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Uvalde aftermath: What should we do today?

“Sadly, this isn’t the last time we will see these headlines, but for us, today, put the tourniquet away and focus on the heart and soul of those in our charge.”


Emergency personnel tell people that Uvalde High School is secure after a school shooting at the nearby Robb Elementary School in Uvalde, Texas.

William Luther/San Antonio Express-News/Zuma Press/TNS

Another profound American tragedy occurred on Tuesday afternoon. In the town of Uvalde, 85 miles west of San Antonio, at least 19 children and two adults were killed in a shooting at Robb Elementary School.

The suspect, an 18-year-old student at Uvalde High School, is also dead. This person – who shall remain nameless, so as not to attract notoriety – also shot his grandmother before the school killing spree.

I could go on to author an essay, reminding all of the need to redouble our efforts to stop the bleed, to check our tactics, techniques and procedures (TTPs), plans and drills for the response to active shooters, and ensure that we are ready for the next MCI, but today is different.

In the fire and EMS community, our demographics suggest that the younger generation of providers have children of their own and the older members have grandchildren. We can all visualize how we would feel if it were our town, our community, our children. While the 15,000-strong population of Uvalde are waking up to the aftermath of this event, we need to open our eyes to the human and emotional aspects of what being a firefighter or EMS provider in the era of this repeating hell means to us.

Consider the physical and emotional effects on the medics and other public safety personnel that responded. It would be fair to say that this would have been a once-in-a-lifetime event for providers in a small town where everyone knows each other, and the prospect of having to return to the station and provide emergency response all over again today is unbearable.

The effects on any team in this situation may result in post-traumatic stress injury; profound effects on home life, relationships, depression and substance abuse; and may extinguish the desire to continue to serve the community in the future.

What can we do today?

Of course, we can immediately share a thought, a prayer and lower our flag to half-staff, but we should also ponder how we look after the team that we have around us and identify if we have all the things in place to ease the grief, pain and emotional injury that would inevitably come after such an event.

This morning’s checklist may well consist of the following:

  • Critical incident debriefings/therapy. Do you have a team in place or the ability to call in specialists (a regional team) to conduct such debriefs? Are they trained and prepared? Critical incident stress debriefing (CISD) is designed to allow people to talk about the traumatic event and how it is affecting them, allowing participants to share their descriptions, thoughts and feelings in a safe and non-threatening environment. Can you mount such a session at short notice?
  • PTO policy. In the event of a major incident where crews have been exposed to unfathomable levels of emotional and real trauma, what is the convention for providing time off, paid or otherwise? Does the Employee handbook need to be revised to consider such an event?
  • Chaplaincy. Does your organization have a chaplain? How would you utilize their services? In a recent article, EMS Chaplain Russ Myers wrote, “The role of the EMS chaplain is to support the paramedics, EMTs and dispatchers who serve our communities. EMS professionals serve in a job with a lot of emotional weight from the cumulative stress of caring for people in need; with a critical incident; a routine call that suddenly becomes urgent, and the sights, sounds and smells associated with an emergency call.” This is exactly what is needed after a critical incident – if you have one.
  • Employee assistance plan (EAP). Once the immediate event is over, what does your EAP cover – do you even have one? An EAP is part of an employer’s commitment to promoting employee health and wellbeing. It is usually offered at no charge and provides a valuable resource for support and information during tough times, as well as consultation on day-to-day concerns. An EAP usually consists of an assessment, short-term counseling and referral service designed to provide employees and their families with assistance.
  • Employee wellbeing. To prepare employees for events and scenarios that may occur tomorrow, assess how you are looking after them today. Does their package include reasonable compensation and retirement plans? Is the organizational culture conducive to maintaining a decent work-life balance? Do you offer affordable health insurance plans, wellness programs, training and development, tuition reimbursement and access to coaching and mentoring?

Management by walking about

The morning after a cumulative mass trauma is also a time for leaders to lead; to be present; to offer support, encouragement and reassurance. If there was ever a time for enacting management by walking about (MBWA) this would be it.

Out in the rest of the country, right about now, armchair quarterbacks, media commentators, politicians and special interest groups will begin the circular discussion of arms prohibition versus constitutional rights. We know the arguments. We hear them every time, and the fact that we can recite them is testimony to the frequency of such tragedy and violence. Sadly, this isn’t the last time we will see these headlines, but for us, today, put the tourniquet away and focus on the heart and soul of those in our charge.

Learn more about supporting members’ mental health

Support your members in times of crisis, and plan for trauma with the following FireRescue1 resources:

Rob Lawrence has been a leader in civilian and military EMS for over a quarter of a century. He is currently the director of strategic implementation for PRO EMS and its educational arm, Prodigy EMS, in Cambridge, Massachusetts, and part-time executive director of the California Ambulance Association.

He previously served as the chief operating officer of the Richmond Ambulance Authority (Virginia), which won both state and national EMS Agency of the Year awards during his 10-year tenure. Additionally, he served as COO for Paramedics Plus in Alameda County, California.

Prior to emigrating to the U.S. in 2008, Rob served as the COO for the East of England Ambulance Service in Suffolk County, England, and as the executive director of operations and service development for the East Anglian Ambulance NHS Trust. Rob is a former Army officer and graduate of the UK’s Royal Military Academy Sandhurst and served worldwide in a 20-year military career encompassing many prehospital and evacuation leadership roles.

Rob is a board member of the Academy of International Mobile Healthcare Integration (AIMHI) as well as chair of the American Ambulance Association’s State Association Forum. He writes and podcasts for EMS1 and is a member of the EMS1 Editorial Advisory Board. Connect with him on Twitter.