Paradigm shifts – major changes in the way things operate – happen slowly, especially in law enforcement. Only on the rarest occasion will police operations suddenly change to adapt to anything. The best tactical example of a rapid paradigm shift is Columbine. The transition from “Isolate, Contain, Wait for SWAT” to an immediate entry of patrol officers seemed to happen overnight.
Virtually every department in the US conducted in-service Active Shooter training using some sort of four officer, diamond or Y-formation. Most police academies began to teach this same Active Shooter patrol response.
The reason for this almost immediate change in technique was simple math. The average response time for a SWAT team is 50 minutes. The timeline of violence in Active Shooter scenarios is less than 5 minutes. To stop the Active Shooter, the police have to engage him. By the time SWAT arrives, the killing is long over. Patrol officers made entry as soon as the diamond formation was formed.
Very slowly, that same simple math, that same short timeline of violence, began to take hold again. Even in well-staffed urban departments, and especially in under-staffed rural areas where most school shootings occur, it could take too long to assemble four patrol officers.
Over a 10-year period, no four officer patrol formation actually stopped the ongoing killings. It was all over just too quickly. Again, slowly, four officer formations gave way to an immediate entry by the first officer on the scene. Again, it is simple math. If it is all over in less than 5 minutes and someone gets shot every 15 seconds, the first officer simply must enter.
We are now seeing another time-based, time-forced change in our Active Shooter response. The reality is that the shooting may have stopped, but the victim bleeding has not. Since the ultimate mission has always been to save lives, the latest paradigm shift is working with Fire/Rescue to quickly stop the bleeding. That means rapidly transitioning the hot zone into a warm zone and getting paramedics into the scene as soon as possible. Not the SWAT teams’ TEMS officers, but Fire/Rescue’s medics.
These are not just any paramedics. Instead, those who have trained with the police, have been equipped with body armor and helmets, and have their load bearing vest specifically fitted for the mass casualty incident response, i.e., dozens of tourniquets and numerous bags of homeostatic agents.
The SWAT teams TEMS cannot fill this role. SWAT is not there in time and the first responsibility for TEMS is the SWAT team. The paramedics are on the scene as fast as the patrol officers. Use who is already there.
Properly trained and equipped paramedics entering a warm zone is the paradigm shift. This is entry into a declared warm zone, meaning known perpetrators are either dead or in-custody. However, the structure has not been searched and secured; unknown perpetrators may exist; other threats may exist.
The rapid bleed-out time is the simple math compared to the time to declare a structure safe. Most departments are up to speed on buddy-care or self-care. The very essence of buddy-care is the short bleed-out time from an arterial injury. It depends on a number of factors relating to the injury, but 5-minutes keeps popping up in lethality timelines: “…within 5 minutes…” and “…more than 5 minutes…”
Yes, this next life-saving step in the Active Shooter response requires inter-agency coordination. However, a number of police and fire departments have already got this all sorted out. Arlington County, VA Police and Fire is one example. The Hillsboro, Ore. Police and Fire is another example.
Protocols differ, but typically two officers (front, rear) escorts two paramedics. The paramedics decide where they want to go. The patrol officers decide how to get there and when to move. This is indeed a medical mission. We just pull the security detail. They do triage, not us. We don’t have the time to move the wounded to the paramedics – we need to escort the paramedics to the wounded. And that 5-minute countdown? It started when the first person was shot, not when the police/fire arrive.