Rescue Task Force (RTF) configurations:
What would be the recommended configuration if it were desired to form two RTFs using an Engine and an RA?
Two Rescue Task Forces each comprised of:
-3 fire dept members
-3 Force Protection officers
One paramedic (from the RA) would accompany each RTF under this configuration.
Although exceptions can be made based on the situation, what is the largest reasonable combination of personnel for an RTF?
-4 fire department members
-4 force protection officers.
Larger combinations of fire department members and officers will make it more difficult to move quickly.
To limit the visibility of the RTF, it may be advisable for fire department members not to wear ______ over body armor.
If available, ballistic helmets may also be used by fire department members to increase protection and reduce visibility.
yellow brush jackets
The first RTFs will enter the area and treat patients AS THEY ASSESS. Any patient that can walk without assistance will be directed by the RTFs to self evacuate to safe areas, dead patients are left in place.
When the RTFs are operating in the _____ Zone, treat the area as an IDLH. NO TRIAGE is conducted.
Warm Zone
The initial Rescue Task Force (RTF) will start the extraction of the injured when:
-they run out of equipment to use
-all accessible victims have been treated
Additional RTFs that enter the area should be primarily tasked with?
Extraction of the victims treated by the initial RTFs or if needed to send into areas unreached by the initial RTFs.
It may be advisable for the ______ Group Supervisor to collocate with the law enforcement command officer that is coordinating tactical operations and/or possibly accompany the RTFs as they make entry to conduct RTF activities.
Rescue Group Supervisor
Although the majority of active shooter incidents no longer present a threat upon the entry of fire personnel, as RTFs move through areas in search of victims, it is advisable to maintain _____
LCES
The intent of the Trauma Treatment and Evacuation Aid Bag is to bring critical lifesaving equipment to the patient in one package.
The bags are specifically stocked to treat _____ trauma patients, addressing the “Four Preventable Causes of Death”, utilizing the M.A.R.C.H Algorithm.
Two patients
The _______ helmets shall be worn when responding to reported active shooter incidents and other incidents where gunfire may be encountered.
At any time that the ballistic helmet is donned, members shall also don ________.
ballistic helmets
body armor
The ballistic helmets will be identified with the company designation with a velcro passport located on the _____ of the helmet.
Back of the helmet
Tactical Emergency Casualty Care (TECC) is the counterpart to the military’s Tactical Combat Casualty Care (TCCC) guidelines.
TECC focuses primarily on the intrinsic tactical variables of penetrating trauma compounded by prolonged evacuation times. The principle mandate of TECC is the critical execution of the right interventions at the right time.
______ Threat Care is rendered once the casualty is no longer under fire (i.e., Warm Zone).
Medical equipment is limited to that carried into the field by RTF personnel typically including tourniquets, large trauma dressings and adjunct airways.
Indirect
Tactical Emergency Medical Support (TEMS) is the provision of preventative urgent and emergent medical care during high-risk, extended duration and mission-driven law enforcement special operations.
The LAFD has established a _____-tiered TEMS program.
3 tiered
Which tier TEMS are all LAFD members trained to?
This Tier enables them to be assigned to a Rescue Task Force (RTF)
Tier 3 is the TEMS First Responder Operations (TEMS FRO).
All LAFD members receive 4 hours of tactical awareness training enabling them to function as responders at the TEMS FRO level.
Detailed tactical information should never be broadcast over the radio. It is advisable to communicate sensitive information via _______ or _______
cell phone or face- to-face.
Law Enforcement have Rescue Teams that are configured to search for and rescue the injured.
When fire department personnel are joined together with these Rescue Teams, they are designated as _________.
Rescue Task Forces.
ZONE AND PERIMETER CONCEPTS:
The _____ Zone is that area wherein a direct and immediate threat exists.
This zone should be considered an Immediate Danger to Life and Health (IDLH).
Hot Zone
Any unsearched area where a threat may be present should be considered a Hot Zone.
Any area within direct line of fire of where a gunman may be located or can easily move to should also be considered a Hot Zone.
ZONE AND PERIMETER CONCEPTS:
The _____ Zone is that area wherein a potential threat exists, but the threat may not be direct or immediate.
(I.e. an area already searched by law enforcement officers could still be within the range of gunfire and/or a subject could be hiding in an unsearched area or return to an area that has been searched)
Warm Zone
(Warm zone is considered an IDLH.)
Allowing fire department personnel to operate for a short period of time within the Warm Zone is permissible if they are provided with _________
Force Protection
The Warm Zone would not be designated as a Cold Zone until?
the subject’s apprehension
or
after a thorough search has been conducted
The _____ Zone is that area where no significant danger or threat can be reasonably anticipated.
Cold Zone
The Cold Zone is established with due regard for:
-distance
-time
-terrain
-type of firepower being used.
Which Zone is the appropriate location for treatment of patients, staging, and command functions?
Cold Zone
For the sake of fire department operations, the LAPD term “________” should be considered an IDLH.
inner perimeter
The LAPD term “Cover” is defined as an area where adequate protection from live fire exists.
The LAPD term “Concealment” is defined as an area where visual concealment exists.
The wall of a structure that bullets or shrapnel could penetrate may provide concealment, but would not provide _______.
Cover
When a tactical law enforcement incident impacts an area several city blocks in size or a large public venue and when a long time frame is anticipated for incident resolution, it may be advisable for the fire department to designate a _______ area.
tactical area
Designating a tactical area with MFC allows the IC to control any responses into what could be designated as a WARM ZONE.
Any 9-11 calls for service that originate from within the tactical area will be communicated from MFC to the Command Post for dispatch of a ________.
Rescue Task Force (RTF)
In such circumstances, fire department resources from outside the area will not be dispatched to an incident in close proximity to a dangerous situation.
What is the area called OUTSIDE the Hot Zone to which casualties are taken to INITIATE TREATMENT in the case of critical injuries, or be further extracted to treatment areas by Rescue Task Force members?
Casualty Collection Point (CCP)
_________ is the term for:
Any armed person who uses or has used deadly physical force on other persons and continues to do so while having UNRESTRICTED access to additional victims.
Active Shooter
A stone or concrete wall, or tree of at least ____ feet in diameter would provide cover from most SMALL ARMS FIRE.
To obtain cover from high-powered weapons fire, much more substantial barriers would be needed
Two feet
_________ is the term for:
The initial team of up to 4 police officers who form at the scene of an active shooter and deploy to the shooter’s location with the goal of initiating contact to contain or eliminate the active shooter to prevent further injury or loss of life.
Contact team
_________ is the term for:
The swift and immediate deployment of law enforcement resources to ongoing, life threatening situations where delayed deployment could otherwise result in death or serious bodily injury to innocent persons.
Immediate Action Rapid Deployment (IARD)
_________ is the term for:
Team of up to 4 police officers who form at the scene of an active shooter and deploy behind Contact Teams into the Hot Zone with the goal of extracting viable patients to a Casualty Collection Point or treatment area.
Rescue Team
_________ is the term for:
A combination of fire department and police deployed to identify, quickly stabilize the critically injured, and extract them from the Warm Zone to an area where they can receive definitive care and/or transport to the hospital.
Rescue Task Force
_________ is the term for:
The provision of preventative urgent MEDICAL CARE during high-risk, extended duration and mission-driven LAW ENFORCEMENT special operations.
Tactical Emergency Medical Support (TEMS)
_________ is the term for:
Specialized law enforcement tactics designed to enable officers to immediately deploy contact teams or squads to locate, move to and neutralize violent assaults and/or terrorist acts.
Multi-Assault Counter-Terrorism Action Capabilities (MACTAC)
Tactical law enforcement incidents are among the most dangerous that the fire department can respond to and require _____________.
special planning and coordination.
