Virginia Tech shootings encouraged new strategy for first responders
The Roanoke Times | April 10, 2017
By Amy Friedenberger
Police officers rushed to the second floor of Norris Hall on April 16, 2007, and found bodies strewn about. They began administering first aid until two tactical paramedics, who had arrived with SWAT teams, joined them about a minute later.
Responders affixed victims with red, yellow or green tags to note how severe their injuries were. Thirty-one deceased people — including the shooter — bore black tags. Paramedics and officers used various life-saving techniques to treat the wounded and carried them out of the building so they could be taken to hospitals.
State and medical officials have praised the effective work of responders that day at Virginia Tech. Their rapid medical intervention encouraged fire and EMS agencies to reconsider how they respond to mass casualty incidents, leading to the growing development of “rescue task force” programs across the country.
The traditional standard for responding to an active shooter incident is for fire and EMS to stage in a secure location away from the scene. Once police say the scene is secure, those waiting outside can come in and provide medical care.
But there’s a problem with that approach, experts say. Clearing a scene can take anywhere from minutes to hours, meaning people are dying when they might have a chance at survival.
“When fire departments say they’re going to stand by, that doesn’t cut it for citizens anymore,” said E. Reed Smith, operational medical director for Arlington County Fire Department, a pioneer in the rescue task force model. “For first responders, it doesn’t cut it anymore for us, either. This is our community, and we have to do something.”
Rescue task forces use rapid triage to stabilize life-threatening injuries and get victims away from the scene as quickly as possible. When an active shooter incident happens, the first police officers at the scene work to eliminate the threat, which could mean bypassing the dead and wounded. The rescue task force — medics outfitted with ballistics vests and helmets, with a police escort — soon follows. Paramedics focus on stopping bleeding, clearing airways and treating chest wounds.
Arlington County decided to work toward adding the rescue task force concept to its agency a year after the shooting at Virginia Tech.
“In these situations, we need to stop the killing and we need to stop the dying,” Reed said. “But our thought process changed when we realized these two priorities can occur in parallel. They don’t have to occur in sequence.”
The quick arrival of the SWAT teams and tactical medics at Norris Hall occurred mostly by chance, according to the state’s official report on the shootings. After the discovery of the two murdered students in a dorm room earlier that morning, Blacksburg and Virginia Tech police called up their SWAT teams. Each team came with a tactical medic.
When the shootings at Norris Hall began, the SWAT teams went there, allowing for the two medics to make contact with victims more quickly. Additional EMS units staged outside.
But that’s not how quickly SWAT teams normally work. They can take nearly an hour to assemble and arrive to an incident. The tactical paramedics typically are not there immediately to help the wounded; they stick with the SWAT teams to ensure that officers are healthy.
‘This problem isn’t going away’
SWAT teams were created in response to the 1966 sniper attack at the University of Texas at Austin, in which a gunman killed 14 people.
Columbine led to a tactical overhaul.
When the Columbine school shooting happened in 1999, police and paramedics waited outside for a SWAT team to arrive as the killing continued inside.
After the tragedy, police across the country developed active shooter training that called for the first responding officers to rush toward the gunfire, past the victims, and stop the gunman first. SWAT teams would follow. At Virginia Tech, three of the first five officers who entered the classroom building were trained to deal with an active shooter, according to the official report.
The fire and EMS profession largely didn’t change following Columbine.
The Blacksburg Volunteer Rescue Squad started thinking about how it could better respond to mass casualty incidents a few years before the Virginia Tech shootings, said Chief David English. The rescue squad, with about 125 EMS volunteers, formalized the program within the past several years and has helped surrounding agencies learn how to implement similar models.
“There are always medical people who want to go in and help, so we figured that it was important that we get them trained and give them the right equipment and knowledge so they do it safely and effectively,” said English, who was a responder to the Virginia Tech shootings.
The rescue task force was deployed in 2013 when a New River Community College student opened fire at the New River Valley Mall in Christiansburg, wounding two people. Fortunately, English said it isn’t deployed often.
The need for a change in the fire and EMS field has become more urgent with the increase in active shooter events. Between 2000 and 2006, there were an average of 6.4 active shooter incidents a year, according to FBI data. Between 2007 and 2013, that has jumped to 16.4.
Medics were kept from entering the movie theater in Aurora, Colorado, where 12 people were killed in 2012. Police officers took many of the victims to hospitals in their own cruisers. A similar scene played out last year at the Pulse nightclub shooting in Orlando, where 49 died and more than 50 were wounded, surpassing Virginia Tech as the deadliest mass shooting in U.S. history.
A Journal of the American Medical Association article attributed the impressive survival rate after the 2013 Boston Marathon bombing to EMS units already on scene and treating people while bomb blasts continued around them. Of the 264 people wounded, three died.
“It’s important for us to get to victims and stabilize them to give them a better chance of survival,” said Roanoke Fire-EMS Battalion Chief Marci Stone.
Roanoke Fire-EMS and police trained together for a rescue task force program a couple of weeks before a workplace shooting in October, when a gunman killed one person and wounded three others before turning the gun on himself at FreightCar America.
When Roanoke introduced the program, Stone said it was met with apprehension and resistance from some employees, who felt it was too risky.
“People were saying, ‘This is not what we signed up for,’ ” Stone said.
Smith said that reaction is not uncommon, but it’s often due to a lack of understanding about the risk involved in active shooter situations and how training mitigates risk.
An FBI analysis of active shooter incidents between 2000 and 2013 showed that 69 percent of the incidents ended within five minutes or less, so many were over before police and EMS arrived. Often, the shooter had already committed suicide, fled or someone else intervened.
Smith said that if police and paramedics want to save lives, they have to adapt.
“The bad guys change and adapt to our procedures, so we have to get out in front of them and be smarter than them,” he said. “This problem isn’t going away.”
By Amy Friedenberger
Police officers rushed to the second floor of Norris Hall on April 16, 2007, and found bodies strewn about. They began administering first aid until two tactical paramedics, who had arrived with SWAT teams, joined them about a minute later.
Responders affixed victims with red, yellow or green tags to note how severe their injuries were. Thirty-one deceased people — including the shooter — bore black tags. Paramedics and officers used various life-saving techniques to treat the wounded and carried them out of the building so they could be taken to hospitals.
State and medical officials have praised the effective work of responders that day at Virginia Tech. Their rapid medical intervention encouraged fire and EMS agencies to reconsider how they respond to mass casualty incidents, leading to the growing development of “rescue task force” programs across the country.
The traditional standard for responding to an active shooter incident is for fire and EMS to stage in a secure location away from the scene. Once police say the scene is secure, those waiting outside can come in and provide medical care.
But there’s a problem with that approach, experts say. Clearing a scene can take anywhere from minutes to hours, meaning people are dying when they might have a chance at survival.
“When fire departments say they’re going to stand by, that doesn’t cut it for citizens anymore,” said E. Reed Smith, operational medical director for Arlington County Fire Department, a pioneer in the rescue task force model. “For first responders, it doesn’t cut it anymore for us, either. This is our community, and we have to do something.”
Rescue task forces use rapid triage to stabilize life-threatening injuries and get victims away from the scene as quickly as possible. When an active shooter incident happens, the first police officers at the scene work to eliminate the threat, which could mean bypassing the dead and wounded. The rescue task force — medics outfitted with ballistics vests and helmets, with a police escort — soon follows. Paramedics focus on stopping bleeding, clearing airways and treating chest wounds.
Arlington County decided to work toward adding the rescue task force concept to its agency a year after the shooting at Virginia Tech.
“In these situations, we need to stop the killing and we need to stop the dying,” Reed said. “But our thought process changed when we realized these two priorities can occur in parallel. They don’t have to occur in sequence.”
The quick arrival of the SWAT teams and tactical medics at Norris Hall occurred mostly by chance, according to the state’s official report on the shootings. After the discovery of the two murdered students in a dorm room earlier that morning, Blacksburg and Virginia Tech police called up their SWAT teams. Each team came with a tactical medic.
When the shootings at Norris Hall began, the SWAT teams went there, allowing for the two medics to make contact with victims more quickly. Additional EMS units staged outside.
But that’s not how quickly SWAT teams normally work. They can take nearly an hour to assemble and arrive to an incident. The tactical paramedics typically are not there immediately to help the wounded; they stick with the SWAT teams to ensure that officers are healthy.
‘This problem isn’t going away’
SWAT teams were created in response to the 1966 sniper attack at the University of Texas at Austin, in which a gunman killed 14 people.
Columbine led to a tactical overhaul.
When the Columbine school shooting happened in 1999, police and paramedics waited outside for a SWAT team to arrive as the killing continued inside.
After the tragedy, police across the country developed active shooter training that called for the first responding officers to rush toward the gunfire, past the victims, and stop the gunman first. SWAT teams would follow. At Virginia Tech, three of the first five officers who entered the classroom building were trained to deal with an active shooter, according to the official report.
The fire and EMS profession largely didn’t change following Columbine.
The Blacksburg Volunteer Rescue Squad started thinking about how it could better respond to mass casualty incidents a few years before the Virginia Tech shootings, said Chief David English. The rescue squad, with about 125 EMS volunteers, formalized the program within the past several years and has helped surrounding agencies learn how to implement similar models.
“There are always medical people who want to go in and help, so we figured that it was important that we get them trained and give them the right equipment and knowledge so they do it safely and effectively,” said English, who was a responder to the Virginia Tech shootings.
The rescue task force was deployed in 2013 when a New River Community College student opened fire at the New River Valley Mall in Christiansburg, wounding two people. Fortunately, English said it isn’t deployed often.
The need for a change in the fire and EMS field has become more urgent with the increase in active shooter events. Between 2000 and 2006, there were an average of 6.4 active shooter incidents a year, according to FBI data. Between 2007 and 2013, that has jumped to 16.4.
Medics were kept from entering the movie theater in Aurora, Colorado, where 12 people were killed in 2012. Police officers took many of the victims to hospitals in their own cruisers. A similar scene played out last year at the Pulse nightclub shooting in Orlando, where 49 died and more than 50 were wounded, surpassing Virginia Tech as the deadliest mass shooting in U.S. history.
A Journal of the American Medical Association article attributed the impressive survival rate after the 2013 Boston Marathon bombing to EMS units already on scene and treating people while bomb blasts continued around them. Of the 264 people wounded, three died.
“It’s important for us to get to victims and stabilize them to give them a better chance of survival,” said Roanoke Fire-EMS Battalion Chief Marci Stone.
Roanoke Fire-EMS and police trained together for a rescue task force program a couple of weeks before a workplace shooting in October, when a gunman killed one person and wounded three others before turning the gun on himself at FreightCar America.
When Roanoke introduced the program, Stone said it was met with apprehension and resistance from some employees, who felt it was too risky.
“People were saying, ‘This is not what we signed up for,’ ” Stone said.
Smith said that reaction is not uncommon, but it’s often due to a lack of understanding about the risk involved in active shooter situations and how training mitigates risk.
An FBI analysis of active shooter incidents between 2000 and 2013 showed that 69 percent of the incidents ended within five minutes or less, so many were over before police and EMS arrived. Often, the shooter had already committed suicide, fled or someone else intervened.
Smith said that if police and paramedics want to save lives, they have to adapt.
“The bad guys change and adapt to our procedures, so we have to get out in front of them and be smarter than them,” he said. “This problem isn’t going away.”
