Updated Nov. 21, 2017
In 2016, at the age of 96, Dr. Henry Heimlich used the maneuver that bears his name to save a choking victim for the very first time.
I spend a fair amount of time in restaurants and have only twice had a potential choking victim – both recovered as I was moving toward them. I know firefighters who have made choking saves, but most of us haven’t.
Likewise, despite heart attacks and sudden cardiac arrest being a leading cause of death, how many of us have performed CPR as a bystander? I haven’t.
Yet, nearly every firefighter is trained and regularly recertified in CPR and the Heimlich maneuver – those who aren’t, should be.
The string of mass shootings and bombings in recent times is a stark reminder that we need to prepare for what we don’t expect will happen on our watch.
Mass shootings should make every firefighter ask, “What if it happens here?” By now, most jurisdictions have a mass-casualty, active-shooter response plan in place. But those plans need constant re-evaluation and adjustment; here are four items to help with that.
1. Plan and practice with other agencies
It is often emphasized that you don’t want your first meeting with an outside agency to be on an emergency scene. Yet just as important as being able to work with police and private ambulance companies, will be the inclusion of local hospitals and other medical facilities that may be pressed into action to receive a large numbers of casualties.
Likewise, if there are weak or nonexistent mutual-aid agreements with surrounding jurisdictions, get those shored up. And if those agreements have been withdrawn over political differences or financing, be sure everyone agrees to shelf those differences for major incidents and that help will come.
If you’re not in a large metropolitan area, the chances are greater that you’ll be called in as a mutual-aid agency to assist another community. And that too, must be prepared for with training and agreements.
2. Plan for resource deployment
Well-coordinated attacks, also known as hybrid targeted violence, like the one that took place in Paris, can cover multiple sites. Even if it is a single-site incident, car crashes, trash fires, chest pains and all of the other “routine” calls will not simply cease.
This ties back to having a plan and a relationship with outside agencies that will be called. In some cases, it will make sense to hold back local crews who are most familiar with the jurisdiction and deploy mutual-aid units to the mass-casualty scene.
3. Plan for rehab in a mass violence event
Mass-casualty calls are physically and mentally draining. Fatigued firefighters and medics do not perform at their best. Have a plan for cycling them through a rest area for long-running incidents and have professionals on hand to help them cope with the emotional strain.
For departments without a solid critical incident debriefing team or process, sources from outside the jurisdiction are available. Many states have teams they can dispatch.
And larger cities will often lend their teams in times of tragedy. For example, Boston dispatched a team of therapists to help Orlando firefighters and medics in the wake if the shooting.
4. Train like it matters
Not everyone has the skills or make up to be a tactical medic who enters the hot zone with SWAT units. And frankly, if you’re not a SWAT member or tactical medic, mass-shooter trainings can be real sleepers.
Organizers can look for ways to add stress to the trainings to heighten realism, especially for those tasked with triage or moving patients on cots.
Dr. Heimlich went 42 years before first using his maneuver on a real victim. Hopefully, we can go our entire lives without having to respond to a mass shooting or other act of terrorism.
Yet, being ill-prepared is no longer a responsible option; training for it like it’s a basic skill is the new reality.
