Five Years Ago Now (yikes!), I wrote in this blog about a serious “multi-casualty incident” (or MCI) in my county. That happened on a Sunday — coincidentally the day after we finished a two-day MCI training.
For such a small county, we do a lot of interesting training: ten years ago, it was how would we rescue a bunch of injured students and teachers who went over the side in a school bus on one of our steep mountain roads. My role then was to get video of it all, and cut it down to something short …which is also in this blog.
This year, we took our MCI training further, putting on a full-scale exercise on Saturday. The scenario reflects our times: a school shooting. Yes, even small towns do (or should do!) such training scenarios. Here in Colorado, the Platte Middle School incident also hit these pages, and reminded us that it can happen anywhere.
Planning for Realism
This was no “Hey, let’s go down to the school tomorrow and practice this.” It took a year of planning, meetings, and setting up, in large part to get the kind of participation we’d get in a real event such as this: we brought in police from all three law enforcement entities in our county, as well as state troopers, firefighters for extra hands, neighboring counties’ ambulances, hospital personnel, and more. And, of course, school officials. It was all coordinated by our fairly new county emergency manager.
He even borrowed special guns that use “simunition” — special ammunition that goes into real guns (but converted so they can’t shoot actual ammunition) that make the noise of shots, and actually do shoot projectiles, but at a low velocity so if someone is hit by one, it stings, rather than penetrate and cause real injuries or death. (Yep: eye protection is a must with those.)
We got teen and adult volunteers to act as victims, and those who worked to not be victims and hiding in the school. The “shot” victims were made up to have fake wounds. Some of the adults “showed up” at the school in the role of anxious parents wanting to rush in and check their kids. Every group had to be handled properly, and without putting them at risk of being shot, being “accosted” by reporters, or whatever.
We set up a “reunion” area, where we would in fact have parents go, and students, and others who were not injured. We actually took several of the “injured” victims to the hospital — a half-hour drive — to make it all more realistic and to give them practice dealing with a “surge” of patients.
The local medical helicopter team even participated in the transport portion: they actually flew one of the mock patients to the hospital. But first, they had to know where to land that was safe, and we had to coordinate finding the most-serious victim, and getting them to the chopper.
And meanwhile, our police and EMS folks had to deal with any real calls for help that came in at the same time. Sure enough, we had to cut loose an ambulance for a real medical emergency elsewhere.
Different Roles
Just because I’m a medic didn’t mean I was used for triage, treatment, or transport: I wear different hats in the county, and have some skills that others don’t have. Radio communications expertise, for instance, and an ability to remain “supernaturally calm” and make decisions. The idea is to assign people to the positions where they fit best.
As far as radio expertise, at the last meeting before the exercise, the emergency manager handed out the communications plan. I had bad news for him. “This channel assignment isn’t right: the wrong radio system is specified. And you can’t use these channels the way you’re proposing, because…” — I won’t go into the actual reasons why here, in public, but the bottom line is almost everything needed to be changed just a couple of days before the exercise.
The emergency manager took it in stride, just as he’d have to do in a real situation. But it demonstrates the importance of carefully choosing people for their roles based on their expertise, and thinking through the gotchas that would come up in real life.
My wife also had a special role: she was in charge of a reserve team to medically treat anyone who was actually injured as part of the exercise. She was below the safety officer, who reviews all the plans and keeps an eye on things to call a halt if he sees something go dangerously wrong. Happily, Kit was bored to tears: the worst injury was a boo boo that needed a Band-Aid.
And… Go!
We all got into position and started the exercise, which was scheduled to last four hours.
During that time, I was assigned to the command post, working the logistics of getting ambulances coordinated — and getting them the resources they needed to “save the lives” of our mock victims.
Yeah, there were glitches — we expect them. But we handled them. For example: one radio call to me was “Medics are all tied up doing triage! We need someone to drive the ambulance to get people to the hospital!”
The local fire chief was also at the command post: I simply asked him if he could send one of his firefighters. He did; problem solved, and on to the next one. In all, I drafted three of his men to do tasks that didn’t need someone who was medically trained. It’s what we would do in real life.
Rumors
There are two kinds of rumors in a situation like this: first, the “what’s really going on?!” reactions from civilians who see scores of emergency vehicles converging on one spot, and maybe not believing it’s a training exercise. Planners can send out press releases (and they did), but we also used Social Media to remind people that it was coming up, and to please help reassure friends and neighbors who didn’t get that advance word.
And second, what the responders to the incident don’t know, and try to get from witnesses and victims. The responders didn’t know how many shooters there were, how many victims there were, and more — just like in real life. The exercise command staff knew, for instance, that there were two shooters, but very quickly, a confused witness reported that there were three.
Hey, that happens in real life too: they just don’t know. When we at the command post heard that, we knew it was bad information, but we kept it to ourselves to see how the law enforcement responders would sort it out, which is exactly what they’d have to do in a real situation. And they did.
And all the while, the two emergency managers from neighboring counties were there to watch and offer advice, to help train each other and think of details that might get lost otherwise. It was fascinating to be “behind the scenes” of something like this.
Expensive
It’s hard to pay for something like this. Sure, “everyone” agrees that such training is needed. Millions could be thrown at an actual event, and such trainings can help reduce the cost of a real one. But can every jurisdiction actually budget the funds to put something like this on?
Nope, not when taxpayers are understandably intent on reducing their taxes. Simunition is close to a dollar a round, and to make it realistic you need lots of it. The volunteers needed to be fed: local restaurants stepped up to help prepare it all and serve, but I’ll guess the county paid for the food. (They even thought of food bars to send with us!) Fuel for all the vehicles used. And… and… and….
But that’s part of why we brought in resources from other counties: cops and medics and emergency managers and more who participated and learned a lot, and will take those lessons home with them.
Lessons Learned
And indeed we learned a lot. We took a lot of notes, and will meet in a couple of weeks to go over what went right, and what went wrong — and how to fix those problems. But all in all, this went incredibly smoothly, and we showed even small town rural folks can rise to challenges in a fully professional way.
I hope we never need to put this specific training scenario into real life use. But if we do, we’re much better prepared for it, which is why we all got up very early on Saturday morning and volunteered our time.
Thus, special thanks to the Ouray County Emergency Manager who pulled this all together: Glenn Boyd did a fantastic job with it.
Note: Yes, I was intentionally vague about a lot of details. I don’t want to make anything easier for the bad guys….
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Once again, the dedication of all our emergency responders, paid and volunteer, astound me. Thanks to you and Kit for your part in it and to all the other dozens of participants, volunteers and observers. Sure makes me wish our little town and nearby college town would run this kind of simulation. May I share it with a couple of folks, an EMT and Deputy Sheriff that I know would appreciate it?
It also dawned on me that as a Board member of a local Food Pantry, that we need to put an emergency response plan in place since we have over fifty people a day walk through our doors, many of whom we do not know. If you have a link or materials you could point us to, I would really appreciate it.
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I don’t have a link for you offhand, but I can certainly say you’re most welcome to share this link to whomever you think would be interested, professionally or otherwise. -rc
It seems that as time goes on, these exercises get more elaborate, and expensive. But then, 30 years ago, an “active shooter” wasn’t as sophisticated.
Curiosity makes me ask if the lessons learned from the Columbine School Shooting were incorporated into your exercise? As one of Colorado’s first EMT’s (in 1975 or 76), and as a former Emergency Department Supervisor, the questions flow even though I am now out of the “game” due to increasing physical incapacitation. Not asking you to give away details (as you said, no one wants the bad guys to have information that will help them) but can you expand on the scenario in general? You’ve already said two shooters, how about victims and how badly they were “injured?” The outcome for the “shooters?” Anything other than what you and I (and every first responder) doesn’t want someone contemplating this to know.)
I enjoyed watching the clip you did on the school bus over the cliff rescue, reminded me of a “Mass Cal Exercise” that my nursing class at Fitz took part in, in 76, at the old Stapleton International. To think that in that one, we were moulaged, placed along the runway and on board the aircraft, “rescued,” transported, and through in a bit over 6 hours.
Also, did you POST a video of the exercise?
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To clarify, it was the 5-year-ago (bus accident) scenario I did a video for. For this exercise, I was at the command post on logistics, and didn’t take any video.
As far as more details, I think I’m at the level I’m comfortable with, except to add injuries ranged from very minor to very severe. And for those who wonder, “moulage” is the term for the fake injuries applied to the scenario victims. -rc
“The scenario reflects our times: a school shooting. Yes, even small towns do (or should do!) such training scenarios.”
No one thinks small towns in Britain “should” do such training — simply because there haven’t been any since Dunblane in 1996 (as a result of which hand guns were banned, semi-automatic and pump-action rifles had already been banned in 1988). Such events are common in the US but practically unknown in Europe and probably Canada.
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Where does it say I’m advocating such training in Britain? Yet I am: there are certainly MCIs there, and any MCI training helps, just as the training we got five years ago made our mine accident response much smoother. What did a mine accident have to do with a shooting? Nothing, and everything: multiple casualties. Coordination. Outside help. Communications. Logistics. Rescuer safety. And on and on and on. Last, when we ARE faced with such incidents, you seem to suggest there’s some folly in training to counter it if happens. I don’t think so — at all. -rc
I was fascinated at all that went into the planning and execution off this event.
As someone who had to call 911 for a terrifying family medical emergency recently, I can attest to how difficult it can be to keep your head under such circumstances. Thank you for being the one who could remain supernaturally calm — even though I’ve always been good in small emergencies, I now understand at a much deeper level how hard it can be to remember details, to know exactly what to do in a major one. I will forever be grateful to the 911 operator for her calm and instructive voice and attitude, who kept me focused and able to do the best for the victim! (And fortunately, as awful as it was, my family member appears to have suffered no permanent ill effects from the incident.)
Even though I’ve always respected first responders, you folks who are actually doing it have a tremendously challenging job to do and even more of my respect now. It’s great to hear how you practiced in such depth so that in the future you’ll all be more prepared. I appreciate everything you ALL do to keep your (and my) community safer in the future.
One thing I noted recently, too — after the synagogue shooting, I read that the hospital which received most of the victims was so well-prepared for an MCI that they ended up with TOO MANY people available to help. The realization that they could have handled even more victims must have been one of the few positive results from the horrific event! And that’s the kind of result that an exercise should bring — the knowledge that in the future you’ll be in a better position to serve your community.
I’ve always wondered why none of the schools use any of the inventions a few teachers have made to make school shootings more difficult. I’ve seen several simple but effective tools that make classroom doors impossible to open so the shooter can’t get in, but have never heard of any school using them. One of them simply slips over the arms of the pneumatic device on doors and makes them inoperable. If a school had these in each classroom, a shooter wouldn’t be able to get into the room to shoot anyone. None of the devices I’ve seen are expensive either.
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I’m not sure why you’d think “no schools” use devices. I’m quite sure many do, and they have procedures in place as to what to do. But it is not prudent to talk publicly about what any specific school does with regard to security, eh? -rc
Well over thirty years ago I was also involved in organizing MCI drills for a volunteer ambulance corps in New York State, much simpler scenarios than what you described. What was made clear was that incidents wherein people are ready for a scheduled event still have many logistical and communication problems that would be multiplied in a real situation when the early responders have to cope & perform a lot more functions until the rest show up. We increased cross-training and worked toward having any duty crew (four volunteers) function capably as the first on scene.
The biggest perceived difficulty was instilling the confidence and attitude in some people to assume authority, act decisively and fulfill the immediate responsibilities. Written outlines and protocols are valuable support tools but you still need those who have absorbed the training and quickly react & perform the tasks.
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Yep. The “rule” early on in an MCI is when someone asks, “Who’s in command?” the answer is …the person who asked the question. It’s a good starting rule. -rc
Thanks for the information — enough but not too much. Training helps with communication, which can be a weakness in any scenario, as well as problem-solving. What impresses me about your descriptions is that no one needs to get their nose out of joint — there is enough (or more) work to go around. Fill in where you are capable. And, if you are not needed, get out of the way!
As for those who provide water, food, snacks (and prayers), “they also serve” and fill a vital role.
What is the best way to volunteer as a “victim”? I can do a pretty good trauma amputee — more realistic than most….
Contact the local 911 center? Sheriffs? Fire dept?
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That would be awesome! Check with the local place where they train EMTs, which is probably your nearest Community College, and/or your local EMS agency. -rc