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MCI Active Shooter Tabletop

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by

David Neubert

on 1 October 2016

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Transcript of MCI Active Shooter Tabletop

TABLETOP EXERCISE
MCI / Active Shooter Scenario

David Neubert, MD

"911 What is your emergency?"
"Yea... there's... a guy here looking for his wife
he seems pretty angry. And he's acting
suspiciously. Can you send the police?"
"Okay... cars will be en route... could you give
me more information please..."
"Unit 54... Respond to the Calhoun Building.
100 block of Avenue A. For a suspicious person
possible domestic. Unit 55 and Car 4 to assist."
"Unit 54 responding."
"Unit 55 responding."
"Car 4 is en route."
"911 What is your emergency?"
"He has a gun!! He's shooting people!!"
"Ma'am... okay I need you to be calm for me.
Where are you?"
"At the Calhoun Building! He's looking for his
wife! She works on the 3rd floor..."
"Are there any injuries?"
"Units responding to the Calhoun building...
expedite response. Report of possible active
shooter. Suspect is described as male 5'10" tall
red shirt, black ballcap, jeans. Reportedly has
rifle and handguns. Possibly heading towards
a 3rd floor office. Report of multiple people down at the scene."
"Dispatch... Car 4. Have all available units in
the area respond. I'm pulling up now with
Unit 54. Multiple people running from the
building."
"10-4 Lieutenant"
"Dispatch... active shots audible, Unit 55 on
scene and we are entering the building."
"... showing units 50, 56, 57 on scene. Car
4 advises to enter through the lobby -- shooter
has not been located yet."
"Dispatch Car 4."
"Go ahead 4."
"Start EMS, we have at least 10 victims in the
lobby, we have a team heading towards the
3rd floor... and need additional units..."
"County control to Medic 1... respond to assist
the police for shots fired at the Calhoun Bldg.
100 block of Avenue A. Reports of at least 10
victims at this time. Shooter has not been
located yet. Stage in the area. Car 4 has
police command at the scene."
Thoughts at this point...
What resources are you going to need?
Staging plan?
Communications with the police?
How close to the scene should you park?
Additional units at this time?
Other considerations?
"Dispatch Car 4."
"Go ahead Car 4."
"We have injured people that have been
evacuated to the front of the building. Advise
EMS that they can access the parking lot in
front of the building on the Avenue A side, it
has been secured for them."
"County Control to Medic 1. Car 4 is advising
that the parking lot in front of the Calhoun
Building on the Avenue A side has been secured and asks that you respond there. Injured victims are being evacuated outside the building at this time. Shooter is still at large inside the building..."
Thoughts at this point
Additional information?
Additional resources?
Any other considerations?
Considerations at the scene
Where will you park the ambulance?
What will be your first steps in scene control?
How will you set up your incident command?
Additional resources?
Further thoughts?
Unified Command
Lt. Hightower introduces himself with a handshake and explains that his officers are continuing to clear the building. There are injuries in the lobby, but it has not been secured yet. There are reports of other injuries in the building, but he does not know how many.
He directs you to the grassy area by a police SUV and tells you that some of the injured self-evacuated there.
Pic References
Ambulance pic -- abc.net.au
CCC - LAFD Flicker acct.
Room clearing -- cheaperthandirt.com
Dispatch center -- ci.niles.mi.us
MAP -- redistricting.scsenate.gov
GSW victim -- johnminchillo.com
Victims in lobby -- news.cnet.com
Police LT -- thecarolinascoop.com
3rd floor Pic -- glockforum.com
Police lights -- komu.com
Office building -- Dallasnews.com
What are the next important steps to take at this point?
Other thoughts or considerations?
There are 10 injured workers in the field where the Lt. has directed you. A few have obvious gunshot wounds and are in various stages of distress. There is also a man clutching at his chest, and a female with a twisted ankle. They are being attended to by bystanders. Two of the patients appear unresponsive. There is a police officer providing security for the workers.
What scene management considerations do you have?
What command officers do you assign here?
Do you treat here or attempt to move elsewhere?
What further resources do you need / request?
What are your priorities in assessment and treatment?
Further scene considerations
Incident command established
Triage and treatment in progress in field
Where should you establish a Casualty Collection Point?
Where would you stage responding ambulances?
What further steps need to be taken at this time?
Casualty Collection Point
What resources do you need at the CCP right now?
What command staff should be assigned to the CCP?
Who should be notified of the CCP's location?
What personnel do you use to staff the CCP?
Other thoughts and considerations?
"Unit 54 to Car 4"
"Go ahead 54"
"Lobby has been secured. It is safe for EMS to enter. We have multiple unconscious patients here. Please request that they expedite. Second floor is also clear, no perp and no victims."
ALL VICTIMS HAVE BEEN MOVED TO THE CCP FOR FURTHER CARE AND TRANSPORT
New "scene" to access in lobby
From where do you assign resources to the lobby?
What equipment should be taken to the scene?
Do you need to reposition any units?
Other thoughts and considerations?
As you enter the lobby you are directed by a police officer to a number of gravely injured victims. A quick count shows 8 people down. There are a number of people that are unconscious and not moving. One person has a GSW to the chest and is profoundly short of breath. A few people are sobbing in the corner covered in blood. One man is holding his leg with a rapidly expanding pool of blood and a bystander attempting to help. Another police officer yells that he needs help for an injured child. You can hear a mother screaming.
.
What scene management considerations do you have?
What command officers do you assign here?
What are your priorities in assessment and treatment?
Who do you treat here?
Who do you attempt to move elsewhere?
How do you direct the evacuation of the patients?
What further resources do you need / request?
Other thoughts and considerations?
CCP redux
As patients start to arrive at the CCP from the lobby...
How do you ensure a smooth handoff?
How do you assign resources to their care?
What command officers would you want / need at this time?
What further requests would you have for resources?
When should hospitals be notified?
What information should be provided to the hospitals?
Other thoughts and considerations?
Unified Command Redux
Where should we be at this stage in the incident?
What is the role of the EMS IC at this point?
What command staff is assigned to the incident at this point?
What should the next steps be?
Other thoughts and considerations?
"Unit 55 to Car 4"
"Go ahead 55."
"Suspect is down on the 3rd floor. He has been
secured and EMS may enter the scene. Advise
them that we have multiple injuries here, and
at least 10 critical patients. There are also
many 'walking wounded' ..."
New "scene" on the 3rd Fl.
From where do you assign resources to the 3rd floor?
What equipment should be taken to the scene?
Do you need to reposition any units?
How are you going to extricate these victims?
Do you need a secondary casualty collection point?
What command staff must be assigned to this scene?
Other thoughts and considerations?
Patients are being treated and evacuated from the 3rd Fl.
Units in lobby radio that the lobby is clear.
CCC reports patients are being transported to local hospitals.
How do you ensure that the event demobilizes smoothly?
Further considerations...
Media
CISD / Debriefing
Equipment restocking
Placing units back in service
Thanks for participating!
Questions or concerns?

DNeubert@Tac-Med.org
www.facebook.com/tacmedicine
@tacmedicine
www.Tac-Med.org
Full transcript