Case study: Fire department response to a Cincy mass shooting

The incident command structure and coordination with multiple hospitals saved lives

In the early morning hours of March 26, the Cincinnati Fire Department and mutual aid units from Hamilton County fire departments responded to what has been labeled the worst mass shooting in that city’s history and the largest mass shooting so far this year in the United States. 

An estimated 200 to 250 people were attending a late-night rapper dance at the Cameo nightclub in the far eastern portion of the city. It appears that what started as an altercation ended in a melee by at least three shooters who killed two patrons, one alleged to be one of the shooters, and wounded 15 others.

According to records from the Hamilton County Auditor’s Office, the club was built in 1956 as a restaurant that overlooked both a marina on the Ohio River and the main runway of Cincinnati’s Executive Lunken Airport. The restaurant, along with a small office, totaled 17,000 square feet situated on approximately 3.5 acres. 

Members of the ATF and local police work at a crime scene at the Cameo club after a fatal shooting, Sunday, March 26, 2017, in Cincinnati.
Members of the ATF and local police work at a crime scene at the Cameo club after a fatal shooting, Sunday, March 26, 2017, in Cincinnati. (AP Photo/John Minchillo)

The building was sold in 2005 and converted to a nightclub that has changed names and clientele three times since then. The most recent change was to the Cameo, a favorite dance spot for people between the ages of 18 to 30.

Over the past two years, the club had experienced two shootings, one in the club itself and the other in a large parking lot adjacent to the club. For that reason, the Cameo contracted with off-duty Cincinnati police officers to provide security in the parking area. Security inside Cameo was maintained by employees.

On the morning of March 26, four off-duty officers were working the parking areas, and their response and report of the shootings to the Cincinnati 911 communications center was almost instantaneous to the gunfire. This allowed dispatchers to call fire, rescue and paramedic units from the Cincinnati Fire Department simultaneously to the “officers need assistance – shots fired” dispatch of additional police units.

Upon dispatch, fire communications indicated that they had a report of between six to 10 people shot at the night club. Realizing the potential magnitude of the call, fire communications also opened the Greater Cincinnati Hospital Net, which simultaneously put all area hospitals on alert and started a rollcall of each hospital requesting its capacity for patients.

Cincinnati’s staffing requires every engine and ladder company to have at least one paramedic assigned to the unit and the remaining firefighters to be at least EMTs. Each fire unit carries a complete set of advanced life support equipment including a drug box and trauma bag.

Fire transport units are assigned two paramedics, and an EMS supervisor is sent on any major medical call.

Out of chaos, order

The scene was initially described by witnesses as utter chaos when the first fire units, Engine and Ladder 18, arrived. Patrons were still trying to exit the club – others were outside yelling for assistance and many were in cars attempting to leave the parking lots.

Meanwhile, dozens of police units from both Cincinnati and the Hamilton County Sheriff’s Department descended on the scene. 

The officer in charge of Engine 18, Lt. Aaron Sweeney, immediately started to triage patients in the parking lot. He quickly ascertained that the most seriously injured remained inside the club. He estimated that in addition to those in the parking area, approximately 10 more victims remained inside. 

District Chief Marc Monahan arrived at the scene and assumed overall command, keeping Lt. Sweeney in charge of triage and using the bulk of the incoming fire units for treatment. Lt. Mike Gundrum, the EMS supervisor, assumed the role of transportation officer. 

The location of the shooting at the Cameo club placed seven paramedic transport units (four Cincinnati and three Anderson) within approximately a 4-mile radius of the shooting scene. 

In all, eight Cincinnati and three Anderson Township paramedic units were used to transport the patients to five area hospitals. Depending on the severity of the wounds, the victims were either transported to the University of Cincinnati Medical Center, a level-one trauma center, or the other hospital facilities which were at least level-three trauma centers.

The University of Cincinnati Medical Center also acted as medical control for the Hospital Net in conjunction with Lt. Gundrum to direct the transport of the victims to an appropriate hospital with the capacity to handle the incoming patient.

Triage and on-scene treatment

Cincinnati’s Interim Fire Chief Roy Winston was part of an 11 a.m. news conference that same morning, with Mayor John Cranley, City Manager Harry Black and Police Chief Elliot Isaac. 

Chief Winston conveyed to the media the pivotal roles played by these firefighters, along with those of fire communications. He emphasized that while this was a highly unusual mass-casualty incident, that saving lives is a role the fire service performs everyday with little or no notoriety.

He also noted that the use of both the triage and treatment of patients on the scene and their transport to five area hospitals, based on their degree of injury and the hospital’s surge capacity, saved many lives.

Chief Winston, while acknowledging the assistance from Anderson Township, indicated that other county fire units were also automatically available to the incident command should the need have arisen.

Thus far, the subsequent police investigation confirmed three alleged shooters: one from among the critically wounded who subsequently died at University Hospital, one who was arrested and charged within days of the shooting and a third who remains at large. 

The Cameo owners surrendered their liquor license and permanently closed within five days of the mass shooting.

From this incident, fire officers can clearly see the value that training plays if and when such a mass-casualty incident occurs.

Whether a major motor vehicle crash along an interstate, a terrorist attack on the street or a mass shooting in a nightclub, we must be prepared to quickly and effectively implement those elements of incident command that integrates our role into the overall response that saves lives, while protecting the safety of our own personnel.

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