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Training for a firefighter mission shift: Mass casualty incidents

The role of the firefighter is changing as mass shootings, natural disasters and mass casualty events increase in frequency, requiring additional training


Today, we must prepare for the increase in frequency of low frequency, high intensity events.

Photo/Greg Friese

By David Cain, FireRescue1 Contributor

Times are changing and they are changing fast. The world where firefighters are concerned is also changing fast. In fact, the mission is changing and the term fire department doesn’t really tell the whole story.

The term has already made a shift by adding “rescue” to our title. Almost all fire departments run more medical calls than fire calls. And, the number of actual structure fires is down in many areas.

So, what is shifting? Does the public expect more and do they understand the scope of work within a fire department? Over time, many fire departments have added dive teams, hazmat teams, trench and confined space rescue, wildland teams and tactical teams.

Early in my career, I never thought that I would be one of the first SWAT medics to work hand in hand with the police department. It was a very intense job that required me to work with a bunch of guys who loved to jab at firefighters. The training was tough and the gear was heavy. I loved it and can say that it showed me a completely different side of being a cop.

But more important, the tactical medic program built a solid relationship between the police and fire departments. The bottom line is that this was a mission shift. Today, many agencies have fire medics assigned to SWAT teams.

Later in my career, I became a terrorism logistics officer for the city. In this position, I received a clearance that allowed me to get intel on various goings-on in the state and country. Over time, I began to see the shift that would eventually impact fire departments. The events of 9/11 led to the first big shift.

Unfortunately, the disconnect between the fire department and the police department was a signal that things had to change. The emergency service agencies had to move toward cooperation and intelligence sharing.

An increase in active shooter events

Today, we must prepare for the increase in frequency of low frequency, high intensity events.

Emergency response is a mutual response between police, fire, EMS, feds and other resources. We can no longer stick our heads in the sand and think this problem is going away. We must educate ourselves, learn from the past, and become ever-more prepared to address the present and future.

Looking back at domestic events is a stark reminder and predictor of some of what we can expect going forward:

Locally, I remember a shooting at a Chuck E. Cheese restaurant back in 1993 that killed a number of people. At that time, the event stood out as highly significant because of the relative infrequency of these types of events.

Now, the active shooter has become a routine event in America and throughout the world. In many cases, abject horror and disbelief have been replaced, at least in part, by acknowledgement that these types of occurrences have become commonplace in everyday life.

There were 160 particularly high-profile shooting incidents from 2000-2013. The trend toward such events is increasing. During the 13-year period, 486 people were killed, 557 wounded. We know that 45.6 percent of these events happened in commercial environments and 24.3 percent happened in educational environments.

On top of this, gang activity and crime are ever present. Natural disasters continue to hit us hard. Hurricanes, floods, wildfires, political upheaval and civil unrest continue to challenge our response. These events are opportunities for bad people to do terrible things.

There are articles and books (e.g., from Lt. Col. David Grossman) about the nature of wolves in our society. Humans can be classified as sheep, wolves and sheepdogs. The sheep are the good people who just want to live a peaceful life. Wolves, on the other hand, feed on the sheep. And, in between are the sheepdogs – soldiers, cops, and even firefighters and EMS providers. Make no mistake, the wolves are out in force and increasing in population and destructive power. The notion of “it will never happen here” is foolish and reckless – akin to a sheep putting its head in the sand and hoping for the best.

In many cases, the low frequency and high intensity calls are very complex. Responders must understand the nature of what is at hand and what they may face. Most of us, including myself, have not seen large scale death and destruction. The wildfires in Colorado left a vivid impression in my mind. And, I will never forget seeing so many people lose it all. Today, the media has brought to light how terrible things can be when disaster strikes. The images and videos bring all the horror to our homes.

In the case of an active shooter or shooters, the danger to first responders can be hidden. Most shooting events are over in 10 to 15 minutes, but in the Columbine school shooting, the attackers set bombs in dumpsters. The motive was clear – attack and kill the first responders.

It is not only the active shooter, but hurricanes, tornadoes, riots, wildfires and other events that make the front page of the news. Right or wrong, disasters always make good news stories. In the middle of all this chaos are the first responders. And to their peril, many are not trained or prepared to deal with all the complicated variables that can harm them.

About the author
David Cain is a retired deputy chief with the Boulder (Colo.) Fire Department, where he served for 34 years. He works as a consultant for, a technology service that helps fire departments across the country automate their apparatus, equipment and inventory checks.