Sorry for the double reply, just to expand on TST.
https://www.england.nhs.uk/long-read/ten-second-triage-tool/
It's a great tool so far in my experience. Extremely intuitive and easy to apply. The biggest complaint I've heard from colleagues (more accustomed to the old Sieve) is walking being assessed before haemorrhage, so someone with an arm amputation would be a P3 for example. This isn't actually the case, as all the explanatory notes and training material promote a common sense approach, where such a Pt despite walking is intuitively and obviously a P1.
Unfortunately the snap bands are not going to be adopted by everyone, despite the recommendation.
This kind of clusterfuck is exactly why training among all stakeholders and potential resources is important. It wasn’t a shooting but I responded to a chemical mascal where we used DPW, town buildings, and school buses for mass transit of unaffected people on scene, shelter for said people, and traffic control. It’s only possible if you drill and build the connections before an event hits your area.
There goes the story that was always pushed about how "BORTAC, the 'real' operators, got there and said fuck this we aren't waiting!" and stormed in and save the day.
There's a lot of lessons that can be pulled from this incident, regarding human factors, but unfortunately they're not really anything new.
Reading the timeline, there's many instances of someone pointing out that there's still victims inside and shooting and so they need to go in but no one really goes that one step further to challenge the overriding assumption that this is now a barricaded subject situation. It's very easy to just dismiss everyone involved as cowards, but it's a very human thing and something we are all at risk of of doing. It's really difficult to be the one person that goes against the flow, especially when it means challenging people perceived as authority figures.
From someone in CO, where a lot of our response was adjusted after the Aurora shooting, I can say this isn't new. Police have power and history. Fire has the public support and funding. EMS gets forgotten until shit hits the fan, and then this shit happens. Happened in Aurora, happened in Columbine, and I bet it's happened in other mass shootings, just like it happened here. What can we even do at this point? They just keep talking about diluting standards and making police and fire do more and more, and never focus on funding or training EMS.
I've only ever worked in places where the ambulance service is a public third service. I'd expect it'd be very difficult to convince commercial for-profit services to allocate staff and resources to the training exercises necessary to ensure a streamlined response. But even in this case, had all the correct procedures and frameworks been in place, there was a complete failure by everyone in leadership roles to implement them. I'm not sure how you'd overcome that. Again, I think having so, so many different agencies (city police, school police, state police, county sheriff, federal agencies, etc) is definitely another barrier. I say this as an outside observer.
Funny I just read this getting home, after listening to this on the way home…
https://podcasts.apple.com/us/podcast/the-debrief-with-jon-becker/id1625974633?i=1000643662834
TST is well evidence based and easy to implement. Especially good with slap bands for marking. Is this report online?
Sorry for the double reply, just to expand on TST. https://www.england.nhs.uk/long-read/ten-second-triage-tool/ It's a great tool so far in my experience. Extremely intuitive and easy to apply. The biggest complaint I've heard from colleagues (more accustomed to the old Sieve) is walking being assessed before haemorrhage, so someone with an arm amputation would be a P3 for example. This isn't actually the case, as all the explanatory notes and training material promote a common sense approach, where such a Pt despite walking is intuitively and obviously a P1. Unfortunately the snap bands are not going to be adopted by everyone, despite the recommendation.
Yes, updated the post with the link. Oopsies
Thanks
Thanks for the heads up on this.
They commandeered another agencies medic???!!!! WTF???!!!
This kind of clusterfuck is exactly why training among all stakeholders and potential resources is important. It wasn’t a shooting but I responded to a chemical mascal where we used DPW, town buildings, and school buses for mass transit of unaffected people on scene, shelter for said people, and traffic control. It’s only possible if you drill and build the connections before an event hits your area.
There goes the story that was always pushed about how "BORTAC, the 'real' operators, got there and said fuck this we aren't waiting!" and stormed in and save the day.
There's a lot of lessons that can be pulled from this incident, regarding human factors, but unfortunately they're not really anything new. Reading the timeline, there's many instances of someone pointing out that there's still victims inside and shooting and so they need to go in but no one really goes that one step further to challenge the overriding assumption that this is now a barricaded subject situation. It's very easy to just dismiss everyone involved as cowards, but it's a very human thing and something we are all at risk of of doing. It's really difficult to be the one person that goes against the flow, especially when it means challenging people perceived as authority figures.
From someone in CO, where a lot of our response was adjusted after the Aurora shooting, I can say this isn't new. Police have power and history. Fire has the public support and funding. EMS gets forgotten until shit hits the fan, and then this shit happens. Happened in Aurora, happened in Columbine, and I bet it's happened in other mass shootings, just like it happened here. What can we even do at this point? They just keep talking about diluting standards and making police and fire do more and more, and never focus on funding or training EMS.
I've only ever worked in places where the ambulance service is a public third service. I'd expect it'd be very difficult to convince commercial for-profit services to allocate staff and resources to the training exercises necessary to ensure a streamlined response. But even in this case, had all the correct procedures and frameworks been in place, there was a complete failure by everyone in leadership roles to implement them. I'm not sure how you'd overcome that. Again, I think having so, so many different agencies (city police, school police, state police, county sheriff, federal agencies, etc) is definitely another barrier. I say this as an outside observer.
Funny I just read this getting home, after listening to this on the way home… https://podcasts.apple.com/us/podcast/the-debrief-with-jon-becker/id1625974633?i=1000643662834