Responding to Ultra-Violent Incidents

2. Ultra Violent Incidents The problem… many of us have experience responding to a Mass Casualty Incident (MCI). For most of us the MCI is a motor vehicle accident and the occasional plane crash. Both of these events trauma. For most of us, blunt trauma constitutes the vast majority of trauma victims that we encounter. Both of these types of incidents accidents intentional. An MCI caused by shooting, stabbing explosives penetrating trauma. And these events involve people trying to kill other people… and us. cause blunt are not and and in results

3. Most of us do not have a great deal of experience dealing with an MCI involving penetrating trauma. Some may say “What’s the difference? Trauma is trauma.” I disagree. These events cause unique injuries and injury patterns. Ultra Violent Incidents also include violence toward responders. Responders are targets. This new training program Responding to the Ultra Violent Incident will explore: · · · · · · The perspectives of Law Enforcement, EMS, Fire\Rescue, School Districts and business will all benefit from this engaging training and exercise program. Incident Management Communications Triage Transport Resource Management Unified Command

4. The Medical Issues Anytime we have to deal with more than one injured patient the specter of the MCI looms large. Many responders are rightfully intimidated by the prospect of an MCI. There are so many variables, presented so quickly that it can be overwhelming. If you have had training and experience these incidents can be dealt with quickly and efficiently. Done correctly triage is actually easy to perform. Often it is made more complicated than it has to be. There are many triage systems. Not one system has been studied and proven effective let alone the “best.” My take on triage is direct: the simpler the better. The Israeli model of triage is hard to beat. There are fewer categories and the system does not require extensive training. Managing patient distribution and destination are two other challenges of the MCI. If there is a system in-place to manage transport and deal with patient distribution and destination those tasks become less stressful.

5. Incident Management In my 30 years of experience communications has been an issue in every After Action Review (AAR) that I have ever participated in. There are several elements of communications that impact the Ultra Violent Incident. The information that is received by the Communications Center is often inaccurate, conflicting and not complete. This is completely understandable! The individuals in the midst of these events are calling 911 at the worst moment of their lives. Can you imagine being a lay person at the Boston Marathon Bombing, the Beslan Mass Hostage Siege or the Dolphinarium Suicide Bombing? Communications between responders is a complex problem. Sometimes there are technical issues (how many millions communications?). More often the issue is sharing of timely and accurate information. Do you have a communications plan (ICS 205) established for the Ultra Violent Incident? Why not? We know who, what & how. We may not know when or where but we can pre-load the Incident Command System (ICS) before the Ultra Violent Incident occurs. So why aren’t we? Read more www. allriskconsulting.com of dollars have been spent on

6. Managing the large number of resources is incredibly challenging in the setting of an active killer(s). Law Enforcement agencies train to engage active killer(s) immediately. This is an effective strategy (offensive) and tactic (penetrate & neutralize). It makes command & control difficult. The resources from Fire/Rescue, EMS and other organizations will all contribute to an Ultra Violent Incident. Unified Command everyone talks about it but have you ever seen it? Can it really be done? Does it work? This response can and must be exercised before the Incident.

7. Law Enforcement Law Enforcement is obviously the primary focus of the Ultra Violent Incident. Until the violence stops it is difficult to access the victims and perform triage, treatment & transport. Therefore, all of the efforts of Law Enforcement are directed toward that simple objective – stop the killing. These Incidents are once in a life time events, we all have the obligation and responsibility to prepare for them. If you are interested in hearing more on the subject, I am rolling out a new series of training exercises about Responding to the Ultra Violent Incident. Please feel free to contact me with any questions! Jim programs and