The next nine minutes: Lessons learned from the large-scale active shooter training prior to the STEM school shooting

Authors

  • Alissa Lenz, BS
  • Ryan Shelton, MPS, NREMT-P
  • Rebecca Ryznar, PhD
  • Kit Lavell, BA
  • David Ross, DO, FACEP
  • Susan Carter, MD, FACOG, FACS
  • Andrew W. Kirkpatrick, CD, MD, MHSc, FRCSC, FACS
  • Jessica L. McKee, BA, MSc
  • Anthony J. LaPorta, MD, FACS
  • Chris Wells, BS

DOI:

https://doi.org/10.5055/ajdm.2020.0373

Keywords:

mass casualty training, active shooter, rescue task force (RTF), warm zone, Cut Suit®

Abstract

Objective: As the incidence of active shooters increase, local emergency response has also changed. South Metro Fire Rescue coordinated a series of hyper-realistic active shooter simulation drills involving multiple agencies.

Methods: “The Next Nine Minutes” was one of the largest active shooter drills performed to date with 904 personnel that were trained in 18 mass casualty active shooter drills. Evaluation was from point of injury to and including care in the operating room (OR), and evaluation of real-time system logistics.

Results: A total of 126 patients in Cut Suits® received a total of 479 procedures such as needle decompressions, cricothyrotomies, tourniquets, wound packs, and chest tubes. Central to this exercise, law enforcement (LE) established a warm zone from the initial shooting. EMS was able to move into the facility, locate casualties, extract the first victim, move them to a casualty collection point (CCP), and transport them to safety within 12 minutes.

Conclusions: Strengths and weaknesses were identified in prehospital and in-hospital care. These included what roles agencies play in a true event, specific timing in establishing areas such as the warm zone and CCP, transportation, and logistics at the accepting hospitals. Only after the barriers to success were identified and addressed did the timing of casualty movement drastically improve. Lessons learned from this training were ultimately used to save lives at the STEM School, Highlands Ranch, and Colorado Shooting. This in situ immersion training should be practiced as a whole system.

Author Biographies

Alissa Lenz, BS

Rocky Vista University College of Osteopathic Medicine, Parker, Colorado

Ryan Shelton, MPS, NREMT-P

Lieutenant, South Metro Fire Rescue, Centennial, Colorado

Rebecca Ryznar, PhD

Executive Vice President, Strategic Operations, San Diego, California

Kit Lavell, BA

Assistant Professor, Department of Biological Science, Rocky Vista University College of Osteopathic Medicine, Parker, Colorado

David Ross, DO, FACEP

Associate Professor, Department of Specialty Medicine and Office of Simulation in Medicine and Surgery, Rocky Vista University College of Osteopathic Medicine, Parker, Colorado

Susan Carter, MD, FACOG, FACS

Director, Office of Simulation in Medicine and Surgery, Rocky Vista University College of Osteopathic Medicine, Parker, Colorado

Andrew W. Kirkpatrick, CD, MD, MHSc, FRCSC, FACS

Professor, Departments of Surgery and Critical Care Medicine, Tele-Mentored Ultrasound Supported Medical Interaction (TMUSMI) Collaboration, Regional Trauma Services, Foothills Medical Centre, Calgary, Alberta, Canada

Jessica L. McKee, BA, MSc

Tele-Mentored Ultrasound Supported Medical Interaction (TMUSMI) Collaboration, Regional Trauma Services, Foothills Medical Centre, Calgary, Alberta, Canada

Anthony J. LaPorta, MD, FACS

Professor, Department of Specialty Medicine, Rocky Vista University College of Osteopathic Medicine, Parker, Colorado

Chris Wells, BS

Captain South Metro Fire Rescue, Centennial, Colorado

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Published

10/01/2020

How to Cite

Lenz, BS, A., R. Shelton, MPS, NREMT-P, R. Ryznar, PhD, K. Lavell, BA, D. Ross, DO, FACEP, S. Carter, MD, FACOG, FACS, A. W. Kirkpatrick, CD, MD, MHSc, FRCSC, FACS, J. L. McKee, BA, MSc, A. J. LaPorta, MD, FACS, and C. Wells, BS. “The Next Nine Minutes: Lessons Learned from the Large-Scale Active Shooter Training Prior to the STEM School Shooting”. American Journal of Disaster Medicine, vol. 15, no. 4, Oct. 2020, pp. 241-9, doi:10.5055/ajdm.2020.0373.

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Section

Articles