FEMA, CONTOMS & Local First Responders

The Federal Emergency Management Agency (FEMA) recently promulgated guidelines recommending that medical first responders provide First Aid to victims in areas that have not been secured by law enforcement. If the threat is not direct or immediate, medical personnel should consider enter “Warm Zones” even though potential threats exist.

It will be interesting to see how the new recommendations will impact training for paramedics, firefighters and other personnel.

It is now apparent that many of the 250 people killed in shootings and bombings since the massacre at Columbine High School could have been saved with immediate attention. In the Columbine attacks, LEOs waited 30 minutes before entering the school.

Since that time, law enforcement have developed active shooter protocols in which one or two of the first officers to arrive engage the active shooter without waiting for SWAT teams. This is also the reason that many patrol officers now carry AR-style rifles. One officer at Columbine could have taken a shot but hesitated because of the risk of hitting students at the distance involved.

FEMA and other experts studied the Boston Marathon bombing and determined that the numbers of dead victims were greatly reduced because of a number of medical personnel at the finish line that administered immediate assistance. Newtown and Aurora, Colorado also provided data for the study,

More than 200 people were injured but only three died from their injuries at the Boston Marathon. Should we prepare some paramedics to carry guns? There are definitely new training protocols on their way. There is reason to believe that “within five years you are going to see this required of everyone” in the EMS field. Towns and cities must coordinate their emergency response efforts.

Mass shootings are usually over in less than 10 to 15 minutes. Dr. Lenworth Jacobs said in an interview with the New York Times. “We’re seeing these events in increasing frequency, and unfortunately we have to change how we approach them to keep death tolls down.”

Medics should be trained in weapons and ammunition so they can better assess the damage that different firearms can do, according to the recommendarions of The Hartford Consensus. The study involved eight experts from medicine, the military and law enforcement. The group is advocating for local governments to implement their suggestions.

Most fire departments have a policy of not responding to emergencies where there is an imminent threat of violence. There has been a Counter Narcotics Terrorist Operations and Medical Support (CONTOMS) program funded by the Department of Defense:

The CONTOMS Program is unique in that it provides the student with actual certification as an Emergency Medical Technician -Tactical (EMT-T). The program provides a comprehensive approach to emergency care and operational medical support in the tactical environment. It is focused on the broad range of knowledge and skills required for crisis management medical response including: care under fire; Weapons of Mass Destruction (WMD); medical counterterrorism; counternarcotics; protective operations; hostage rescue; explosive ordnance disposal; maritime operations; civil disorder; and major national security events.

The program trains paramedics and EMTs assigned to SWAT teams. They are like combat medics in the military. We live in a time when budgets are strained beyond belief. New programs seem to be out of the question.

During the Los Angeles riots in 1992, many firefighters and EMTs dispatched from all over the Northwest could not carry legally, but they carried concealed firearms nevertheless.

We should not be in denial when it comes to the potential for violence. Law enforcement is presently trained with much more intense and innovative tactical methods than ever before. Armed citizens need to discuss new methods for protecting our schools, homes, churches and the workplace. Let’s also find ways to equip firefighters and EMTs for emergencies where the potential for violence is present.

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