Target Audience

The Attack One crew members find the child in the basement; he is awake and alert, although pale and tachycardic. He has a single wound to his right upper leg, but it does not look like a bullet wound. There is moderate bleeding, and he has a weak distal pulse in that leg. No other wounds are found. His bleeding is controlled by direct pressure. There is no gunpowder staining of the wound.

The Attack One crew leader assigns his crew to dress the wound, the paramedic to set up and start an intravenous line in the ambulance, and everyone to expedite a rapid load and transport to the hospital.

He communicates with the battalion chief: “Sir, our victim is red category, and we are initiating transport. I will serve as transport director and assign crews as they complete assessments of the other victims.”

“Command to transport,” the chief responds. “Clear on your duty to assign crews as they complete assessments of other victims. You are also to track victim names and where they were injured and transported from. I have assigned a captain as safety officer, and another as liaison to the police department. The shooters are unknown, and there may be further victims. I have requested a total of 10 ambulances, and a lieutenant is serving as staging officer, with the resources staged at the local police precinct parking lot.”

Then a fire officer from the first-arriving engine at another scene calls in.

“Main Street Sector to Command,” he reports, “we have two victims at this bar; one is a police officer. He is red category, and the other victim is yellow. Requesting two ambulances immediately and another to stand by, as we still have a lot of police activity here.”

“Main Street Sector, clear on two victims, one red and one yellow,” Command responds. “Assigning you Medic One and Medic Four immediately, and Medic Six will be your third ambulance in. Contact transport director for transport destination. Operate with your crew safely, and take cover immediately if further violence occurs. A safety officer has been assigned.”

The other first-arriving crews report to Command, and ultimately the tally is seven victims being assessed by fire-EMS personnel. They are scattered across five locations in the neighborhood.

“Liaison officer to Command,” the captain working with the police leadership calls in. “One of the current victims is likely one of the shooters. There are at least three other suspects in a car that are not in custody, and there is a potential for more victims and high-risk police activity. Police are interviewing the suspect in custody.”

Then, from the Medic Two crew leader: “High Street Sector to Command, we have assessed that victim, who is yellow category and stable, and in police custody. They are interviewing him, so our transport will be delayed. We will have two police officers accompany us to the hospital.”

“Command to High Street Sector, clear on one yellow victim in police custody, and per protocol make sure there is at least one officer in the patient compartment with you, and he has no weapon, but has keys for the handcuffs. Have a squad car follow you to the hospital. Transport director will assign the hospital.”

“Transport director to Main Street Sector and High Street Sector,” the Attack One crew leader comes back. “Each of your victims is to be transported to the trauma center, which has been notified. No radio traffic is needed to them. Security has been notified at the hospital.”

One by one, the other victim reports crackle across the radio. Six of the victims will be transported to the trauma center, and one yellow victim will go to a nearby hospital.

The paramedic caring for the police officer returns with some critical information: “Main Street Sector to transport director, the police officer is red category, and we need the trauma center to be prepared for his care. He has a bullet wound to his left upper leg that was bleeding profusely, and another officer applied a belt to tourniquet the wound. We replaced that with a formal tourniquet, as we cannot control the bleeding with direct pressure. His vest was struck several times in the abdomen and chest, but he has no visible wounds to the torso, and no tenderness. He is awake and talking with us, but is in significant pain in the left leg.”