Since our “boots on the ground” experience during the October 1, 2017 mass shooting at the Route 91 Harvest festival in Las Vegas, Community Ambulance is all too aware of the devastation active shooter incidents can create. Not only did our personnel treat the wounded and dying, but our special-event crews also came under personal attack, with bullets raining down all over the concert area. Luckily, no one in the company’s employ was injured, at least physically.
Company directors have also learned from other EMS agencies about MCIs where attackers have used vehicles as weapons and violence has been perpetrated against all types of first responders during EMS calls. As 9-1-1 providers in Clark County, Nev., Community’s personnel find themselves standing by at domestic violence calls and other police incidents more than ever. For all these reasons company leaders are highly engaged with addressing the issue of potential violence before, during, and after both scheduled and unscheduled events. And in 2020 company leaders’ commitment to ensuring safety extended to an extra push to practice meticulous infection-control measures for COVID-19.
A Role in Reopening
Last year marked a unique time in Las Vegas’s EMS history where special-event medical services leaders came to consider COVID-19 as its own event. Las Vegas relies on tourists and locals to frequent its hotels, casinos, and especially the year-round schedule of large events that help make Las Vegas an international vacation destination. Community Ambulance’s special-event staff plays a crucial role as the community attempts to reopen all these properties and venues safely. And, after proving the value of EMS’s help in planning for and conducting reopenings—including thousands of COVID-19 assessments, COVID testing, and hundreds of vaccine inoculations for one of the world’s most famous cities—Community Ambulance has earned a seat at the emergency management table. It is a trusted consultant and reopening on-site implementer for many venues across Clark County.
“It is because of our experience with testing and treating COVID-19 patients and our approach to planning,” says Glen Simpson, director of special operations for Community’s Special Event Medical Services Division. “With events we now spend more time than ever weeding out every contingency. Our efforts in helping reopen Las Vegas events have included extensive ‘what if?’ tabletop exercises that factor in infection control; violent incidents; event participant, attendee, and VIP safety; and EMS crew safety and resilience.”
During event preplanning with venue managers and producers, Simpson and his staff offer perspectives based upon what they know about responding to medical emergencies at events. Now, being especially concerned about COVID-19, they are educating these nonmedical professionals, giving them information about infectious diseases like COVID-19, making sure everyone understands how they are spread, and offering up-to-date CDC recommendations. Stop the Bleed has also been a given community education topic for the last three years.
As Las Vegas cautiously reopens, event planning needs have become even more complex. Since June 2020 Community Ambulance has hired at least 40 new employees, at least 20 of whom serve as nonmedical “ambassadors” who assist with COVID-19 testing of hotel/venue employees and hotel guests. Since the Las Vegas Strip’s local sports arenas and stadiums are sequestering attendees in seat “pods” and event participants in sports “bubbles,” event medical staffing is threefold pre-COVID demands.
In addition to increased staffing, Simpson and his managers also play an instrumental role in innovating ways to keep event attendees from wandering from one “pod” to another, where they might potentially cross-contaminate. They are also innovating ways to quickly isolate and move patients. Now they are locating paramedic-staffed first aid stations in areas where they can minimize cross-contamination risk among event staff and the company’s own employees.
Not today! is the Community Ambulance motto for not getting hurt at work, and it is reinforced before all crews’ shifts daily. During this COVID-19 crisis we approach every patient as if they have an infectious disease.
“We operate with the notion that ‘if it’s wet and it isn’t yours, don’t touch it (without gloves on),” says Simpson.
Wearing ballistic gear is an employee option, and so is easy access to psychological counseling. And when the company’s EMS providers are told to “hold short” by dispatch or law enforcement personnel, that is not optional, no matter what. In fact, there are radio codes to use if crews need an extra pair of hands at a scene and another that calls for law enforcement and immediate company help if crews come under attack.
Simpson credits interagency cooperation for fostering and maintaining great working relationships with both fire and police on the front lines as well as among the company’s leaders and Clark County’s fire chief, sheriff, and Metro police chief counterparts. Everyone in the Las Vegas Valley works from the “same sheet of music” when it comes to incident command. All first responders have each other’s backs when a patient encounter goes south or a large-scale incident occurs. When you see #VegasStrong on every ambulance, fire apparatus, and police cruiser, it is easy to see how unified the first responder community is after getting through the trauma of 2017 together. We have truly earned that term.
“In our industry there are a lot of tough guys and gals who look out for one another,” says Simpson. “No one could have fathomed the 1 October mass shooting would happen. But when it did our Community Ambulance family and the whole first responder community rushed in to help. We were all in harm’s way. There wasn’t anywhere around that scene that was truly safe. Yet they came anyway, holding short but there in spirit and taking care of those carried or dragged to the street.”
The downside of having everyone at the company painfully aware of the dangers of guns, vehicles, chemicals, and even fireworks as weapons is the added stress when employees truly understand how easy it can be to get hurt at work. They see police preparing for violence during every traffic stop and domestic complaint. Violence against EMS personnel has risen, and far too many EMTs and paramedics nationwide have become infected and/or died from COVID-19. Yet it remains the job of EMS to respond to all calls for help, for victims and victimizers alike. That’s why company leaders at Community Ambulance do all they can to support employees’ safety attitudes and practices, offering them the education, PPE (including ballistic gear), good medical equipment, and the individualized psychological support they need.
“Even though our company has been through a lot and worked to adapt,” says Simpson, “we don’t have it all figured out. We will keep on learning, though, and continue to commit to our ‘Not today!’ motto.”
Sidebar: Standby Services and More
A premier provider of medical standby services for Las Vegas’s dynamic and world-renowned sports and entertainment scene, Community Ambulance has served Southern Nevada for more than 10 years. Locally owned and operated and CAAS-accredited, the company fields more than 300 employees and more than 40 ambulances. It offers both emergent and nonemergent medical services, including advanced life support and critical care transport, as well as neonatal, flight, and long-distance transports.
Community’s Special Events Division has provided medical management and support for high-profile venues and events such as the Electric Daisy Carnival and Route 91 Harvest music festivals, Wrangler National Finals Rodeo, events at Allegiant Stadium, and more. For more see communityambulance.com.
Glen Simpson is director of special operations at Community Ambulance in Henderson, Nev.
Janet E. Smith is an EMS consultant and president of JS&A On Assignment.