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Crisis leadership at mass violence incidents

Four primary lifesaving missions that fire service leaders need to manage mass violence

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Police, fire and EMS chiefs, along with hospital doctors, are asked to exercise crisis leadership by connecting, collaborating and coordinating with each other to cope with the various aspects of active shooter incidents.

AP Photo/Peter Dejong

By Assistant Chief Joseph Pfeifer, FDNY (Ret.)

When visiting Paris, we think of climbing to the top of Eiffel Tower, wandering around the largest museum in the world at the Louvre, viewing beautiful Gothic cathedrals, and eating delicious food in French cafes.

After the Nov. 13, 2015, terrorist attacks on Paris, my visits were even more incredible, as I met with those who had to live through the ordeal.

I sat with some of the hostages from the Bataclan. They described what it was like being held by terrorists who had just killed 130 people, (89 in the Bataclan alone) and were pointing their Kalashnikovs (AK-47s) at them.

I spoke with the SWAT team of the BRI (Brigade de Recherche et d’Intervention) and heard stories from the police officer who carried a large metal and ceramic shield that took 25 rounds from assault rifles as they entered a narrow hallway to rescue the hostages.

Fire chiefs and their firefighters from the Paris Fire Brigade told me how one of their fire trucks took a bullet as they desperately tried to stop the bleeding of victims. And French doctors talked about the door to their trauma center constantly opening, as an endless stream of critically injured patients flowed inward.

Mass violence forms crisis leaders

From these stories comes an understanding of how mass violence incidents form crisis leaders.
Extreme events not only require the skills to manage incidents but also demand crisis leadership. Police, fire and EMS chiefs, along with hospital doctors, are asked to exercise crisis leadership by connecting, collaborating and coordinating with each other to cope with the various aspects of active shooter incidents.

It has become a first responder cliché to “stop the killing and stop the dying,” but to do this takes courage, teamwork and leadership. Every day we see courage displayed by our first responders. It is up to us chiefs to demonstrate teamwork and leadership to make sure the injured and rescuers can go home to their families.

Connecting decision-makers

Teamwork begins with connecting decision-makers to critical information for situational awareness. Leaders need to ensure that information is shared at the scene and that Emergency Operations Centers connect to develop a common operational picture. This is especially important when multiple events are occurring simultaneously.
Next, crisis leaders set the condition for collaboration. This is done by introducing yourselves to your counterpart and articulating that you are willing to share the risk of making tough decisions. Incident commanders from fire, police and EMS must stay within arm’s distance of each other. If they are across the street from each other, they will not talk. However, setting this simple condition of co-locating commanders within arm’s distance will dramatically enhance collaboration and coordination. Without collaboration, there is no coordination. Crisis leadership is like real estate; it is all about location, location, location.

Four primary lifesaving missions

At active shooter incidents, ICs must exercise leadership by coordinating across four primary lifesaving missions:

  1. Engaging the shooters
  2. Creating warm zones
  3. Deploying Rescue Task Forces
  4. Transporting victims

Complete the form on this page to download a copy of the four primary lifesaving missions of crisis leadership to keep and have with you.

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Engaging the shooters: Ever since the 1999 Columbine shooting in Colorado, law enforcement has learned that quickly engaging the shooters saves lives.

Hearing the gunfire at the Bataclan, two police officers with 9mm handguns entered and quickly engaged the shooters. One police officer firing his weapon hit one of the terrorists in the chest, which caused his suicide vest to detonate. The other two terrorists retreated to the second floor and took hostages. The action by these officers stopped the killing in the Bataclan.

During the engagement phase, it is crucial to have paramedics standing by to take care of any injured officers. These activities may occur before the formation of a Rescue Task Force (RTF).

Creating warm zones and deploying RTFs: An important lesson learned from mass shootings is for fire and police departments to form RTFs that can enter a warm zone as quickly as possible to stop the dying by providing emergency medical care. Even with police force protection and fire personnel ready to go, there are questions: Who decides when to change an area from hot to warm? How is this done without falling into the same Columbine dilemma of waiting too long for a SWAT Team to declare the area warm?

After many full-scale exercises between FDNY and NYPD, we learned that it is a best practice to assign a law enforcement officer with the authority to create a warm zone. This police officer needs a team whose only mission is rapidly designate warm zones. Think of this as if it was a distribution of work at a fire scene. Engine companies extinguish the fire, while ladder companies search for victims.

At an active shooter incident, patrol and SWAT officers engage the shooter(s), while the Zone Team creates a warm zone, so an RTF can be deployed to do patient care.

Developing a policy to create a warm zone rapidly is the next evolution in active shooter procedures. The critical element for this to occur is to designate a separate team to push for warm zones aggressively.

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FDNY firefighters and EMTs quickly move a gunshot wounded patient from the warm zone to the ambulance at a full-scale exercise in New York City.

Transporting victims to selected trauma centers and hospitals: While continuing to treat the patients, the last lifesaving mission is to transport the patients to a trauma center or hospital immediately.

It was not that long ago in France that they debated whether they should stay and play (do advance medical care at the scene) or scoop and go (rapid transport patients to hospitals).

From the 2015 incident and other shootings incidents with assault rifles, we have learned that the best chance for survival is to get the patients to the operating room as fast as possible. The public also knows this and will seek any means for transportation, whether it is by ambulance, taxi or private vehicle, often overloading the nearest hospital.

As patients arrive, each hospital needs to institute a Hospital Incident Command System. From my conversations with trauma center doctors, there are at least four critical positions: 1) The hospital executive is the IC for the hospital; 2) the Trauma Center Director is the Operations Chief, who manages a 3) Triage Leader and 4) Clinic/Operating Room Coordinator.

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As the skills needed for attacks decrease, the probability of mass violence increases.

Doctors are great under stress to take care of patients, but they are uncomfortable in the role of incident management. Every hospital needs to train its medical staff to manage extreme events.

Anticipate future events

Before a crisis, chief officers must anticipate future extreme events. We can project that the probability of mass violence will increase as the skills needed to carry out these attacks decrease, and the availability of weapons is easily attained.
On 9/11, it took a lot of skill and money to use commercial airlines as weapons against high-rise buildings. But taking over a plane was done with readily available weapons. Today, the probability of using planes as missiles is lower because acquiring the skills and carrying weapons onto a plane is more difficult to attain.

However, it does not take a lot of skill or money to acquire and use assault rifles with large-capacity magazines for mass murder. Therefore, we can anticipate more mass violence.

Our job as chiefs is to always think of the safety of our first responders and the public. We do this through preparedness efforts and joining together to lessen the probability of these attacks.

Complete the form on this page to download a copy of the four primary lifesaving missions of crisis leadership to keep and have with you.

About the Author

Assistant Chief Joseph W. Pfeifer retired from the FDNY as the Chief of Counterterrorism and Emergency Preparedness after 37 years. He is a Senior Fellow for Crisis Leadership at the Harvard Kennedy School and the Combating Terrorism Center at West Point. Pfeifer is also the Director of Crisis Leadership at Columbia University. He writes frequently and is published in various books and journals.

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