Expo Opens With Focus on Mass Shootings

Expo Opens With Focus on Mass Shootings

By John Erich Oct 18, 2017

With a somber nod to the deadliest mass shooting in U.S. history and a detailed postmortem of last year’s last deadliest mass shooting in U.S. history, EMS World Expo officially kicked off Wednesday in Las Vegas.

Amid the normal Expo merriment, the Las Vegas Strip massacre of October 1 set a grim context for the opening ceremonies and keynote remarks. The first speaker, Clark County Fire Chief Greg Cassell, credited the familiar necessity of relationships for his department’s successful response.

“If you don’t have rock-solid relationships [with police, hospitals and other disaster players], take that away” from the show, Cassell said. “It paid off tremendously for us on October 1.”

Specifically, Clark County Fire—in whose jurisdiction the Route 91 Harvest Festival occurred—has worked closely with local law enforcement under a framework known as MACTAC (for multi-assault counterterrorism action capabilities). Department personnel teach things like ICS and command and control at the police academy; LEOs in return offer “PD 101” classes with insight into their operations for fire and EMS personnel. The result has been both operational and personal familiarity that’s essential for complex responses.

The second keynote speaker, Orlando physician Christopher Hunter, MD, PhD, revisited the topic with a review of last year’s Pulse nightclub shooting. Hunter’s duties that night included serving as associate medical director for Orange County EMS.

He noted a couple of key aspects that helped limit the Pulse body count, including the proximity of Orlando Regional Medical Center (just 600 yards away) and a fire station across the street. The initial EMS response was very fast, he noted, and between EMS, police and civilians, large numbers of victims were transported quickly to definitive care.

ORMC initially received 38 patients in 53 minutes, including at one point 26 in 26 minutes. A second patient wave occurred after police breached into the club and resolved the ensuing hostage scenario.

Hunter noted the situational awareness of nearby resources as a key to Orlando’s response. He also credited a simplified triage process and lack of on-scene interventions such as intubations and IVs. “There was nothing we could have done on scene for most of these patients,” he said.

Of 57 Pulse victims transported, 15 were taken by the police. This echoed the 2012 Aurora, Colo., movie theater shooting, where LEOs accounted for 16 of 27 victim transports, and EMS only 3. Hunter cited a 2016 study that found victims of penetrating trauma transported by police were no more likely to die than those transported by EMS. “We know what will happen in MCIs,” he said, “so why not engage [your law enforcement colleagues now]?”

Other things went right in Orlando: ORMC closed to all non-Pulse patients and staffed up for the surge. They brought hospital stretchers to the doors to take patients, allowing faster turnaround by those bringing them; this helped result in a relatively small number of vehicles moving a large number of victims.

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Among the lessons learned: the importance of family reunification efforts, which must start quickly; and dealing with the crush of national media, which required medical personnel to become immediate experts on patient privacy laws.

Prior to Hunter, Emergency! star Randolph Mantooth offered a more inspirational paean to emergency responders, particularly those in Vegas. He credited “second responders”: the doctors, nurses and other ED staff who helped care for victims; “third responders,” the citizens who saved and sheltered victims and lined up in the wee hours to donate needed blood; “fourth responders,” the other citizens who brought them food and water while they waited; “fifth responders,” the airlines, hotels and restaurants that offered free goods and services to victims’ families; “sixth responders,” the hospitals and ambulance services that waived fees; “seventh responders,” local clothing retailer Zappo’s, which covered all the deceased’s funeral costs; and “eighth responders,” the county commissioner whose GoFundMe for Vegas victims raised $10 million in a week.

Mantooth paraphrased veteran EMS provider, author and sage Thom Dick in noting that you can teach providers skills, but not what they must have in their hearts to do the job. “Courage, compassion, caring—it’s in your DNA,” he told attendees. And while people may not remember exactly what you did for them, they will always remember how you made them feel in their hour of need.

EMS World publisher Scott Cravens announced a donation by parent company HMP Communications to the Las Vegas victims’ fund and noted that some in attendance may someday respond to the next deadliest mass shooting in American history—a good reason to maximize the learning at events like Expo.

The opening ceremonies also featured the presentation of the annual National EMS Awards of Excellence. The winners:

  • NAEMT/Nasco Paramedic of the Year, Terry Bottjen, Faith, SD;
  • NAEMT/Braun Industries EMT of the Year, Ryan Houser, Morristown, NJ;
  • NAEMT/North American Rescue Military Medic of the Year, Sgt. Jacob Ponczkowski, Joint Base Lewis-McChord, Wash.;
  • NAEMT/Jones & Bartlett Learning EMS Educator of the Year, Ginny Renkiewicz, Fayetteville, NC;
  • Dick Ferneau Career EMS Service of the Year, Allina Health EMS, St. Paul, Minn.;
  • ZOLL Volunteer EMS Service of the Year, Greenlawn Fire Dept. EMS, Greenlawn, NY.

Read more about these deserving providers and services here.


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