By Ralph Mroz and Craig Allen, American Cop Magazine
The Rapid Treatment Model
The first generation of active shooter response protocol came out of LAPD and the NTOA after Columbine. Its basis was 4-officer teams to search the structure and locate and neutralize the shooter. If a team heard gunfire they moved directly towards it. If they didn’t, they did a quick but highly structured search of every nook and cranny of every room they encountered until all teams had searched the structure and the shooter was found dead or was neutralized. They ignored the dead and injured victims because neutralizing the shooter was the first priority.
Once the scene was reasonably safe, 4-officer teams then provided an armed escort of EMS providers in a rescue team formation to the injured throughout the structure. This approach required training patrol officers in SWAT-like techniques to solve the problem of finding a shooter in an unknown location in a building. It took a lot of training to get patrol officers to maintain the high level of skill and discipline required for 4-person team movement and proper room entry. Very few line officers ever got good at it.
It also required EMS personnel to train with these presumably well-trained law enforcement response teams. Cross-training seldom happened, and when it did, the results often weren’t pretty. It further required the injured to wait for treatment until the structure was secure enough to introduce EMS personnel with structured rescue teams, and people died as a result.
The problems with this approach were many. It was good in theory, but fell apart in practice. It was so complicated and difficult to implement that few agencies ever practiced it enough to be competent with it. Then, when the real deal happened, cops were often hunting the bad guy willy-nilly throughout the structure, fire and EMS were left more-or-less on their own and the injured bled out. People died unnecessarily.
Second generation active shooter response modified the first generation model basically by relaxing the techniques. This helped a bit in the training aspect of things, but didn’t amount to better outcomes.
All personnel can help to get the triaged injured from the CCP
to waiting ambulances at a cleared staging point.
3rd Time’s A Charm
Sgt. Craig Allen of Hillsboro PD and Engineer Jeff Gurske of Hillsboro FD developed the latest protocol — the Rapid Treatment Model — in Oregon. Understanding the shooter is either already dead or kills himself when LE shows up, they realized hunting the bad guy wasn’t the most appropriate first priority for responding officers. Sure, if the killing’s still going on, that’s the priority. But usually the killing is over. If the shooter is dead or not shooting, getting care to the wounded within the golden hour should be the first priority — or at least have equal priority with shooter neutralization.
EMS doesn’t or won’t go into a hot zone. They’ve been trained to, and as a matter of policy, generally won’t go into a structure until it’s been declared safe. If a shooter isn’t even located yet, how can the building be safe?
Actually, the military figured out the answer to this question over 100 years ago. You establish a secured Casualty Collection Point (CCP) within the still-hot zone. That is, you embed a warm zone (the CCP) into the hot zone. At the CCP, armed officers stand watch while EMS personnel triage, attend to and prep the wounded for transport.
With an area secured, other officers can drag or carry the injured to the CCP.
How & Why It Works
As the first officers arrive on-scene, the commander (hopefully a sergeant) establishes a Forward Operating Base (FOB). Using a school as an example, the FOB would probably be in the lobby or somewhere near the main entry point. The FOB should not be confused with the incident command post.
From the FOB, the on-scene commander directs incoming officers to take and hold ground — not search — hallways or other large parts of the building. In this way, officers are deployed in a controlled, systematic manner and the entire building is taken quickly and methodically, piece-by-piece. One or two rifle barrels can control a hallway; there’s no need to immediately search the rooms off the hallway if no gunfire’s coming from them.
With the hallway or other areas held by a couple of gun barrels, additional officers drag and carry the injured to the CCP, which was established near the FOB. If a shooter emerges from a room, he can be neutralized by one of the officers holding that area. This is a good reason why all officers should have patrol rifles. If shooting erupts in a room off a held hallway, officers can then enter and neutralize the shooter.
The Rapid Treatment Model eliminates most of the problems associated with previous approaches to active shooters. It directs incoming officers in a systematic way so the entire structure is “taken” under orderly control, making efficient use of resources. It focuses on securing critical real estate so the injured can be transported and treated immediately, rather than searching the entire structure first. EMS can immediately begin patient treatment in a secure area.
It requires coordination but not cross-training of EMS and LE, allowing each service to swim in their own lanes and do what they’re comfortable doing. It’s also less complicated than training personnel to be proficient at TEMS (Tactical Emergency Medical Support) and TCCC (Tactical Combat Casualty Care) — think SWAT medics — and is something any cop or EMS can do. It’s easier for EMS to teach proper drag and carry techniques to cops than trying to teach EMS to embed into a LE formation.
The first officers on scene secure an area for the FOB (Forward Operating Base),
from which they direct other officers as they arrive.
The emphasis is on seizing and controlling ground. One or two rifle
barrels can effectively control an entire corridor or large hall.
In 2005, the Hillsboro police and fire departments embarked on their first full-scale, joint active shooter exercise. Their response was based on the standard rescue team concept of four police officers escorting two firefighters in a lumbering mega-cell, moving through already swept areas to the victims. Their intent was pure, but it was clear each service was being asked to operate outside of its inherent skill set. Five years later, in 2010, they began active shooter response training based around the CCP concept. The intent was to keep cops and firefighters doing what they do best and provide a “quick connect” (the CCP) between their operations, thus allowing each service to do their own familiar jobs simultaneously.
The two agencies began a series of six training sessions to drill in the various elements of the Rapid Treatment Model: corridor lockdown, victim retrieval, fire security and mass casualty incident operations in the CCP. Over the course of the next two years the agencies tested the integration of these procedures in 15 full-scale exercises in schools, office complexes and movie theaters with great success. Today the two agencies jointly plan, train and are prepared to implement a fully operational Rapid Treatment Model response to criminal mass casualty incidents.
Next, what to do if the shooting is ongoing