TECH TOPICS: Communications >> Predictive Policing >> Lessons from Ferguson

October 2014 Volume 10 Issue 9

Technology
Led Policing:
g How Atlanta PD changed
patrol in the city p.28

PLUS >>
Re-thinking Defensive Tactics p.38

Life After Law Enforcement p.42

Critical Incident Response p.48

1410lo_C1 1 9/30/14 10:31 AM

 Sheriff Shaun Golden and Undersheriff Robert Dawson

 




Spillman customer since 2011

THE POWER OF INTELLIGENCE-LED POLICING,

JUST A CLICK AWAY
At Spillman, we pride ourselves on being more than just another “electronic filing
cabinet.” Our software is not only designed to simplify the process of collecting and
storing data, but more importantly, analyzing that data. Spillman’s intelligence-
led policing tools enable agencies to easily identify trends and patterns, develop
forward-thinking strategies for crime prevention, and determine how to allocate
resources. Spillman offers tightly integrated management dashboards, map-based
analytics, extensive searching, and community crime maps that enable command
staff, analysts, supervisors, field personnel, and the public to analyze agency data in
meaningful ways.

Visit www.spillman.com/lawofficer or use the QR code to see how

intelligence-led policing tools can positively impact your community.

Choose 1 at www.lawofficer.com/rs.

Spillman Technologies is the industry leader in multi-jurisdictional data sharing, total product integration, and reliable customer service.
CAD | RMS | JMS | Fire | Mobile Data & Field Reporting | CompStat & Intelligence-Led Policing | Data Sharing | Mapping & GIS | Personnel & Resources

1410lo_C2 2 9/30/14 10:31 AM

 Contents–October 2014
Columns & Departments

16 CRUISER

44 FIREARMS
4 Editor’s Note
Lessons from Ferguson
By Dale Stockton
6 Staging Area
• International Public
Features 22
22 Do You Copy?
What the Christopher Dorner incidents
48 TRAINER
taught us about interagency communication
problems
43 Below 100 By Michael Guerin
Right side approaches
By Gordon Graham
28 Technology-Led Policing
44 Firearms How Atlanta PD changed patrol
Training the “in-between” By Alanna Maya

34 Context: Critical
Safety Association By Kevin R. Davis
• Embracing Below 100
48 Train the Trainer Mobile data, deployment levels & the
10 Street Survival The solitary offcer
challenge of public perception
Pigs once again By R.K. Miller
By Nick Selby
By Lt. Jim Glennon
54
38 Rethinking Defensive Tactics
Product Spotlight
14 Social Media Knives & vehicle
Connect with accessories Success & safety come from realistic
your community training, follow-up practice
By JR Gamez 56 Third Degree By Brian N. O’Donnell
Vertx Pants
16 Cruiser Corner
Traffc stop safety
By Jeff Chudwin &
Kimberly Heath
42 Life After Law Enforcement
The time to start making plans for
By J.P. Molnar
60 Bullethead retirement is now
20 Fitness The militarization By Brad Smith
Overall wellness
By Mark Sherwood
of law enforcement
52 Predictive Policing
How your agency can use data to forecast &
prevent crime before it happens
Exclusively on LawOffcer.com By Josh Levin
Growing Courage: Leadership for Law
Enforcement—Courageous leadership is key to
improving the law enforcement profession and restoring
its rightful place of honor. How do we begin training Through the use of city-wide video surveillance systems, the Atlanta
Police Department has decreased crime by 9%. The program, Operation
ourselves to become the type of leaders we need? Shield, was a game-changing force multiplier for the department’s ABOUT THE
crime fghting efforts. COVER
By Roy Bethge Photo courtesy Atlanta PD

LawOffcer.com October 2014 l LAW OFFICER MAGAZINE l 1

1410lo_1 1 9/30/14 10:21 AM

 BUILT FOR LIFE
EDITOR-IN-CHIEF DIRECTOR OF ePRODUCTS
Dale Stockton Tim Francis
editor@lawofficer.com timf@pennwell.com

MANAGING EDITOR AD TECH MANAGER

Alanna Maya Adrian Zavala
alannam@pennwell.com adrianz@pennwell.com
858-638-2609
DIGITAL MEDIA CAMPAIGN
SENIOR EDITOR
COORDINATOR
Lisa Wolf
Erin Northrop
lisaw@pennwell.com
erinn@pennwell.com
858-638-2616

ONLINE NEWS/BLOG MANAGER PUBLICATION OFFICE

Bill Carey Phone 800-266-5367; Fax 858-638-2601
billc@pennwell.com
301-852-3925 ADVERTISING DEPARTMENT
Phone 800-266-5367; Fax 619-699-6722
EDITORIAL DIRECTOR
Kristina Ackermann GLOBAL SALES MANAGER
kristinaa@pennwell.com Veronica Foster
858-638-2607 veronicaf@pennwell.com; 918-831-9162

LAW OFFICER MAGAZINE REPRINTS, ePRINTS & LICENSING

TECHNICAL TEAM Rae Lynn Cooper
TECHNICAL EDITOR/FIREARMS raec@pennwell.com; 918-831-9143
Kevin R. Davis
VICE PRESIDENT,
COLUMNIST/VEHICLES PENNWELL MARKETING SERVICES
J.P. Molnar Paul Andrews
COLUMNIST/TRAINING marketingservices@pennwell.com
R.K. Miller 240-595-2352

COLUMNIST/LEGAL SUBSCRIBER SERVICE

Laura L. Scarry Phone: 847-763-9540
Email: lo@halldata.com
COLUMNIST/FITNESS
Mark Sherwood AUDIENCE DEVELOPMENT MANAGER
COLUMNIST/TACTICS Ron Kalusha ronk@pennwell.com
Eric Dickinson
CONFERENCE DIRECTOR
CONTRIBUTING EDITORS Debbie Murray debbiem@pennwell.com
Chris Boyd, Travis Yates,
Jeff Chudwin, Jim Glennon
CHAIRMAN
ART DIRECTOR Frank T. Lauinger
Clark Bell
clarkb@pennwell.com PRESIDENT & CHIEF EXECUTIVE
OFFICER
PRODUCTION COORDINATOR Robert F. Biolchini
Katie Noftsger
katien@pennwell.com CHIEF FINANACIAL OFFICER
Mark C. Wilmoth

VICE PRESIDENT/GROUP PUBLISHER

Ryan Dohrn ryand@pennwell.com

THE RECHARGEABLE, DUAL-OUTPUT P1R PEACEKEEPER™

produces a wide reflector-focused 600-lumen beam on high,
ideal for maintaining situational awareness. There’s also a single-
output Peacekeeper Tactical model. Both versions use a standard,
widely available 18650 li-ion rechargeable battery and can even
be powered by two disposable 123A lithiums in an emergency.
Designed, machined, and built in America—guaranteed for life.
Choose 2 at www.lawofficer.com/rs.
SUBSCRIPTION INFORMATION: Law enforcement personnel may start a free subscription
to Law Officer at http://www.lawofficer.com/about/subscriptions. Individuals outside the law
enforcement industry may start a paid subscription by calling 847-763-9540. One year
subscription rates are $50 in the USA, and $85 in Canada/International for surface delivery, and
$125 in Canada/International for airmail delivery. For additional paid subscription information
call 847-763-9540. ADVERTISING INFORMATION: Rates are available at www.LawOfficer.
com/about/advertise or by request from Advertising Department at 4180 La Jolla Village Drive,
Ste. 260, La Jolla, CA 92037-9142; 800-266-5367. EDITORIAL INFORMATION: Direct
manuscripts and queries to Editor, 4180 La Jolla Village Drive, Ste. 260, La Jolla, CA 92037-9142.
No material may be reproduced or uploaded on computer network services without the
expressed permission of the publisher.
LAW OFFICER is printed in the United States. GST No. 1268113153

surefire.com/peacekeeper
LawOfficer.com
MSRP $250

1410lo_2 2 9/30/14 10:21 AM

 Choose 3 at www.lawofficer.com/rs.

1410lo_3 3 9/30/14 10:21 AM

 Editor’s Note
Lessons from Ferguson
Incident provides a learning
experience for all LEOs
B
Before Aug. 9, 2014, most people had never heard of
Ferguson, Mo., let alone their police department. That
all changed when Ferguson PD Officer Darren Wilson and
18-year-old Michael Brown crossed paths in an encounter
that left Brown dead. What happened in Ferguson could have
happened in many communities and there are plenty of les-
sons to be learned:
1. Things are seldom as they seem. Brown had been
involved in a strong-arm robbery shortly before he was
contacted by Wilson. According to Ferguson’s police chief,
Wilson did not have this information and contacted Brown
because he was walking in the middle of the street. Con-
sider how this may have affected Wilson’s readiness.
2. Conducting contact from the car puts you at a dis-
tinct disadvantage. Best information indicates
Brown aggressively engaged Wilson and a fight,
as well as the first shot fired, took place in Wil-
son’s car.
3. Appearance of insensitivity. After the shoot-
ing, Brown’s body lay in the street in full view
of passersby for a prolonged period. While there
may have been some evidentiary rationale, there
are ways to maintain crime scene integrity while
preventing a public viewing. A forensic screen
would have gone a long way to mitigate what
appeared to be callous insensitivity.
4. Appearances are important. Much has
been made of the high-powered long guns and armored
vehicles that were brought into this situation. Obvious-
ly, it’s important to be ready and capable. However, the
images of officers in turrets pointing rifles at protesters
were shown repeatedly and caused a lot of questions to
be asked. In fact, the entire 1033 program (repurposing
military equipment) has been called into question, with
multiple congressional hearings scheduled and calls to
gut the program. This would be a huge step backward for
law enforcement. Every situation is different, but we lost
ground on this one.
5. It’s best to under promise and over deliver. Short-
ly after Missouri State Highway Patrol Captain Ronald
Johnson arrived in Ferguson, he proclaimed an end to
tear gas. That didn’t hold and there were some tough
nights that followed. It is likely that Johnson’s actions will
be discussed for a long time.
6. Develop community alliances before you have a
4 l LAW OFFICER MAGAZINE l October 2014
1410lo_4 4
problem. It’s virtually impossible to gain community
support when battle lines have already been drawn. The
time to build alliances is before things go south. Seek out
community leaders, build bridges and—this is impor-
tant—actively use social media before you have a prob-
lem. When an incident occurs, leverage social media to put
out your message quickly and without media filters.
7. There will be a rush to judgment. This is an area over
which you have little control, but you can ensure that you
provide timely and informative updates that are clear,
concise and complete to the extent possible.
8. Race matters. The days of racial divide should be behind
us, but they’re not and Ferguson demonstrated that in
almost visceral ways. More than two-thirds of Ferguson’s
20,000+ residents are black, yet there are
only three black officers and more than 50
white officers. A police force, in general,
should strive to reflect its community or
What happened in
Ferguson could have
happened in many
communities.
at least demonstrate a commitment to do
so. It is understandable that some would
feel disenfranchised. Would a higher percentage of black
officers on the PD have made a difference in the shooting
itself? Probably not, but it may have engendered a high-
er level of trust and confidence, areas that are essential
when a critical incident occurs.
9. Technology might have made a difference. There’s
been a lot of discussion regarding body-worn video since
Ferguson. Although some officers resist the idea, it’s
becoming increasingly clear that, more often than not,
police video vindicates an officer, or at least provides
greater context.
What happened in Ferguson will affect law enforcement
in this country for a long time. Challenge yourself to under-
stand the issues and engage proactively. The effort will be
worthwhile.
—DALE STOCKTON, EDITOR-IN-CHIEF LOM
Follow Dale on Twitter! Twitter.com/DaleStockton
LawOfficer.com
9/30/14 10:21 AM
 ™ In 1990 a Navy SEAL was navigating a minefield when his pack failed. As his gear tumbled to the ground,
he vowed that if he got out of there alive he would make gear the right way. Today this obsession with
quality applies to everything we do. We’re constantly researching, refining and perfecting every detail
to provide gear that won’t let you down. Because we’re not just making stuff. We’re honoring a vow.

MAKE THE DARK

AFRAID OF YOU.

© 2013
2 13 BLACKHAWK!®
B NORFOLK, VA U.S.A
U.S A.. BLACKH
BL ACKH
HAWK.
AW com
AWK m
Choose 4 at www.lawofficer.com/rs.

1410lo_5 5 9/30/14 10:21 AM

 Coming Together
Public safety elements
unite with launch of IPSA

T
he International Public Safety Association (IPSA) of an effective joint response to
was recently launched with the intention of bringing all public safety incidents.”
together all elements of the public safety community, IPSA’s efforts will focus on
including police, fire and emergency medical responders. sharing of information, resourc-
“IPSA was established because we recognize these disci- es, expertise and time, as well
plines often do not have the opportunity to collaborate and as communication and collabora-
cross-train in advance of a critical or mass casualty inci- tion throughout all public safety disci-
dent,” Heather Cotter, IPSA founder, says. “Our vision is for plines. The cost to join IPSA (JoinIPSA.org) begins at $25.
a stronger, more integrated public safety community capable

Taking ians in armed standoffs, noting that just

Responsibility
Police Foundation pres.
says military surplus
two weeks before the hearing, the Cook Safety First
County (Ill.) Sheriff’s Department used
armored vehicles to rescue six children
Ohio law enforcement
embraces Below 100
and two adults after a home invasion by
heavily armed criminals. By Lt. Craig Cvetan

I
“While Congress reviews these pro-
equipment saves lives grams in the wake of Ferguson, I urge n our efforts to protect the lives of our
you to consider the benefits and greater community members, law enforce-

A
midst speculation that United
States law enforcement agen-
cies have become too militarized,
Police Foundation President Jim Bueer-
mann addressed a Senate committee to
assure that surplus military equipment
provided to law officers throughout the
country has saved lives and should be
preserved, but requires better oversight
and regulation.
Bueermann testified Sept. 9 during
the U.S. Senate Committee on Home-
land Security and Government Affairs
hearing on oversight of federal programs
for equipping law enforcement agencies.
The hearing was called in response to
the national debate over unarmed pro-
testors facing heavily armed police in
Ferguson, Mo., after a police-involved
shooting in early August. One program
in particular—the 1033 program—was
criticized by senators for giving out
equipment they felt was inappropriate
for police forces.
Bueermann pointed out that the pro-
gram has provided equipment that has
saved the lives of both officers and civil-
context along with possible changes,”
Bueermann told the committee. “There
has been substantial positive impact
on public safety and officer safety from
1033 and other programs that provide
equipment to law enforcement.”
During the hearing, Bueermann ad-
mited that law enforcement agencies
need to reassess how they use the equip-
ment and address the public’s growing
concern that police are becoming too
militarized. The Police Foundation rec-
ommends tighter controls and more
transparency in the program to ensure
proper use. Police agencies seeking sur-
plus equipment should provide proof
that they have received public input and
local governing body approval or acqui-
sition of property; implement a publicly
accessible policy governing the use of
armored vehicles and tactical units; and
make a report on when and how it has
utilized armored vehicles and tactical
units available to the public.
Bueermann’s full testimony is avail-
able on the Police Foundation website,
PoliceFoundation.org.
ment officers cannot forget our own
safety. In Ohio, multiple law enforce-
ment agencies have partnered to ensure
our men and women are receiving the
training they need to protect their own
lives while protecting others. The train-
ing, Below 100, is part of a nationwide
effort to reduce annual line of duty law
enforcement deaths to less than 100—a
number not seen since 1943.
“Below 100 isn’t just about remem-
bering to buckle up,” Col. Paul A. Pride,
Ohio State Highway Patrol Superin-
tendent, says. “It’s about considering
what’s important and realizing our
choices affect those around us as well as
ourselves. By choosing to prioritize our
safety, we set an example for others to
do the same.”
The Ohio State Highway Patrol, Ohio
Attorney General, Buckeye State Sher-
iffs’ Association, Ohio Association of
Chiefs of Police and Nationwide Insur-
ance have partnered to offer Below 100
training to law enforcement officers free
of cost in several locations. Information
on Below 100 is at Below100.com. LOM

6 l LAW OFFICER MAGAZINE l October 2014 LawOfficer.com

1410lo_6 6 9/30/14 10:21 AM

 Choose 5 at www.lawofficer.com/rs.

1410lo_7 7 9/30/14 10:21 AM

 ALWAYS ON DUTY
What you need, where you need it, in the format you want
LawOfficer.com is formatted to work with your tablet and smart phone. That means you can get all the breaking
news, tactical training and technology reports you rely on LawOfficer.com for, now in the format you want.

Judge Sides with LAPD and LASD on

CONTEST!
License Plate Reader Data
Case has been closely watched by
agencies around the country
By Dale Stockton

A
superior court judge in Los Angeles County has sided with the Los Angeles
Police Department and the Los Angeles County Sheriff ’s Department in rul-
ing that License Plate Reader (LPR) data is not subject to disclosure. The
release of the data had been sought by the American Civil Liberties Union (ACLU) and the Electronic Frontier Founda-
tion (EFF). A key part of the ruling was that the records were exempt under the California Government Code that allows
records of an investigative nature to be withheld…
More at LawOfficer.com

TIMERS INSTALL
T2 SHUT DOWN Independent Time
Delay
TIMER
The Lind T2 Shut Down Timer protects your
vehicle battery from over-discharge, and protects
communications and other sensitive equipment from
low voltage and high voltage damage.

The T2 Shut Down Timer turns off electrical loads at a

preset time after the car engine is shut down. The timer
has two outputs; each has its own time delay.

To learn how the T2 Shut Down Timer can work

for you, contact Lind at 1.800.697.3701, via email
at info@lindelectronics.com or visit us online at
www.lindelectronics.com.

Independent Time
Choose 6 at www.lawofficer.com/rs. Delay

1410lo_8 8 9/30/14 10:22 AM

 FIRST RESPONDERS AT THE UTAH FIRE TRAINING FACILITY WORK OUT IN 5.11 TACTICAL RECON GEAR

Choose 7 at www.lawofficer.com/rs.

VISIT 511TACTICAL.COM/FITNESS.HTML
TO VIEW THE ENTIRE RECON COLLECTION

1410lo_9 9 9/30/14 10:22 AM

 Street Survival by Lt. Jim Glennon (Ret.)

Pigs Once Again

Media-driven hysteria and distrust of cops

I
n the 1960s, it was a disparaging
and all-too-familiar moniker; police
officers around the country heard
it directed at them on a daily basis.
“Pigs!” It continued through much of
the ’70s, ’80s and ’90s, but as long hair
shortened, bell-bottoms narrowed and
body piercings and tattoos replaced
love-beads and Fu Manchus, the term
and perspective began to fade.
“Pigs!” by the new millennium, was
only a faint echo; all but disappearing
in the mainstream.
I believe there are many reasons
for this: Law enforcement embraced a
community oriented policing philoso-
phy; partnering with the community
and listening to citizens and their con-
cerns. Cops began walking beats again.
They got on bikes and ATVs, and start-
ed Citizen Police Academies. Police

COPYRIGHT BETTMANN/CORBIS / AP IMAGES

organizations and unions became
involved in charitable drives such as
the Special Olympics, Shopping with
Cops and Running with Torches.
We listened to the community and
modified our training, adding sub-
jects such as cultural diversity, mental
health issues, understanding the com-
plexities of domestic violence, sexual
assault prevention and advocating for
victim’s rights. In addition, use of force
training evolved and became more
comprehensive, resulting in officers
using less force when dealing with
unruly subjects.
In short, cops were doing better jobs
and putting in a collective effort to
reconnect with the citizens they were
paid to protect.
Fast-forward to August 2014, and
“Pigs” is back in vogue once again. At
least, it is if you follow certain members
Protestors at the University of California campus in Berkeley, 1967, struggle with
police who were called after anti-war demonstrators crashed through a police bar-
ricade and set up picket lines around the Student Placement Center. Images like this
fueled the anti-police attitude and the popularity of the moniker “pigs” for members
of law enforcement at the time.
of the national media who are creating executioners, power hungry, out of con-
hysteria in spite of the true facts. trol thugs and even murderers. Phras-
Some reporters and pundits are es such as “epidemic of violence from
using extraordinarily negative ter- the police toward citizens” are being
minology and applying malevolent bandied about with unchallenged
motivations to the more than 700,000 impunity despite reality, truths and
individuals in the law enforcement statistics.
profession. Anchors, moderators, A journalist named Michelle Ber-
expert guests, and opinion journalists nard on a national broadcast insinu-
are describing police officers as mili- ated that what happened in Ferguson,
tarized brutes, racists, storm-troopers, Mo. is an example of a “war

10 l LAW OFFICER MAGAZINE l October 2014 LawOfficer.com

1410lo_10 10 9/30/14 10:25 AM

 The most powerful weapon
known to law enforcement.

Developing your critical-thinking skills may be the best way to

enhance your law enforcement career. The College of Criminal
Justice & Security helps you do just that with a leadership-
focused degree program taught by practitioner faculty with
real-world experience.

Start now at phoenix.edu/law-enforcement-jobs.

© <2013> University of Phoenix, Inc. All rights reserved.

Choose 8 at www.lawofficer.com/rs.

The University’s Central Administration is located at 1625 W. Fountainhead Pkwy., Tempe, AZ 85282. Online Campus: 3157 E. Elwood St., Phoenix, AZ 85034.
© 2014 University of Phoenix, Inc. All rights reserved. | CJS-2825

1410lo_11 11 9/30/14 10:25 AM

 Street Survival
on black boys” by the police, and opined
that the result could be “genocide.”
Genocide? Where the hell are any
kind of stats, anywhere, to suggest
anything remotely like that is hap-
pening between cops and young black
men? And her comment was virtually
unopposed by anyone else on the pan-
el.
No one knows what really happened
in Ferguson except a limited few. Rele-
vant information is not being released
(contributing to some of the paranoia)
and nature abhors a vacuum so there
is no shortage of pundits willing to
simply jump in and make stuff up.
But, Pigs?
Here are some stats gleaned from
such organizations as the National
Institute of Justice:
In the 1960s, it was a disparaging and all-too-
familiar moniker ... Fast forward to August
2014, and “Pigs” is back in vogue once again.
2011: Police officers had direct con-
tact with citizens more than 40 million
times. 1,146 of those people were shot
(not killed) by police. That means out
of all the people police encountered,
approximately 0.00002865% were shot.
If you consider that there are more
than 320 million people in the country,
that would mean 0.00000358125% of
them were shot by cops.
2012: There were approximately 12
million arrests, which equals about
34,000 per day; slightly more than 400
were killed by police over the course of
the year. And almost all of them were
killed because they were an immedi-
ate deadly threat to an officer or the
public. Which means that at the times
of those shootings, cops were saving
lives.
The truth: Cops are not “gunning
down” people in the U.S. Are there mis-
takes, overzealousness, an overreac-
tion to stress on occasion? Yes, and we
have to accept that and do something
about it when it happens. If a crime is
committed by a police officer, criminal
charges need be filed—No doubt.
But a war on the citizenry? Genocide
12 l LAW OFFICER MAGAZINE l October 2014
1410lo_12 12
being perpetrated by the police? Stor-
mtroopers taking over cities?
Pigs? Come on.
I’ve been in law enforcement for
more than 30 years. I’ve seen more
than I care to share with people who
don’t need to know such evil exists. I’m
no different than every other cop out
there, and let me guarantee you this:
we feel. We are not heartless, nonhu-
man, Neanderthals looking to inflict
pain. In fact, it’s the damn exact oppo-
site. We beg, literally beg, people not to
resist, not to fight. And the stats are
there to prove it; but why bother with
reality? Pigs?
We are attacked tens of thousands
of times a year. We are wounded, para-
lyzed, put in comas that last decades
and are killed. We’ve been shot with
every type of gun, including our
own, by people who were originally
“unarmed.”
Our attackers are young, old, male,
female, small, large, weak and strong.
Some have extensive criminal records,
some have never been in trouble in
their lives. We’ve been stabbed with
swords, commando knives, kitchen
utensils and box cutters.
We also jump into rivers, run into
burning buildings, reach into flaming
cars, hold victims who need it and cry
with people hurting and feeling the
deepest of loss.
When somebody is shooting up a
mall, university or movie theater, we
are the ones running toward the gun-
fire, not knowing how many assailants
there may be, what type of firepower
they are wielding, where they are and
if there will be any opportunity for
cover or chance to survive.
We lay on the street holding dying
children, women, men, pets and, yes,
other police officers. We knock on
doors in the middle of the night and
tell sleepy unsuspecting parents that
the child they saw just a few hours
ago is in the morgue. We hear and
feel their subsequent pain and do our
best to comfort them in those impos-
sible situations. And we often ask God:
Why?
We find lifeless children in ponds,
pools and lagoons. We listen to 7-year-
olds describe being raped by uncles. We
try to calm women who are beaten so
badly that they can’t enunciate words
or open a swollen eye. And we try to
control our rage as we listen to them
tell us not to make an arrest because it
was all their fault, all while the degen-
erate husband laughs and calls her a
bitch in our presence.
We stand next to officers who get
shot. We hold their hands and hug
them as they die. We watch the flags
get folded and handed to children who
don’t understand why someone would
purposely kill their mommy or daddy.
We go home and try our best to have
normal lives. We hug our kids, help
with chores, coach little league and do
whatever it takes to hide the ugly side
of humanity from our families.
We see the murders, the suicides,
the mentally unstable. We help the
homeless, give the unfortunate rides,
hand a few bucks to the hungry, buy
shoes for the shoeless and get families
into hotel rooms in order to protect
them from the cold and the monsters
looking for prey. Pigs?
Here’s my challenge for those who
dare to yell “Pig” and cast baseless
assertions on an entire profession
while having no idea what we do or
what you are talking about.
You try it. Do what we do. See what
we see. Hear what we hear. Feel what
we feel. You try to handle the fear that
we experience. Make the decisions that
we have to make in the blink of an eye.
Decisions that will be second-guessed
and sometimes haunt us for years.
Live in our shoes for a year, then see
if you think we are all still pigs. LOM
LT. JIM GLENNON, a third generation LEO, retired
from the Lombard, (Ill.) PD after 29 years of service.
Rising to the rank of lieutenant, he commanded
both patrol and the Investigations Unit. In 1998, he
was selected as the first Commander of Investiga-
tions for the newly formed DuPage County Major
Crimes (Homicide) Task Force. He is the owner
of the Calibre Press Street Survival Seminar.
LawOfficer.com
9/30/14 10:26 AM
 PELICAN
TM

> WEAPONS CASES

WATERTIGHT s DUSTPROOF s WHEELED

> PISTOL CASES

8 SIZES s WATERTIGHT s DUSTPROOF

> TACTICAL LIGHTS

LED TECHNOLOGY s DUAL SWITCH TECHNOLOGY

> REMOTE AREA LIGHTS

IR NIGHT VISION AND AREA LIGHTING SOLUTIONS

FORCE
MULTIPLIER
With the right resources from Pelican, you can
> NEW: 1910/1920 LED LIGHT

s On / Off / Momentary
extend your range and impact. From IR night push button tail switch

vision lights to weapons cases, you will find 3.6" s (IGH PERFORMANCE
and compact
the best tools for the job. s Aluminum body
5.3" powered by AAA
Q CRIME SCENE INVESTIGATIONS Q SURVEILLANCE OPERATIONS

Q SWAT OPERATIONS QMOBILE COMMAND CENTER

Choose 9 at www.lawofficer.com/rs.

www.pelican.com\lm
Pelican Products, Inc. 23215 Early Avenue, Torrance, CA 90505
866.574.3793 (TOLL FREE) Tel 310.326.4700 sFax 310.326.3311
All trademarks are registered and/or unregistered trademarks of Pelican Products, Inc., its subsidiaries and/or affiliates.

1410lo_13 13 9/30/14 10:26 AM

 Social Media
The Expansion of Social
Media in Policing
What the Redwood City PD is doing now
S
ocial media has become
increasingly nuanced within
the context of law enforce-
ment administration. I often
receive inquiries from police chiefs
across the nation with a strong desire
to leverage these social media plat-
forms to their fullest potential, yet
this relatively new phenomenon is
often seen as an enigma to many law
enforcement leaders who express con-
cern that their own departments are
not keeping pace with this rapidly
evolving technology.
The role that social media plays
in service to conventional outreach
programs is often overlooked. In
Redwood City, Calif., the police
department periodically hosts
town hall meetings and less-formal
“Coffee with Cops” events in various
communities throughout the city.
These events are advertised heavily
on social media platforms well in
advance, but department members
also live tweet during the event to
entertain questions and comments
from interested residents not
physically present at the event venue.
This concept essentially increases
community participation through
virtual attendance and enhances the
dialogue for all participants, present
or not. After these events, highlights
are posted on social media platforms
to stimulate more dialogue and
generate greater interest for future
events. One of the great advantages is
the feedback gleaned from the public
about these gatherings, which affords
our event organizers the insights
needed to progressively improve their
delivery.
14 l LAW OFFICER MAGAZINE l October 2014
1410lo_14 14
by JR Gamez
Another example
is the department’s
video chat pro-
gram. The program
launched in 2012 as
a new approach to
hold virtual police
and community
interactivity. Video
chat allows residents
to call in and have a
face-to-face discus-
sion with a police
officer from the com-
fort of their home or
office. These chats
are not designed to
replace service calls,
but rather to provide
a forum to ask ques-
tions, get information
or simply to express
concerns in a more
interpersonal man-
PHOTO COURTESY REDWOOD CITY PD
ner. While it is not a Events like this “Coffee with Cops”
social media platform program are promoted using social
by definition, the vid- media and allow private citizens some
one-on-one time with your department
eo chat program was
and help to foster trust in your officers.
advertised heavily
through Facebook and Twitter pages component of law enforcement. Many
during its inception because this tech- departments—including Redwood
nology was new and not readily rec- City’s—have explored social media
ognized by potential users. Through platforms to generate leads, gather evi-
these social media posts, utilization dence and even as a means to engage
of video chat increased and allowed in covert activities. Following the
residents to access services and report violent rape of a child, Redwood City
crimes without the need for a physi- detectives were able to locate a social
cal police response. The net effect has media page for the suspect and traced
been a reduction in conventional dis- the IP address to obtain the physical
patches and resource draws, and a location of the computer the suspect
potential for cost reductions. used to make his most recent posts in
Without a doubt, social media is another country. This tenacious police
now fully integrated into almost every work coupled with the practical under-
LawOfficer.com
9/30/14 10:26 AM
 standing of social media technology
led to the issue of an extradition war-
rant. Other platforms, including Pin-
terest, have helped detectives reunite
burglary victims with their stolen
property, an outcome that was previ-
ously unlikely.
Detectives have been accessing
social media pages for several years
to mine evidence; however, we now see
an increased interest on law enforce-
ment’s part to mine social media
content for publicity purposes. As
the number of social media users is
expected to exceed 2.3 billion by 2017,
the demographic analytical potential
this user base now provides is undeni-
able.
A successful law enforcement
social media program will be mul-
tifaceted. In some areas, a solitary,
unilingual Facebook page may not be
LawOfficer.com
1410lo_15 15
sufficient to reach a significant por-
tion of the community. In 2013, Red-
wood City PD launched a separate
Facebook page composed exclusively
in Spanish. Its intended purpose is to
provide useful, culturally competent
content to the approximately 35%
Latino community in Redwood City.
This page has become a big hit with
the community, but more importantly,
it has provided tangible returns in
the form of increases in volunteerism
and participation in community pro-
grams. In 2013, prior to the launch of
the department’s Spanish language
Facebook page, the department had
only one Spanish-speaking member
of its Volunteers in Policing Service
(VIPS). After the launch of the new
Facebook page and its reciprocal effect
of increasing attendance at the Span-
ish Language Citizens Police Acad-
Choose 10 at www.lawofficer.com/rs.
October 2014 l LAW OFFICER MAGAZINE l 15
emy, the department now boasts 12
Spanish-speaking VIPS, all of whom
hail directly from largely Latino com-
munities throughout the city. This
development is helping the depart-
ment realize exponential increases in
the efficacy of its targeted community
outreach, particularly in communi-
ties that previously seemed more
challenging to communicate with.
LOM
CHIEF JR GAMEZ has been with the Redwood
City Police Department since 2011, after serving for
26 years with the San Jose Police Department. In
2012, Chief Gamez was recognized by Comput-
erworld as one of the top 100 premier IT leaders
in America. The Department’s Social Media Team
has twice been honored by Connected COPS in
the categories of Excellence at a Small Agency and
Leadership, and by the California Peace Officers
Association with its Award of Distinction. Locally,
the Social Media Team has received awards
from the Silicon Valley Leadership Group and the
Association of Bay Area Governments in recogni-
tion of its use of technology and social media.
9/30/14 10:26 AM
 Cruiser Corner
Traffic Stop Safety
Stay smart when contacting the unknown
Traffic stops are dangerous for a number of reasons, some of which can lead to the loss of officer lives. When we look at the
mechanics of traffic stops, we can see that there are ways to make this part of the job safer, including the use of particular equip-
ment that places the odds of a safe stop in the favor of the officer.
I
am sure that July 30, 2014, started
out like most others for Officer Scott
Patrick of the Mendota Heights
(Minn.) Police Department, but it
tragically didn’t end that way. At about
12:20 p.m., Patrick made a traffic stop
in his quiet suburban Twin City-area
town, one of thousands he had probably
made throughout his distinguished
career. What he didn’t know as he exited
his patrol vehicle was that the driver he
was approaching was a career criminal
with outstanding warrants who would
later state, “I hate cops and I am guilty.”
Witness accounts stated that Pat-
rick never got a chance to interact with
the driver because he fell victim to
gunfire while on his initial approach. It
was the first time in the history of the
department that an officer had been
lost. While we can’t be certain as to the
exact sequence of events, what is cer-
tain is that Officer Patrick was doing
what thousands of us do—and have
done on a daily basis: traffic stops.
16 l LAW OFFICER MAGAZINE l October 2014
1410lo_16 16
Let’s be clear: We all cringe when
we hear the uninformed talk about
“routine traffic stops” as there are too
many dangers inherent in contacting
the unknown to be that casual about
it. It’s dangerous and hazardous for a
number of reasons, some of which lead
to tragically losing an officer in the
process. When we dig a little deeper,
we see that many of these deaths are
related to patrol, whether it be by gun-
fire as in Officer Patrick’s case, or other
events such as Arizona Department of
Public Safety Officer Timothy Huff-
man, who was struck in the roadway
while investigating a crash near Yuma,
Ariz. In Huffman’s instance, the driv-
er of the vehicle that struck him was
eventually charged with manslaughter
and multiple felony reckless driving
charges after it was determined that
he was driving his tanker truck down
the highway while surfing the Web on
his cellphone.
In either case, the end result is an
by J.P. Molnar
PHOTO DALE STOCKTON
officer lost forever. In all instances,
we can only hope to learn from these
tragedies by identifying ways in which
traffic stops can become safer in the
future. In doing so, let me be clear that
in no way am I saying that either offi-
cer in both of the cases I mentioned did
anything incorrect in their respective
situations. What I am promoting is
information that could prove valuable
in helping to reduce future tragedies.
In doing so, there are really two areas
that can be discussed: the mechanics of
traffic stop tactics and the equipment
available to place the odds of a safe
stop in favor of the officer.
In this issue of Law Officer, I am
going to discuss the latter. In order to
break it down even further, I have split
the equipment discussed into pre-stop
and intra-stop.
Pre-Stop
It has been widely recognized that deci-
sions regarding use of force don’t flow
LawOfficer.com
9/30/14 10:26 AM
 in a continuum but rather may occur
at any level depending on the situa-
tion presented. For instance, a pedes-
trian contact that starts with simply
a consensual encounter can go imme-
diately to a gun battle without any of
the points between voice and gun. This
PHOTO DALE STOCKTON
designed to do a number of things. The
first is to alert the violator that you
want to make contact. The second is to
alert the surrounding environment that
you are effecting a law enforcement
stop. The third is to provide instruc-
tion to approaching motorists as to the
License Plate Readers: When it
comes to pre-stop tools, information is
king. While the use of MDTs and MCTs
are crucial in gathering information on
any outstanding violations and any
prior history with the vehicle or its reg-
istered owner, another supporting tool

tiered approach to the escalation of
force begins with “presence,” which, in
the context of this article means the
visual presence your vehicle promotes
while on patrol. The message sent by
the graphic, color and lighting packages
you select can go far in establishing the
message to the driving public that they
should pay attention to you and your
movements. Why is this important?
Because we still get crashed into and
run over on a regular basis. So, what are
some equipment choices we can make to
help us out?
Graphics: The earlier a motorist recog-
nizes an emergency vehicle as such, the
more likely they will take appropriate
corrective action toward either compli-
ance or evasive action (ie, move over
one lane, slow down, etc.). As I travel
the country, I still see many agencies
where identifying the vehicle as law
enforcement-oriented is very difficult.
So, if it’s tough for me, then imagine
how tough it is for the average citizen
behavior you would like them to adopt.
In the past, lighting system design was
somewhat limited due to size and power
constraints, but with the advent of LED
lighting, the sky is pretty much the limit
because they are compact, powerful, low
energy draw and affordable. Lights can
pretty much be placed anywhere, but
since there is such a thing as too much
lighting and poor lighting application,
working with an established emergency
lighting company to go over your needs
and provide the appropriate solution
is important. Furthermore, the type of
policing you do can greatly affect the
type of emergency lighting you might
need. So, if your fleet is lacking on effec-
tive lighting packages, the following
companies can help:
Code 3: Code3pse.com
Federal Signal:
FederalSignal.com/pss
Hg2 Emergency Lighting:
Hg2Lighting.com
Whelen: Whelen.com
is LPR. The system can do much of that
work for you by reading plates and pro-
viding any relevant alerts while oper-
ating in the background. The effective-
ness of LPR is well documented, and
the pre-stop alerts it can provide allow
an officer to use the appropriate time
and gather the appropriate resources
prior to conducting the stop. Some
leading companies are:
3M Motor Vehicle Systems
and Services: Solutions.3M.com
Elsag North America: Elsag.com
Motorola: MotorolaSolutions.com
NDI Recognition Services:
NDI-rs.com
Vigilant Solutions:
VigilantSolutions.com
Genetec Autovu: Genetec.com
Eyewear: It may seem minor, but con-
sider for a second the predatory habits
of a red tailed hawk. It relies primar-
ily on its razor sharp eyesight that is
eight times more powerful

PHOTO COURTESY 511 TACTICAL

who may become “surprised” by the
sudden behaviors of a patrol vehicle in
the first stages of a traffic stop. To help
with this, there are numerous options
that have proven to be effective. One is
the use of retroreflective materials on
all sides of the vehicle to help clearly
identify it at night, especially when
crossing intersections and from the
rear. Take a good look at your patrol
vehicles. If they aren’t providing a clear
visual message with maximum early
warning potential, then contact one of
these leading law enforcement vehicle
graphics companies:
Grafix Shoppe: GrafixShoppe.com
PDecals: PDecals.com
Vinyl Graphics: Police-Graphics.com Protective eyewear reduces the effects of glare, excessive brightness and even low
light situations to give your eyes every advantage. The Burner Full Frames from 511
Light Bars: Emergency lighting is Eyewear (shown) are polarized and come with a stratch and crack resistant coating.

LawOfficer.com October 2014 l LAW OFFICER MAGAZINE l 17

1410lo_17 17 9/30/14 10:26 AM

 Cruiser Corner
The Integrity lightbar from Federal Signal features built-in multi-color LED technology and 360-degree light output to ensure
that vehicles and people around your vehicle see you, and are aware that you are about to make a stop.
than our paltry peepers to find its next
meal. We may not be hunting squirrels,
but the simple fact is that we use our
eyes as our primary source of informa-
tion gathering, and you can’t react to
what you can’t see. This is especially
critical when observing occupant
movements inside a vehicle prior to
a stop, and when you are making an
approach. Glare, excessive brightness
and even low light situations require
you to give your eyes every advantage.
Proper eyewear with high performance
lenses, impact resistance and anti-
glare technologies have always been
critical components of my duty gear,
and going cheap may cause you to miss
a key piece of information on your next
stop. Some leading eyewear companies
that specialize in LE gear are:
5.11 Gear: 511Tactical.com
ESS: EssEyePro.com
Oakley: Oakley.com
WileyX: WileyX.com
Intra-Stop
Once you have initiated the stop, there
are some tools that help protect you as
you make your way from your vehicle
to the violator vehicle.
Take-downs: Take-down lights are
typically integrated into most mod-
ern light bars, but since the light bar
has to accommodate other lighting
responsibilities, the amount of space
allotted to the takedown bulbs can be
affected. Thankfully, the LED light-
ing industry has numerous options,
some from the off-road industry where
adequate lighting is crucial on dark
trails and during nighttime off-road
18 l LAW OFFICER MAGAZINE l October 2014
1410lo_18 18
races. With many agencies transition-
ing to SUVs, and the compact power
offered by LED bulbs, a lot of white
light can be concentrated on the viola-
tor vehicle from numerous locations.
When thinking LED bulbs, consider
that most are measured in lumens,
which is light output. A typical 100-
watt incandescent bulb produces about
1600 lumens, which is pretty bright. In
comparison, the 14-inch wide spotlight
LED light bar by SpeedTech Lights
uses nine 10-watt LEDs to produce a
blinding 9,000 lumens, so that adds up
to approximately six times the illumi-
nation power on only a 90-watt draw.
Moreover, the unit is compact enough
to be mounted on a push bar, or mount-
ed on top of a light bar, and is just one
example of how additional white light
can provide vital illumination inside a
violator’s vehicle and add to your tac-
tical advantage. Some companies that
make LED spotlight light bars and
spotlights are:
Clearwater Lights (Motorcycle LED
take-down ): ClearwaterLights.com
SpeedTech Lights:
SpeedTechLights.com
Unity (LED A-pillar spot-
lights): UnityUSA.com
Ballistic Panels: Sober-
ing fact: Ambushes on offi-
cers are on the rise. Con-
sider the morning of July
13, 2014, in Jersey City,
N.J. The suspect in this
case entered a Walgreens
with no intention of rob-
This wearable on-body lightbar from 425 Inc. is an
bing it, overpowered a innovative way to identify yourself as a law enforce-
security guard and took his ment officer.
PHOTO COURTESY FEDERAL SIGNAL
weapon; then apologized to a patron
for his behavior while bragging that
he would be “famous,” and waited for
officers. When the first patrol vehicle
arrived, the suspect fired immedi-
ately from close range, killing Det.
Melvin Santiago while he was still
seated in his patrol vehicle. Sadly,
that is just one recent example of
an increasing desire on the part of
criminal elements to “take cops out.”
While we can practice excellent offi-
cer safety tactics, the fact remains
that it is time to consider making our
vehicles capable of more than just
concealment and tertiary cover. In
response, there are a number of bal-
listic panel options available on the
market. This includes bullet-resis-
tant windshields. (Yes, we live in a
society these days where our patrol
vehicles are increasingly becoming
mini armored vehicles, like it or not.)
It may seem excessive, but con-
sider another example: The shooting
of Fortville (Ind.) police officer Matt
Fox. What originated as a stop for a
PHOTO COURTESY 425 INC.
LawOfficer.com
9/30/14 10:26 AM
 taillight violation ended with a short the Jackalope, there’s no such thing, we will address next month, the equip-
pursuit and ambush. Fox was struck in and they are becoming increasingly ment outlined here is just as critical in
the head and wrist when the suspect deadlier as criminal elements become keeping you safe, no matter the source
fired through the patrol vehicle’s wind- more brazen. Similarly, the distrac- of the danger. LOM
shield. The suspect, later determined tions provided by modern smart-
to be a staunch anti-government foe, phones, infotainment systems and tex- J.P. MOLNAR, who has a Master of Arts in educa-
tion and training, is a former state trooper and
was eventually killed by officers in a ting has meant that an equally large has been teaching EVOC since 1991 for various
second shootout. Thankfully, officer danger on the side of the road is get- agencies. He’s a contract instructional designer and
Fox survived and later recovered, but ting crashed into. While there are tac- performance/public safety driving consultant. He
has also raced cars for 25 years and has taught at
this incident provides an example of tical considerations of traffic stops that numerous high-performance racing schools.
why ballistic panels and windshields
should be considered when equip-
ping new patrol vehicles. Yes, they are
expensive, but the price of an officer’s
life far outweighs any cost. Some com-
panies that offer ballistic panels and
windshields are:
Automotive Armor Manufactur-
ing: Auto-Armor.com
DefensTech: DefensTech.com
First Defense (Ballistic glass):
FirstDefense.com
Pro-Gard: Pro-Gard.com U.S. Armor
(Ballistic glass): USArmorllc.com

Flashlight: As with take-down lights,

LED technologies have made ultra-
bright, long lasting high power tacti-
cal flashlights an affordable reality.
For that reason, there is no excuse for
having anything less than a modern
LED light on your duty belt and in
your car. Modern LED compact tacti-
cal flashlights can deliver a lion-sized
amount of light and have multiple
output settings when high power illu-
mination isn’t needed. While there
are many companies out there slap-
ping an LED into a flashlight housing
and calling it “tactical,” the unique
demands of our job mean that you
should consider the following compa-
PHOTO COURTESY 425 INC.

nies when looking to upgrade your

lighting capabilities:
425 inc. (Innovative on-body wearable
LED light bars): 425inc.us
Bayco: BaycoProducts.com
Streamlight: Streamlight.com
SureFire: SureFire.com
AE Light: AElight.com
MagLite: MagLite.com

Summary
Frankly, I cringe every time I hear a
newscaster use the term “routine”
when referring to a traffic stop. Like
Choose 11 at www.lawofficer.com/rs.

LawOfficer.com October 2014 l LAW OFFICER MAGAZINE l 19

1410lo_19 19 9/30/14 10:26 AM

 Fitness by Mark Sherwood

Overall Wellness
The principles of healthy weight management

W
eight loss—actually, it’s
probably better to say
weight management—is
a side effect of wellness.
Body composition changes appropriate-
ly if we follow a few simple principles
that yield discipline to our lifestyle
and the management of our long term
health. The following are 10 simple
concepts to follow and make a constant
part of your healthy lifestyle journey.
1) Change your concept of “Diet”
to “Live It.” If we change our view
of our nutritional protocol to a long-
term healthy plan, we are less like-
ly to fill our bodies with metabolic
waste and junk that gums up and
destroys our metabolism. Each cell
in your body is dependent upon its
own unique formula of micro and
macro nutrients (vitamins and min-
erals) to run with quality and effi-
ciency. Our food choices influence
not only our blue jeans but our cel-
lular genes as well. Our long term
outcome is directly dependent on
how we feed ourselves through time.

2) Carbohydrate intake. Except in

extreme circumstances with mega-
calorie burners and aerobic athletes,
the most you’ll need is 150 grams of
carbohydrates per day. Fat burns car-
bohydrate fuel, the metabolism does
require a small amount of carbohy-
drates to continue to keep things in
balance and stoke the metabolic fires.
This means that in order to burn
your fat stores there has to be some
carbohydrates available on board.
3) Glycemic Index. Stick with a low
glycemic/slow digesting carbohy-
drate nutrition plan. Large amounts
Weight loss is a side effect of wellness. Treat your body with respect and pay atten-
tion to the types of foods you eat to manage long term health and enjoy a smaller
waistline. Through discipline and a little hard work, you can get to your goals.
of sugar prompts the pancreas to 4) Rule of four. If one of the first four
secrete large amounts of insulin, ingredients in your store-bought
which is directly responsible for the food choice is sugar, put it back on
storage of body fat. The more insu- the shelf. The closer the sugar is
lin there is in your bloodstream, the to the first ingredient, the higher
more fat your body will carry. Look the glycemic index of the prod-
at the ingredients on the food you uct. Glucose is the brain’s primary
purchase and make sure your choice source of fuel. With balanced sugar
is not loaded with sugar. levels, a state of mental focus and

20 l LAW OFFICER MAGAZINE l October 2014 LawOfficer.com

1410lo_20 20 9/30/14 10:26 AM

 contentment can more readily be
achieved. Additionally, many indi-
viduals have a sensitivity or allergy
to gluten, grains, milk or casein.
If this is you, pay attention to the
label. This intolerance can create all
kinds of gastrointestinal upset and
issues, and the release of the hor-
mone cortisol, which drives the hor-
mone insulin. Cortisol and insulin
together equal fat.
5) Focus on protein. The Journal of
the American Medical Association
reccomends .36 grams of protein per
pound of body weight per day. Ath-
letes need to adjust this to body type
and sport. Break the total amount
you need up into four or five meals
to allow for a constantly available
amino acid pool to grow muscles,
connective tissues, hair and skin.
Protein provides the amino acids
that are used as the building blocks
of all of the cells in your body.
There are reasons for caution in the
amount of ingested protein. If you
are diabetic or have any problems
with kidney function, ask your doc-
tor about how your personal protein
intake should be adjusted. By eat-
ing varied and plentiful amounts of
protein you will provide your body
with all of the essential amino acids
that are necessary for building solid
muscles and healthy tissues.
6) Fat is an essential nutrient.
Every cell in your body has an outer
membrane of essential fatty acids/
phospholipids (i.e., omega 3s). Fatty
acids are usually derived from tri-
glycerides or phospholipids. When
they are not attached to other mole-
cules, they are known as “free” fatty
acids. Fatty acids are also important
sources of fuel because when metab-
olized, they yield large quantities of
ATP. ATP is also known as energy.
Fat plays a major role in many func-
tions of the nervous system and for-
mation of endocrine hormones as
well. Generally, you should ingest
LawOfficer.com
1410lo_21 21
at least 25–30% of your caloric load
in good fats (polyunsaturated and
monounsaturated) with 10% of the
total coming from saturated. Avoid
trans fats. Sources of good fats and
oils are nuts (almonds, walnuts,
cashews, etc.), olive oil and avocado.
7) Fiber. We need about 25–30 grams
of fiber a day. Fiber has been shown
to reduce the risk of cardiovascular
disease, help lower cholesterol and
minimize absorption of bad choles-
terol. Soluble and insoluble fiber
stabilizes blood sugar levels and
supports the health of the colon.
Fiber has been shown to prevent
constipation and potential intesti-
nal complications. The simple addi-
tion of a teaspoon of psyllium husks
or flax seeds every day will regulate
the digestive system.
8) Increase your pure water
intake. Your body is more than 60%
water. Unless you have a kidney or
heart problem and are unable to
process and get rid of water like one
should, it is a good rule of thumb to
drink plenty of pure water—without
any added flavor. Flavorings contain
additives and preservatives that are
hard on the liver and the bodies’
natural detoxification process.
9) Exercise must be a regular part
of your daily routine. The num-
ber of days you should exercise is
unique to you. It varies if you are
training for an athletic event, try-
ing to gain strength, improve your
mobility or just trying to stay in
motion. Start small in order to avoid
injury. Do your cardio-fitness first
to get the weight off, improve your
mobility and align your joints for
injury prevention. Develop an exer-
cise plan and get it on paper. Choose
your activity, then decide the time
during the day and how many times
per week you will participate in the
activity. Try for at least three times
a week if you are expecting to make
October 2014 l LAW OFFICER MAGAZINE l 21
any progress. Be active for a contin-
uous 30–45 minutes per session and
increase activity only about 10–15%
per week.
10) Eating before bedtime. This can
be a touchy subject, but calories
late at night can do you more harm
than good. The answer is not to stay
awake to eat but to ingest the proper
foods just before lying down for the
night. Proteins and essential fats
help slow digestion and provide a
steady supply of amino acids for fuel.
Be very selective on the type of car-
bohydrates you eat after 6 p.m. Your
body’s digestive enzymes are slow-
ing down. Your engines of metabo-
lism, as well as your brain, are on
a circadian rhythm. Remember that
carbohydrates secrete insulin. If you
eat a lot of high glycemic index car-
bohydrates late in the evening, you
will not burn them very fast. Not
only will you store the calories as
fat, your insulin levels will continue
soaring throughout the night and
your body will not be able to access
its fat stores during your nighttime
fast. When you could be burning fat
as fuel, you don’t because you sabo-
taged yourself with too many inap-
propriate carbohydrates.
It takes time and commitment to
the task. Remember this is a lifestyle,
and it is for life. Here’s to you and your
health! LOM
MARK SHERWOOD retired after 24 years with
the Tulsa (Okla.) Police Department at the rank of
sergeant. He is a naturopathic doctor and the CEO
of 4E Fitness (Live4E.com), a wellness company
that carries a full line of nutritional supplements
and activity DVDs specifically designed to teach the
non-active how to be active. He is a lead instructor
for SAFETAC (safetac.org) and a Cooper Institute Cer-
tified Personal Trainer who speaks to and instructs
law enforcement, military, first responders and
corporations on subjects such as conquering stress,
eliminating wellness debt and achieving personal
wellness. Sherwood is a certified health educator for
Designs for Health (designsforheath.com) as well as
the co-founder of the Protector’s Oath (protectorso-
ath.org). Sherwood’s passion for wellness is further
evidences by his long-running televiosin show, 4E TV,
which can be seen on YouTube and at uanetwork.tv.
9/30/14 10:26 AM
 Officerss Ne
Off Need Help
lp –
Do You Copy?
Communications issues jeopardy of officer safety.
In early February 2013, a series of shootings took place
in the Christopher Dorner in Orange, Los Angeles and Riverside counties. The victims
were law enforcement officers and their families, or civil-
incidents By Michael Guerin ians who had been misidentified as the suspect. At the end

T
he May 2014 release of Police Under Attack, a
comprehensive after-action review of the Christo-
pher Dorner incidents in Southern California, is
important reading for anyone in law enforcement.1
Beyond the strategic and tactical issues discussed at length
in the report, the Police Foundation’s authors highlighted
several specific instances in which a lack of adequate com-
munications caused problems; ranging from confusion to
of a nine-day manhunt, suspect Christopher Dorner, 33,
an honorably discharged Navy Reservist and former Los
Angeles police officer, was dead; as were two civilians and
two police officers—Deputy Jeremiah MacKay and officer
Michael Crain.
The challenges confronting the principal law enforce-
ment agencies in this incident were immense. The subse-
quent manhunt for Dorner took place over a wide expanse
of Southern California encompassing various geographical

In this AP file photo, police in Riverside, Calif., search for former Los Angeles police officer Christopher Dorner, who was fired
from the LAPD in 2008 for making false statements. In February 2013, Dorner led police on a nine-day manhunt, leaving two
civilians and two police officers dead.

AP PHOTO/ KEVIN WARN

22 l LAW OFFICER MAGAZINE l October 2014 LawOfficer.com

1410lo_22 22 9/30/14 10:26 AM

 regions and weather patterns. It required the coordination
of thousands of police officers, sheriff ’s deputies, highway
patrol officers and state and federal special agents, all with
different policies and practices, organizational cultures and
frequently incompatible communications systems.
Don’t Tune Out
The last thing some people want to read is another article
on the issue of interoperability, but as the report reminds
us, the problems have not yet been solved. Perhaps what is
needed is a different approach—one that focuses on issues
brought to light in this case. Perhaps the solutions could
already exist in our toolbox (and in some cases, in our radi-
os). This article focuses not on highly technical issues, but
on operational-level concepts for dispatchers, officers, depu-
ties and troopers. Hopefully it will present ideas they may
wish to consider so that they will be better prepared to use
available communications in an emergency—or to ask intel-
ligent questions as to what is and is not available in their
communications systems.
From the Report:
“Because this was a multiagency event, interoperability was
predictably the first major technological problem to emerge.
Most of the agencies involved in the investigation and even-
tual apprehension of Dorner did not share common radio
frequencies. Several did not even have the capacity to be
patched to a tactical channel in the jurisdiction where they
were working. This lack of real-time communication capac-
ity during high-risk operations put officers and citizens at
extreme risk and diminished opportunities to apprehend
[Dorner]. In addition to the safety risks, even rudimentary
coordination was hampered by the inability to broadcast
information to the field simultaneously and consistently.”
The report went on to describe specific situations in
which officers from one jurisdiction operated inside another
jurisdiction’s territory without even rudimentary means of
communication. In one instance, officers intended to use a
cellphone to call the local agency, but the cellphone became
inoperable. Later, these officers had to borrow a cellphone to
call 9-1-1 when shots were fired at them.
According to the report, “The Police Foundation team
identified success in interoperable communication systems
in Orange County and failures in Riverside County. While
local jurisdictions are attempting to resolve the issues, it is
inexcusable that law enforcement agencies in a county or
region cannot immediately communicate with each other.”
What’s In Your Radio?
In “the old days,” two-way radios were lucky to have four
channels, while today’s modern equipment has the capacity
for anywhere from 16 to hundreds of possible frequencies.
This should be good news, but in some cases our officers,
deputies and troopers don’t remember what tools they have
in their radios. Most agencies program in several interop-
erability frequencies and access channels (more on these
LawOfficer.com
1410lo_23 23
later), but officers tend to remember only those channels
that they use every day, and sometimes forget how to change
zones or find rarely used talkgroups. Even officers who have
dozens of the most complex apps on their smartphones seem
to have this difficulty.
This would indicate that additional training and docu-
mentation are needed. Does each officer have a list of all
channels/talkgroups in the radios and available uses for
each? Have they practiced changing zones and demon-
strated this proficiency? Do they do it often enough to recall
how when under pressure? Do dispatchers know what is in
their consoles, what each channel/talkgroup does and whom
it communicates with? Do they know and practice how to
enable and disable patches and make simulcast transmis-
sions over several or all of their available channels?
AP PHOTO/ CHRIS CARLSON
Two women were wounded when LAPD officers mistakenly
opened fire on them during the hunt for Dorner.
There May Be an App for That
Some agencies have worked with vendors to produce apps
that help the user know, based on his or her geographic posi-
tion, the available interoperability channels. The two I am
aware of in my area are both focused on fire service communi-
cations, but the logic holds that even officers who won’t take
the time to read channel lists may find it useful to look up
radio operation information on a smartphone. One app even
includes short videos on radio operation. Even without your
own app, you can record short videos with the use of radio
equipment, changing zones, etc., and use simple video sharing
sites to post them privately for your dispatchers and officers
to view on their devices. These are interesting possibilities.
Access Channels
Today’s radio systems are not only more complex, they are,
by nature, more compartmentalized. Some agencies, as a
means to optimize use of a group of frequencies, opt for sys-
tems that use trunking technology (as do commercial wire-
less companies). Some agencies have moved to the digital
radio standard known as P25. Some conventional radios
cannot communicate on digital channels. A related issue is
encryption. Some agencies have chosen to encrypt
October 2014 l LAW OFFICER MAGAZINE l 23
9/30/14 10:26 AM
 their radio traffic to ensure that
unauthorized parties cannot
monitor transmissions. While
this seems reasonable on its face,
it too can hinder interoperability.
A solution is available and
is used by many agencies with
“closed” radio systems (systems
others don’t have the technol-
ogy to operate on). This is the
concept of an access channel. By
definition this is a channel—or
repeated pair of frequencies for
wide area systems—that is made
available to allied agencies to

AP PHOTO/ THE SUN/ JOHN VALENZUELA

use to contact your agency. To
be effective it should be analog,
not digital; it should be conven-
tional, not trunked; it should
not be encrypted. Does your sys-
tem have such a channel identi-
fied? Do other area agencies that Communications during the Dorner incidents did not only break down among agencies,
but between police and citizens in the areas affected by the manhunt.
might enter your area know of it
and have it in their radios? help for officers in trouble and the return of critical missing
What if the neighboring agency is on a different band persons—in short, increased public safety. A few other agen-
entirely? As we discuss the splintered nature of our commu- cies are moving in this direction with regional broadcast or
nications, with agencies across the street on different bands, pursuit channels.
it is worth mentioning that some chiefs and sheriffs have
long ago decided to put two mobile radios in each police I’m the Law in This Town
vehicle. Yes, this seems expensive, and yes, it is yet one more Fire agencies in some parts of the country seem to have
item to put in an already crowded patrol vehicle, but it may better embraced the conclusion that they need to commu-
be necessary when neighboring agencies operate with one nicate with other agencies rapidly and accurately on an
another daily on different bands. Some manufacturers are as-needed basis. Many share tactical frequencies with one
finally making dual band radios, and this may be an option another and, perhaps because they tend to work together
for you as well, if you can afford it. The RCMP and CHP are across boundaries more often, their interoperability prob-
working with a vendor to integrate several mobile radios lems are being worked out. (Clearly this is not always the
into an MDT controller, but few can afford such sophisti- case, nor is this to say that law enforcement is not working
cated solutions. Whatever you can afford, think of it as an hard to address their issues.) Law enforcement agencies,
investment in officer safety.2 however, tend to be more independent by tradition and
the nature of their work. Confidentiality, organizational
Calling All Cars history and legal jurisdiction all contribute to this—legiti-
How can officers on several different channels get the word mately so.
when there is a pursuit, help call or critical crime broad- When it comes to the ability to communicate among and
cast? In many agencies this involves dispatchers calling one between jurisdictions, my experience is that law enforce-
another and manually rebroadcasting it on several different ment needs to speed up their efforts and the Police Foun-
frequencies, and on several different radio systems. dation report appears to echo this view. Make agreements
Some broadcasts go out quickly, others less so. At least in with adjoining agencies to place their channels in your
regional or countywide systems (sometimes called subscrib- radios, and yours in theirs, then empower your officers/
er systems) technology exists to ease and speed this process. deputies/troopers to change channels as needed to speak
It does cost extra money, but it works and is proven to do with neighbors.
so on a daily basis. Orange County, in Southern Califor-
nia, has, for two generations of systems, specified a mobile TV Cops, Old School Solutions & Combining the Two
radio with a second receiver section—one that constantly When you tune in to most any current police show on tele-
monitors a countywide emergency channel. This channel is vision, you will see cops using their cellphones (sometimes
only used for pursuits, “officer needs help” calls and critical exclusively) to communicate with their office, their part-
crime broadcasts. It has resulted in apprehensions, faster ners, etc. Cellphones have their advantages in

24 l LAW OFFICER MAGAZINE l October 2014 LawOfficer.com

1410lo_24 24 9/30/14 10:26 AM

 FIT FOR THE
CALL OF DUTY.

RIPSTOP TACTICAL PANT

When you’re in the field, your tactical equipment should be an asset,
not a distraction. Since 1922, Dickies® has proudly kept America
comfortable with time-tested gear that never compromises on comfort,
durability or mobility.
• Dupont Teflon® fabric protector repels water and stains
• Comfort waist with triple waistband gripper
• Roomy bellowed cargo pocket with built in mag pouch
• Reinforced double knee with vent for knee pad

Call 800.336.7202 or contact

your local Dickies Representative
www.dickiesdelivered.com
Choose 12 at www.lawofficer.com/rs.

1410lo_25 25 9/30/14 10:27 AM

 sensitive cases, but should not be considered a substitute
for using two-way radio when available. Cellphone conver-
sations convey information to one party only, which is the
direct opposite of interoperability and sharing of officer
safety information that others may need to hear. Along the
same lines, you should never type your crime broadcast
or important items like traffic stops to your dispatcher on
your mobile data terminal (MDT) or patrol laptop. Again,
it is important for others to hear the information that they
might have to use to back you up, such as your location
and activity.
The Foundation report did note that sometimes the only
available solution is to trade portable radios with an agen-
cy you are working with or when you are working in an out-
side jurisdiction on a case or incident. Even this is superior
to relying on a cellphone in many situations.
A few vendors have recently begun marketing push-to-
talk (PTT) ability to connect cellphones to two-way radio
channels for use in tactical, emergency or travel situations.
Several agencies are testing these promising products.
(For the record, Nextel had such a capability for several
years and a few agencies used this to connect administra-
tors, investigators, etc., to agency channels using their cell-
phones. Nextel, of course, is no more.)
Didn’t We Already Fix This?
Some communications specialists—and certainly some
vendors—would have you believe that the “next genera-
tion” long term evolution (LTE) digital devices will soon
enhance our ability to share information. Beware of two
cautions. Caution one: information sharing that will
improve the most and the soonest is likely to be what we
might call “data” such as photos, fingerprints, etc. Will LTE
soon supplant two-way radio as we know them today?3
Unlikely. Caution two: note the use of the word “future.”
True, the feds, states and locals want to move forward
aggressively toward a nationwide public safety broadband
network, but this will likely take quite a while.4 For the
time being, let’s learn how to best use what we have.
Some vendors would offer that interoperability solu-
tions exist—if you buy a new system or hire them to engi-
neer you a “black box” or something else that they can
sell you. These may be options if your agency has fund-
ing to support them, but some solutions don’t require
that entire systems be replaced—just that some limited
enhancements, using currently available technology be
considered. In other cases, nothing at all needs to be pro-
grammed, purchased or procured. All that is needed is
better documentation, training and exercises to ensure
that capabilities already in place are known and famil-
iar to the dispatchers, officers, deputies and troopers who
need them.
Your Vendor Knows Some, But Not All
True, communications vendors know a great deal about
their products and what they can do for you, but only
26 l LAW OFFICER MAGAZINE l October 2014
1410lo_26 26
you know your jurisdiction and the agencies around
you. When you deal with vendors, be specific about what
you hope to accomplish with the equipment you buy. I
have too often seen vendors steer clients into “solutions”
that may be more costly—and complex—than they need.
Often, law enforcement managers don’t know a great deal
about the technical issues related to communications
and interoperability, but there are resources available
to you. Organizations such as the Association of Public-
Safety Communications Officials (APCO), the National
Emergency Number Association (NENA) and others have
members in partner agencies nearby that may be able to
help you.5,6
Each state has an interoperability manager (State-
wide Interoperability Coordinator, or SWIC) and he or she
can refer you to communications-savvy people in partner
agencies.7 Most states offer Communications Unit Leader
(COML) training classes.8 These are based on a standard-
ized Department of Homeland Security (DHS) curriculum
and provide training for emergency responders to serve
as radio communications unit leaders during all-hazard
emergency operations. COML responsibilities include
developing plans to effectively use incident communica-
tions equipment and facilities, managing distribution
of communications equipment to incident personnel and
coordinating the installation and testing of communica-
tions equipment.
What Next?
The Police Foundation report reinforces what we already
know: we have more work to do when it comes to the ability
to communicate with other agencies during rapidly unfold-
ing events and emergencies. Consider that some of the
answers may be closer—and less costly—than most of us
may realize. LOM
References
1. “Police Under Attack,” (incidentreviews.org)
2. United State Government Accountability Office, Emergency Communications:
Various Challenges Likely to Slow Implementation of a Public Safety Broad-
band Network (February 2012). (gao.gov/assets/590/588795.pdf)
3. (rockwellcollins.com/~/media/Files/Unsecure/Products/Product%20Bro-
chures/Integrated%20Systems/Ground%20Vehicle%20Systems/iForce%20
white%20paper.aspx)
4. (npstc.org/download.jsp?tableId=37&column=217&id=2712&file=Why_Cant_
PS_Just_Use_Cell_Phones_NPSTC_130415_orig.pdf)
5. (apcointl.org)
6. (nena.org)
7. DHS Office of Emergency Communications Emergency Communications
Forum, Volume 9
(npstc.org/download.jsp?tableId=37&column=217&id=2278&file=OEC_ECF_
Vol_9-March_2012.pdf)
8. DHS Communications Unit Leader Training (dhs.gov/
communications-unit-leader-training)
MICHAEL GUERIN recently retired after 38 years of public safety service in
various California agencies. He served as the state’s Law Enforcement Mutual Aid
Chief in the California Governor’s Office of Emergency Services and is a former
dispatcher, patrol officer, sergeant, training manager and chief investigator and
police chief. Guerin is a former instructor at the California Specialized Training Insti-
tute and has traveled the country as an instructor for FEMA’s National Emergency
Training Center. He is a member of APCO and a life member in the California Peace
Officers Association. He welcomes comments to mguerin@csupomona.edu.
LawOfficer.com
9/30/14 10:27 AM
 Youíre most vulnerable
when you exit your cruiser.
Take the extra step. Light your flares
and get home safely.

Share your fare story

and enter toWin
When Orion Flares are used in
addition to cruiser light bars, it has $1,000 Visa Gift Card
been proven that fares: Enter Today
orionsignals.com/win1
Increase lateral separation by 85%
Reduce right lane volume by 89%



  15%
©2014 Orion Safety Products

800-637-7807
Choose 13 at www.lawofficer.com/rs.

1410lo_27 27 9/30/14 10:27 AM

 the Ultimate Public-Private Partnership
By Alanna Maya
Atlanta PD uses technology to deter crime in the city
B
altimore. Chicago. New York. London: All have
impressive city-wide video surveillance systems.
Used to deter crime and to catch and prosecute
criminals, these systems are extremely success-
ful endeavors, and cities across the country have looked to
them for help planning and developing their own surveil-
lance programs.
Just six years ago, the Atlanta Police Department was one
of those cities—crime was up, the number of police officers
employed was down and police leadership looked for ways to
improve the quality of life for all of Atlanta’s citizens. Their
efforts culminated in the formation of Operation Shield, a
game-changing force multiplier for the Atlanta PD.
28 l LAW OFFICER MAGAZINE l October 2014
1410lo_28 28
“At the time, we realized that even though we were
working toward having more police officers—we had about
1,700 [officers] and we were working our way to 2,000—we
realized we would never have enough eyes and ears on the
street to create the appropriate police visibility in the city
that we would hope to have from a deterrence perspective,”
says Dave Wilkinson, President and CEO of the Atlanta
Police Foundation (APF).
So officials looked to technology to solve their prob-
lem. Organizers first wanted to create a communications
network that would connect all the city’s security guards
(whose numbers were estimated to be near 15 for every
one police officer in the city) to police radio. The result was
LawOfficer.com
9/30/14 10:27 AM
 COMNET, a city-owned radio network through which pri- own them, so the city can
vate security guards could operate and communicate direct- avoid budget busters in the
ly with the police department. A text alert network went future. All APD has to do is
one step further, notifying both private security and Atlanta watch what happens.
police when a major crime or BOLO was issued. But these “We do not and cannot
efforts were relatively easy to achieve. The city’s crowning monitor all of these cameras
glory—the Video Integration Center “was the biggest and [at once], but what’s impor-
most difficult part of this plan to build,” Wilkinson says. tant is that we have access
A public-private partnership that employs nearly 3,550 to those cameras,” Brown-
CCTV cameras throughout the city, all feeding back to one ing says. “Our system is
place, the Video Integration Center (VIC) is a real-time additive to the department.
crime center where sworn officers have access to the city’s We are a force multiplier
cameras 24 hours a day. The VIC is similar to other well- for the officers that are out
known surveillance programs, despite one rather large dif- there, so our success stories
ference: The way the police department pays—or doesn’t— can be anything from catch-
for the cameras. At present, only about 20% of the total ing quality of life cases [as
number of cameras in the VIC are owned by the city. It’s a they occur] to being the
convenient solution to a common budgetary problem. eyes and ears for [a public
“There is no way that this city could install, pay for and event] downtown. We have
maintain that many cameras, so [we] look to and partner helped in various homicide
with the stakeholders in the city and the big businesses that cases, assaults, robberies
Most major intersections and
already have their own camera systems, and integrate both and, sometimes, through
public gathering spaces in
the public and private feeds in one place,” says Lt. LeAnne the video footage, we real- Atlanta are visible to officers
Browning, VIC supervisor. ize that the crime didn’t working in the VIC, but orga-
APD and APF spent two years developing the project and actually occur the way that nizers want to increase visibil-
systems. Seed money in the form of a $1.25 million grant somebody said it did, so we ity in the city’s neighborhoods.
from the Department of Homeland Security went to devel- are able to unfound the case.”
opment of the network in the city’s downtown area, and pri- Officers in the field work with officers in the VIC by shar-
vate sector donations filled in the gaps, including $1 million ing information about where the high crime areas are and,
from the Loudermilk Family, for whom the VIC is named. in turn, officers in the VIC are able to monitor camera feeds
City-owned cameras in the network record real-time feeds in those same areas on a daily basis. Occasionally, VIC offi-
that are integrated into the VIC through Physical Security cers will witness a crime as it is being committed and are
Integration Management (PSIM) software that allows for able to call ground units to that location before a
disparate video management systems,

PHOTOS COURTESY ATLANTA PD & ATLANTA POLICE FOUNDATION

data points and alarm sensors to feed
into one location. Private sector feeds
are also transmitted through the
PSIM, but are not recorded by APD.
This comes at no additional cost to
the city, allowing officers in the VIC to
have access to any number of cameras,
whether they are located on city prop-
erty or on the outside of the CNN Cen-
ter in downtown Atlanta. Private enti-
ties maintain possession of their video,
as well as ownership of the cameras
and systems that keep them running.
Both installation and maintenance
costs for privately-owned cameras are
the responsibility of the entities that

Sworn officers monitor feeds from

cameras around the city at the Video
Integration Center. About 80% of the
cameras in the city are privately-owned,
keeping the city’s maintenance costs for
the valuable program low.

LawOfficer.com October 2014 l LAW OFFICER MAGAZINE l 29

1410lo_29 29 9/30/14 10:27 AM

 Now there’s no such thing as a getaway car.

Message and data rates may apply.

1410lo_30 30 9/30/14 10:27 AM

 2014 FORD POLICE INTERCEPTOR ®
Perps will have a tough time running from the law when the law has Intelligent AWD
technology. No matter how nasty the weather gets out there, Intelligent AWD keeps
you in control, on your game and ready to bust up any escape plan.
fordpoliceinterceptor.com

Choose 14 at www.lawofficer.com/rs.

1410lo_31 31 9/30/14 10:27 AM

 “Our officers have been out on
the streets; they understand how
to answer calls and they know
what to look for [and] what is going
on and can advise the responding
officer via radio what they need
to be on the lookout for, and can
tell if another unit needs to be dis-
patched with the responding unit,”
Browning says.
In this way, APD is able to begin
the investigation process before
officers are physically at the scene.
“The analytics in the system are
the key to the system,” Wilkinson
says. “The term ‘monitoring’ cam-
eras seems to be a fallacy, because
nobody can sit there and monitor
all these cameras at once. You have
to be able to have a system that
cues up the appropriate camera
view at a particular time [like when
a crime has just been reported].”
This piece of the puzzle is
The public-private partnership is seamless on all sides—It is hard to tell which cameras
important because APD does not
are city-owned and which are owened by private entities as you walk through the city.
record or store any private sector
civilian has reported the crime. Using PredPol, an existing video. Should a crime occur within view of a private enti-
predictive policing application, along with the VIC, APD is ty’s camera feed, officers would still need to go through the
able to anticipate some crimes. proper channels to obtain that footage, and detectives would
“We push our crime numbers to PredPol every five min-
utes and, in turn, they give us eight hours of predictive ana-
lytics, which we inject into our PSIM at the VIC,” Browning
says. “So the officers that are in the VIC can see the boxes
where crime is more likely to occur, and they are able to
view the cameras that are in those areas and keep an eye
out to hopefully keep crime from happening.”
The applications of the VIC are impressive and growing
by the day, but Wilkinson says monitoring video surveil-
lance cameras is not the end goal of the program. He says
program organizers hope to create an intuitive monitoring
process in which the appropriate cameras are cued up based
on reported incidents or “certain triggers.”
Right now, the 9-1-1 call systems have been integrated
into to the data at the VIC, so an officer who is sitting in
front of three monitors will be viewing two monitors with
camera feeds and one monitor on which a rolling ticker of
9-1-1 calls appears. These calls, as well as the cameras in
the system, are geo-tagged for location so that an officer will
immediately be able to switch views and pull up the four
cameras closest to where the 9-1-1 call originated, giving
APD immediate situational awareness of the incident. The
two closest camera feeds (whether from public or privately
owned cameras) are also automatically rewound to show
the five minutes of recording before the 9-1-1 call came in. The value of being able to tap into private camera views is
This is why having sworn personnel behind the monitors immense; APD has immediate situational awareness for large-
in the VIC is key. scale events in the city and criminal activity is down.

32 l LAW OFFICER MAGAZINE l October 2014 LawOfficer.com

1410lo_32 32 9/30/14 10:27 AM

 more than 1,000 disparate databases—which is also inte-
grated into the VIC dashboard. Anything from license plates
to mug shots to suspect descriptions are now immediately
searchable in one place.
“If a suspect description [from a 9-1-1 call] includes a scar
on the neck, every case that we have with ‘neck scar’ would
pop up [in Search 360],” Wilkinson says. “And this is on the
third dashboard in front of the officers in the VIC. We are
working on getting all the alarms in the city into this net-
work and, as new buildings are coming on board and coming
online, we are bringing all of their surveillance cameras into
the system as well.”
So, how has all this technology helped crime rates in
Atlanta?
“We have been very successful,” Wilkinson says, noting
that the number of police officers employed is now around
Due to Operation Shield’s success, other cities of simliar size
2,000. “We have the lowest crime rate since the late ’60s
hoping to build their own program have turned to Atlanta PD.
and crime is down another 9% this year, so we have made
be sent out to recover it. tremendous progress, tremendous impact and we have a lot
In the last year, APD has partnered with Google and of forward momentum to take the next big step in crime
Edge360, a company that specializes in public safety tech- prevention.” LOM
nologies for law enforcement, to streamline their analytics.
Using Google Maps and Google Search, APD’s program is ALANNA MAYA is managing editor of Law Officer Magazine. Reach her at alan-

Search 360—a searchable database that combines APD’s nam@pennwell.com.

code Red
Fo Outdoor Products
Fox TM

is p pleased to introduce
its
it line of Code Red.
TThis color is perfect
fo
or Emergency Medical
for
SServices (EMS), Fire
De
D
Departments, Medical
Personnel, Military
Co
C
Corpsmen and/or any
T
Tactical Enthusiast!
Yo may view our wide
You
sselection of Tactical,
M
Military, Enforcement,
& Outdoor Gear at
www.foxoutdoor.com.
ww

TOLL-FREE:
TOLL
L-FREE:
FREE: 8
800-523-4332
00-523-4332
523 4332 EMAIL: INFO@FOXOUTDOOR.COM WEB: FOXOUTDOOR.COM PROUD SPONSOR OF
THE NATIONAL TACTICAL
Top Row: Field Operator’s Action Pack, Jumbo Modular Field Pack, Cobra Gold Reconnaissance Pack, Advanced Hydro Assault Pack, Mediumdi Transport
T t Pack,
P k OFFICERS ASSOCIATION
Advanced 3-Day Combat Pack Middle Rows: First Responder Active Field Pouch, Mission Response Bag, Modular Deployment Bag, Jumbo Modular Deployment
Bag, 3-in-1 Recon Gear Bag Bottom Row: First Responder Pouch- Large, Multi-Purpose Accessory Pouch, General Purpose Utility Pouch, First Responder
Pouch- Small w/ Contents, First Responder Pouch- Small, First Responder Pouch- Large w/ Contents, Hydration Carrier Pouch, Advanced Tactical Hipster JOIN US ON:

Choose 15 at www.lawofficer.com/rs.

LawOfficer.com October 2014 l LAW OFFICER MAGAZINE l 33

1410lo_33 33 9/30/14 10:27 AM

 At Border Patrol headquarters in Edin-
burg, Texas, geographic information
systems and other mapping programs
are helping Border Patrol officials to spot
emerging trends in illegal activity in their
sectors.

AP PHOTO/ALEX JONES
PREDICTIVE POLICING
How your agency can use data to forecast & prevent
crime before it happens
BY JOSH LEVIN

I
n a nutshell, predictive policing is the practice of using
data to both predict and forecast future activity so that
agencies can deploy resources in the most effective man-
ner to ultimately prevent and deter crime from occurring.
There have been countless publications and research articles
written in recent years documenting the success of this polic-
ing strategy. There is no doubt that the use of data and analy-
sis to help guide the decision-making process in law enforce-
ment is here to stay. However, there are still many police
departments throughout the country that are not leverag-
ing these techniques. While there are many reasons for this
reluctance, one of the most common notions is that policing
professionals feel that their agency is too small to need or
benefit from predictive policing techniques. Nothing could be
further from the truth.
No matter the size of the agency, the practice of using data
to make better informed tactical, strategic and operational
decisions is a sound philosophy. While predictive policing is
relatively new, the basic principles of this philosophy have
been around for a very long time in the business world.
Businesses decide how much product to order at what time
of year, how many staff members need to be employed and
what projected sales are going to be next quarter all through
the analysis of data. A law enforcement agency claiming that
predictive analytics is only for the “big dog” agencies is akin
to a family-owned grocery store ordering products at random
and ignoring their sales history and other data because they
are not as big as Walmart or Target. That way of thinking just
doesn’t make sense.
There is no doubt that the use of
data and analysis to help guide
the decision-making process in
law enforcement is here to stay.
Another common reason articulated by agencies who feel
that predictive policing is “not for them” is that the analytical
software and skilled crime analysts are too expensive. Almost
every municipality in the country is being asked to do more
with less and have been dealing with shrinking budgets for
years. This has affected agencies both large and small. In

34 l LAW OFFICER MAGAZINE l October 2014 LawOfficer.com

1410lo_34 34 9/30/14 10:28 AM

 fact, it could be argued that a reduc-
tion in sworn officers could more
greatly impact a smaller agency that
did not have the “extra” resources in
various specialty units throughout
their agency. While spending money
on analytical software and/or a crime
analyst may seem counterintuitive
when budgets are tight, these actions
can actually increase the effective-
ness of an agency’s limited resources.
Putting a predictive policing strat-
egy into practice starts with obtain-
ing the right technical software and trained personnel to uti-
lize it. There are several key factors that must be considered
when selecting analytical software, including upfront costs,
ongoing costs and ease of use, but none is more important
than feeling comfortable with the algorithm being used and
feeling confident about the results that are being produced.
While budgets may be frozen and certain resources are dwin-
dling throughout the law enforcement community, data is
abundant in this industry. Every agency, no matter how large
or small, has data available. Case reports and calls for service
are being documented somewhere and that data is typically
available. An agency should be diligent in testing the predic-
tive analytics software that they have against their own data
IBM predictive analytics (top) is used by the Memphis PD to analyze past and present crime records. Crime analysis software
cannot work on its own. When used in conjunction with police dispatch, anaylists are able to push information to officers in the
field both before an incident occurs and as crime happens.
LawOfficer.com
1410lo_35 35
to make determinations about how
and when to utilize it.
There is no software available
that can predict every crime type, for
every time period, in every part of
the county, every single time. There
is no magical equation that can be
used in every situation. However,
through testing, an agency can deter-
mine what works best for their juris-
diction and utilize their software
tools to the best of their potential.
If a grocery store used an analytical
model to determine how much eggnog to purchase around
Christmas and then ended up having case after case still on
their shelves after the holidays that they couldn’t sell, they
most likely would use a different approach next year to avoid
wasting merchandise. The same approach should be used by
law enforcement. If an agency wants to combat residential
burglaries and it uses software to produce a forecast antici-
pating where they are likely to be concentrated next month,
then the department should have already tested that model
and predicted previous months that have already come and
gone so that the predictions could be compared to the actual
concentration of crime. By doing this, the agency will develop
a confidence level and know when it is and is not
AP PHOTO/JASON DECROW
October 2014 l LAW OFFICER MAGAZINE l 35
9/30/14 10:28 AM

Predictive software can help agencies map crime trends and improve response levels in areas of high crime. Real-time data can
be communicated to officers on the street, who can then immediately alter patrol patterns based on this information.
appropriate to use certain predictive algorithms.
Purchasing the right software and fully testing it is only
part of the process of implementing a predictive policing
strategy. The much more difficult job is creating institutional
knowledge about the philosophy and getting buy-in from all
levels of the agency. Predictive policing cannot work if the
chief of police and a few members of the command staff are
the only ones on board. Command staff has to authorize over-
time and change shift allocations when necessary, line level
supervisors need to direct proactive policing efforts within
predicted zones during predicted time periods, and individ-
ual officers need to understand the importance of their role
once in these predicted areas. No matter how accurate a fore-
cast or prediction may be, it will not help an agency achieve
its goal of deterring crime if it is not acted upon quickly.
It is clear that predictive policing is a valuable strategic
approach to fighting crime for any law enforcement agency,
regardless of size. That’s not to say, however, that there will
not be some differences in how predictive policing is used in
a smaller agency. In a smaller agency, next-event predictions
might not be needed for bank robbery or sexual assault series
every week. But the truth of the matter is that the same exact
analytical practices can be applied to any crime series with
the same results. In other words, smaller agencies that rec-
ognize a series of connected, albeit, less serious crimes, such
as a vandalism or bike theft series, could perform next-event
prediction analysis to determine the best place to deploy
resources to disrupt the activity and apprehend the offender.
36 l LAW OFFICER MAGAZINE l October 2014
1410lo_36 36
AP PHOTO/ALEX JONES
The same idea holds true for more general forecasts. While a
larger agency might be forecasting where the 30 or 40 gang-
related violent crimes are likely to be next week, a smaller
agency might be forecasting where the five or 10 property
crimes are going to be next month. The seriousness and the
frequency of the crime is less in a smaller agency, but that
does not mean that the value of using data analysis to guide
police intervention strategies is any less important.
Fortune 500 companies have a responsibility to their
shareholders to be as profitable as possible. It is common
knowledge in the corporate world that analyzing data to
turn raw information into business intelligence is one of
the necessary practices in order to fulfill that responsibil-
ity. The citizens who live and work in the communities that
your agency serves are the shareholders. While law enforce-
ment agencies have a far more awesome responsibility than
quarterly profits and dividends, the field could take a lesson
from the corporate world and accept that examining data
and performing predictive analytics is simply the best way
of doing business. LOM
JOSH LEVIN began his career as a crime analysis technician with the Scottsdale
(Ariz.) PD and later worked as a Crime Analyst II for the Colorado Springs (Colo.)
PD. With both departments, Josh supported specific patrol divisions and provided
tactical, strategic and administrative analysis to decision makers. He is currently
the Pattern Analyst Manager for the Analyst for Hire section at BAIR Analytics. He
has provided presentations and training to law enforcement practitioners and
criminal justice students throughout the United States and Canada and continues
to develop cutting-edge analytical techniques. He has a B.S. in Justice Studies from
Arizona State University and an M.B.A. from the American Military University.
LawOfficer.com
9/30/14 10:28 AM
 Choose 16 at www.lawofficer.com/rs.

1410lo_37 37 9/30/14 10:28 AM

 Success & safety
f t come in. This fear of danger, or perceived danger, is compounded

from realistic training &

by the officer’s lack of confidence or proficiency in handling
violent confrontations. These officers resort to what they

follow-up practice are most confident will help them stay safe.

By Brian N. O’Donnell

A
collection of weaponless techniques, Defen-
sive Tactics (DT) enable officers to control
or subdue those who become combative or
resist arrest. These tactics are an essential
skill. However, the amount of training time allotted to DT,
given the sheer number of techniques officers are expected
to learn, is insufficient. Compounding the problem is that
many skills are too complex and evaporate under the stress
of a real encounter. Further deterioration of skills comes
with the lack of progressive, realistic and follow-up train-
ing. These factors, in turn, lead officers to use the force they
know best, or the force they believe will keep them safe.
It can also lead to fear-based overreaction. Consequently,
many of the current DT systems set officers up for injury
or disciplinary action. Department heads need to rethink
the defensive tactics philosophy of their agencies to reduce
injuries to both officers and suspects.

Fear & Stress are Important Factors

Law enforcement DT training does not prepare the officer
for the speed, emotion and exhaustion often experienced in
real world applications. Officers rarely train at full speed,
with a legitimate fear of being hurt. They often train against It is one thing to practice
complex moves on a
instructors dressed in bulky, unwieldy protective gear—this
passive, accommodating
is like coaching a lineman on a football team at half speed fellow officer, but it is quite
and then putting him into a game. another when needed on the
Without the proper DT training, confidence in a set of street. It has been proven
skills decreases. If an officer is faced with a combative that simple, direct actions
work best against resisting/
subject, and the skills the officer has been taught are not
combative persons.
working—or he doesn’t believe they will work—fear will set

38 l LAW OFFICER MAGAZINE l October 2014 LawOfficer.com

1410lo_38 38 9/30/14 10:28 AM

 This may cause administrative action if department pol-
icy has force guidelines or requires use of “approved” tech-
niques. Even when fear is not in play, stress can cause an
officer to resort to inappropriate techniques that may have
worked in the past, but not necessarily what they learned
about at the academy. Poor technique or personal methods
used when controlling subjects will often cause injury to the
officer and the suspect. Injury to the officer can compound
fear, which can cloud the mind and impair decision making.
Fear-based overreaction may not even be a conscious de-
cision on the part of the officer but merely the automatic
survival response. This is not an issue if the officer can stop
their actions when the threat has been removed, but acute
stress can cause a person to act without conscious thought.
Acute stress can also cause a person to fail to act. Both
responses negatively impact the officer and suspect alike.
Again, these responses may be avoided or diminished with
the proper training.
It Starts with Training
Training should concentrate on a limited number of tech-
niques that utilize gross motor movements, with emphasis
on deflecting attacks and managing the distance between
LawOfficer.com
1410lo_39 39
the officer and the combative subject to facilitate handcuff-
ing or, if necessary, other force options.
Currently, the DT journey begins at the academy with a
week or two of training. Eighty hours—perhaps more in cer-
tain jurisdictions—to learn blocks, strikes, footwork, take-
downs, leg sweeps, escorts, distractions, pressure points,
handcuffing, vehicle extractions, joint locks, balance points,
disarming attackers, ground fighting, etc. The expectation
of this training includes a working knowledge of the tech-
niques, ability to perform them under stress and responsi-
bility by directive for using them in force situations.
Mere weeks after graduation, most officers remember, at
best, a handful of the techniques they were taught at the
academy. Even fewer officers can duplicate them on a resist-
ing subject. Most rely on actions they put into play without
thinking about them and that have worked for them in the
past. Too often, however, these instinctive techniques bear
little resemblance to the techniques officers are directed to
use or have learned at the academy. Hardwiring new skills
takes time. We should consider significantly reducing the
number of techniques and using the limited time designat-
ed to DT to train those techniques until they become natu-
ral responses when subduing or controlling a suspect.
Many of the skills learned in DT require multiple move-
ments in sequence to perform correctly. Time and again, it
is proven that simple, direct actions work the best against
resisting/combative persons. It is one thing to practice com-
plex moves on a passive, accommodating fellow officer, but it
is quite another to perform them when needed on the street.
These are easy to apply in a choreographed setting. The
hard part is recognizing when to apply a technique in a fluid
and violent confrontation, without hesitation and before the
window of opportunity closes. Processes requiring multiple
steps take too long to develop in real confrontations and will
generally fail.
Simple, gross motor movement skills are infinitely more
effective. A strong shoulder lock used to turn a person on his
stomach is a much simpler way to gain control than maneu-
vering him into the T3 handcuffing position.
Follow-Up is Key
Follow-up training in law enforcement, yearly after the
academy, generally consists of four hours spent walking
through a couple techniques. Any physical skill deteriorates
over time if not used or practiced and four hours a year (or
eight) is not enough for officers to stay proficient. Realistic
training, however, even with limited time, would more ef-
fectively help the officer retain the skill.
Most people will use the same techniques that work for
them over and over. These are not uniform across depart-
ments as each person has a different and unique set of expe-
riences. But the rationale behind using the same technique
again and again makes intuitive sense—if it works, you
trust the technique and will use it more often, getting bet-
ter at it because of the frequency of use. More importantly,
your mind has a strong incentive to remember
October 2014 l LAW OFFICER MAGAZINE l 39
9/30/14 10:28 AM

AP PHOTO/ JOHN HARRELL
Law enforcement DT training rarely prepares officers for the speed, emotion
and exhaustion often experienced in real world applications. Without the proper
training, officers confidence in a set of DT skills decreases.
and employ without hesitation those skills and movements
that will preserve your life or stop danger quickly, making
the hardwiring of those skills a faster process.
Become Really Good at a Few Techniques
We need to significantly reduce the number of techniques
we teach to officers by determining the most common en-
counters they have on the street and addressing them. We
then determine when officers should actually go “hands-on.”
Finally, we devise, or adopt, from current systems some sim-
ple techniques to address these issues, focusing on the con-
cepts behind the techniques. If we can, we adapt the skills
for multiple situations.
Learning how to avoid/block a sudden attack or work on
leg sweeps/takedowns are essential skills for any officer, as
one technique can be trained for use in multiple situations,
such as wrist grabs, lapel grabs and sudden attacks by sub-
jects. A person grabbing an officer by the arm or lapel is a
very aggressive action and a palm heel strike to the face is
reasonable to free yourself and prevent further aggression.
If an officer is suddenly rushed on, a palm heel strike to the
face and transitioning to another weapon system is appro-
priate. Multi-use skills should be simple and direct for use
under extreme stress.
In designing this new training, the agency command
40 l LAW OFFICER MAGAZINE l October 2013
1410lo_40 40
staff can decide when an officer should
actually use empty hand techniques on
a subject. If a suspect is told he is under
arrest and refuses to comply with orders, is
verbally combative and exhibits resistant
behavior/body language—why try a hands-
on method of control? Order him to the
ground and, if necessary, follow up with
OC spray or a Taser, then handcuff. Some
experienced officers say that handcuffs
only go on two ways—easy and hard. The
easy method is for a compliant person who
obeys commands. No one gets hurt. The
hard way is generally seen as the pile-
on. Officers should not feel compelled to
approach this combative person until they
are on the ground (ordered) or incapacitated
(using another weapon system). Use of OC
spray and Tasers has helped to facilitate
significant decreases in injury to both
officers and suspects, so the availability
of alternate force methods further reduces
the number of techniques an officer has to
learn.
Once the suspect is on the ground, dan-
ger to the officer is reduced and handcuffing
can take place. Ground control techniques
trained in real time can further facilitate
handcuffing and reduce the incidents of se-
rious injury to the officer and suspect alike.
Conclusion
Once administrators identify where the priorities in train-
ing lie, departmental instructors can develop a program
from existing techniques—choosing only the most simple,
effective procedures and adapting them to multiple scenar-
ios. There is a need to concentrate on protective measures
during sudden attacks, creating distance and transition-
ing to other weapons systems or taking the suspect to the
ground and handcuffing quickly. If departments focused on
these skills, using simple techniques honed with repetition
and realistic training, the officers would be more competent,
confident and operating within policy. This confidence would
reduce fear felt by officers and instances of increased stress,
allowing officers to make appropriate force decisions, reduc-
ing excessive force complaints and uses of deadly force. LOM
Resources
1. A Multi-Method Evaluation of Police Use of Force Outcomes, final report to the
National Institute of Justice, July 2010, NCJ 231176. Retrieved from http://www.
ncjrs.gov/pdffiles1/nij/grants/231176.pdf.
DET. SGT. BRIAN N. O’DONNELL is a graduate of Northwestern University and
a former United States Marine Corps Infantry officer. He has been with the Charlot-
tesville (Va.) Police Department for 18 years. O’Donnell has been a defensive tactics
instructor for 14 years and a Gracie Survival Tactics Instructor for more than three
years. He is currently assigned to the Office of Professional Standards.
LawOfficer.com
9/30/14 10:28 AM
 Federal Signal’s exclusive SpectraLux® multicolor LED technology keeps you safely in control of an
emergency situation. SpectraLux® allows for a single light head to change color while in operation,
providing 360º of continuous light output from takedown and alleys to an impressive food feature.
Use its all-white food light to locate a suspect or select an amber fash pattern to safely direct traffc
away from an emergency scene—and you.

To see EXCLUSIVE SPECTRALUX® LIGHTBAR TECHNOLOGY as featured

on Valor® and Integrity® from Federal Signal, visit fedsig.com
The logotypes displayed on the vehicles are the registered trademark of Ford Motor Company and General Motors Corporation, respectively.

Choose 17 at www.lawofficer.com/rs.

1410lo_41 41 9/30/14 10:28 AM

 Are You Prepared?
Consider your plans for
retirement before putting
down your badge
By Brad Smith
A
re you prepared for life after law enforce-
ment? Before you say yes, take some time
to finish reading the next few paragraphs—
they just might change your life.
The time to start thinking about what you want to do
when you retire is not near the end of your career, but while
your career is in full stride. The good news about this job
is you can retire at an earlier age compared to people in
the private sector. God willing, you can have an additional
20–30 years to enjoy your life and do things you missed out
on during your career.
The bad news is some law enforcement jobs do not set
well with good health and longevity. This is mainly due
to shift work, stress, poor eating habits and, for some, too
much alcohol intake.
When I was a young officer, I didn’t think about retire-
ment—I was busy living in the moment. About halfway
through my 30-year career, I started to think about the sec-
ond part of my life, and possibly a second career. The first
15 years on the job flew by and I assumed the last 15 years
would as well. Boy, was I right.
I started talking to some of my mentors and senior officers
at my department who were going to retire soon and noticed
three very common themes start to emerge. Even though
everyone had their ups and downs during their career, they
all said their time in law enforcement went by faster than
they could have ever imagined. The second theme they all
42 l LAW OFFICER MAGAZINE l October 2014
1410lo_42 42
agreed upon was that “they would miss the clowns, but not
the circus.” I’ll let you ponder what that means.
What shocked me the most was that many of these senior
officers had no plans for retirement. Most said they were
just going to “relax and enjoy life.” That’s fine for the first
month or two, but then what?
I was taught a very strong work ethic by my father and
the FTOs and mentors I worked with throughout my career.
I realized early on that I was not the type of person to just
sit around and relax. I had to be doing something. Retir-
ing only to go back to my department, “doing backgrounds,”
working the 960/Drop program or becoming a greeter at
Walmart just wasn’t going to cut it.
From time to time, retired officers would return to the
department to visit or I would see them at department
functions. In talking to them, I quickly realized the retired
officers who had a purpose in life, a plan and an active life-
style were the ones who looked and acted younger and, most
importantly, lived longer.
It is only natural—if you spend a lot of time working in
a certain field, you will become a subject matter expert in
that field. Why not share all your knowledge and experience
with others? Whether during or after your career, a lot of
subject matter experts turn to teaching. This can be done
at the academy, community colleges or hands-on tactical
schools with private companies or department sponsored
events. Others find it very rewarding to share their knowl-
edge and expertise through public speaking or seminars, by
writing articles for magazines and some even take it a step
further by writing and publishing books.
If you’re smart, you will actually start your second career
before you retire so you can see if this is something you
truly love and wish to continue. You may find out what you
thought you wanted to do isn’t actually for you; in time to
switch gears and try something else.
As a law enforcement officer, once you have worn the
badge or the star with pride and dignity, it truly never
comes off. There is a fellowship that lasts long after the uni-
form is hung in the back of the closet. Once you retire, don’t
forget we are still members of the greatest fraternity the
world has ever known. Retirement truly is great. Take care
and be safe. LOM
BRAD SMITH retired from the West Covina (Calif.) Police Department after 30
years of service. Brad was a K9 handler and trainer for 25 years and a SWAT
dog handler for 18 years. He has been National K9 Chairman for N.T.O.A. and
a K9 Subject Matter Expert for the California Association of Tactical Officers.
Smith designed and implemented a K9 SWAT & K9 Patrol Tactical School called
S.K.I.D.D.S. and CATS www.skidds.com. Brad is also owner of Canine Tactical
Operations and Consulting www.K9TacOps.com and the author of the book
“K9 Tactical Operations for Patrol and SWAT.” Brad is working on his second
book “K9 Tactical Operations for the courtroom.” Brad has published over 80
articles for a wide variety of publications on K9 Swat Deployment and train-
ing. Brad can be reached at Topdogwck1@aol.com or 626-523-4028.
LawOfficer.com
9/30/14 10:28 AM
 by Gordon Graham Below 100

Right Side Approaches

Save Lives
Alternative can put officers at risk

G
ordon Graham here with
“Today’s Tip.” … That’s the
introduction I use on my
regular “tip” presented on
the Lexipol website (Lexipol.com) and
LawOfficer.com. The genesis of this
“tip” concept goes way back to gradu-
ate school, where I spent a lot of time
studying “why things go right and
wrong” and what we can do to prevent
things from ending in tragedy.
My tip for you is on vehicle
approaches and it is quite simple. Let
me see if I can sum this up in three
words: Right side approaches.
Now for those of you who think that
such a serious topic cannot be covered

PHOTO DALE STOCKTON

in three words, I will expand on this
concept to seven words: Stay away
from the left-hand side.
I hope this is not the first time that
you have heard this, but I fear that
for some of you this is a “newsflash.”
A couple of years ago I had the oppor-
tunity to talk to a group of police acad-
emy directors and I asked this ques-
tion: “During a traffic stop, how many
of you still teach your people to walk
up on the left-hand side of the vehi-
cle?” I was shocked when most of the
hands in the audience went up.
Please hear this loud and clear and
think about it. On a left side approach
you have no cover, no concealment
and the peril of passing traffic. Each
of these is a great risk. On a right side
approach you have some cover, some
concealment and no passing traffic. To
me this seems to be a no-brainer, but
the complacency issue pops up and I
regularly hear, “I have been doing this
for years and I haven’t had a problem.”
I ask you to please insert the word
“yet” at the end of that sentence.
In vehicle approaches that have ended in tragedy, one common theme is consistent: a
left side approach. On the left side, an officer is at risk of being struck by passing traf-
fic and has little concealment or cover should a gun fight erupt with the vehicle driver.
Right side approaches provide a higher level of safety from both traffic and attack.
Here is my guarantee: if you con- with me on this. And on the off chance
tinue to approach on the left side of that I have a lieutenant from the
a vehicle, sooner or later it will be a United Kingdom reading this—this
problem. There is not a day that goes article doesn’t apply to you.
by that we do not have a cop struck To wrap up on a serious note: When
(or nearly struck) by passing traffic. it comes to bringing the annual line of
Roadway incursions are a huge risk duty death count below 100, you can
in law enforcement operations. Again, do this! Each of you has the ability to
stay away from the left-hand side. spread the word today about this tip.
Another issue arises with suspects Thanks to all of you who are preach-
in cars who want to shoot when you ing the tenets of Below 100. LOM
approach their vehicle. On a left side
approach you have very, very limited GORDON GRAHAM is a 33-year police veteran
and the president of Lexipol. He is a risk manage-
options when confronted by a suspect ment expert and a practicing attorney. He is one
with a gun. On a right side approach, of the most sought after speakers in public safety
your options are expanded with some and has presented a common sense approach to
risk management to hundreds of thousands of law
additional cover and concealment. enforcement professionals around the world.
As always, I look forward to talk-
ing to anyone who disagrees or agrees

LawOfficer.com October 2014 l LAW OFFICER MAGAZINE l 43

1410lo_43 43 9/30/14 10:28 AM

 Firearms by Kevin R. Davis

Classroom to Range:
Training the “in-between”

I
n between classroom firearms
training and live-fire on the range,
a lot of meaningful training can be
accomplished.
Basic academy cadets and in-service
officers benefit from both classroom
lectures and dry-fire. The fundamen-
tals of marksmanship—platform, grip,
sight alignment, sight picture, breath-
ing, trigger press, follow through and
recovery can all be learned in the class-
room using empty pistols, shotguns
and carbines.
Additional benefit is gained by
introducing inert training rounds and

PHOTOS KEVIN R. DAVIS

learning to “run the gun” with the pre-
sentation of the pistol from the holster
or long gun from indoor ready and
manipulations such as reloads dem-
onstrated with requisite practice rep-
etitions conducted. This training dic-
tum should follow the British military
model of EDIP: Explain, Demonstrate,
Imitate and Practice.
But there can more realistic and
relevant firearms training that can be
safely conducted in a classroom, defen-
sive tactics room or gymnasium using
low cost training tools.
The SIRT Pistol
The Shot Indicating Resetting Trigger
(SIRT) was developed by Next Level
Training. Recently, I’ve been working
extensively with a SIRT Pro model
training pistol, which recreates the feel
of the Glock pistol I carry on duty and
fits into the Blackhawk SERPA hol-
ster I wear with my Class B Training
Bureau uniform.
The SIRT pistol is a completely non-
firing training pistol which projects
a laser from the barrel area. The Pro
model projects a red laser when you
The SIRT pistol from Next Level Training (left), Airsoft pistol (right) and Omaha
Targets’ hostage-taker photo target all offer the opportunity to train realistically
between the clasroom and the range.
touch the trigger and a green laser
when the trigger is fully pressed. This
allows new shooters to work on trigger
press as instructors monitor muzzle
movement indicative of pushing, jerk-
ing or slapping the trigger.
Imagine a line of new shooters (or
even problem shooters in for reme-
diation) in a classroom with targets
aligned on the walls as they work on
trigger fundamentals such as working
through the trigger take-up or slack,
resetting the trigger during follow
through and then getting back to the
pressure wall. It is my opinion that
many new shooters are not properly
trained in trigger press management.
They don’t prep the trigger to the pres-
sure wall as they present the pistol for
a committed shot. Many slap the trig-
ger aggressively as they move their
finger from outside the trigger guard/
alongside the frame to the trigger to
take a shot. This long and aggressive
movement is certainly not conducive to
accurate fire and may be the greatest
reason police have such lousy hit rates
in actual shootings.
In addition, shooters are taught by
some instructors to press and hold the
trigger to the rear for follow through.
This is a range activity to increase
accuracy on static targets and improve
qualification scores. Teaching students
to press and then hold creates a motor
program that is contrary to what they
need on the street to win an actual
gunfight. You now have a training
scar that manifests itself in a shooter
who fires a shot, holds the trigger to
the rear, then resets and fires in one
motion. In truth, the trigger should be
allowed to reset during the recoil pro-
cess and the finger applying pressure
to the pressure wall. Bill Rogers of the
Rogers Shooting School and Master

44 l LAW OFFICER MAGAZINE l October 2014 LawOfficer.com

1410lo_44 44 9/30/14 10:29 AM

 Class competition shooter delves into this subject in much
more detail in his 2010 book, Be Fast, Be Accurate, Be the
Best and in his Panteao Productions DVD, Reactive Pistol
Shooting.
If you are an instructor, add the Ubersense app to your
smartphone or iPad and you can video your students’ fun-
damentals, presentation and weapon manipulation easily
in a classroom with red and green lasers indicating point of
aim and sight deviation. With the Ubersense app, you can
slow the video down, draw circles or lines on the video and
be able to show your students exactly how and where they
are doing something incorrectly.
Advanced training can be conducted with the SIRT pis-
tol as well. By incorporating SIRT pistols with empty hand
skills, your officers can strike heavy bags, impact manne-
quins or focus mitts to create distance to be able to draw
while training in extremely close quarters. Even unconven-
tional shooting while on the ground can be trained with or
without a partner. Imagine a mini scrambler you set up in
the parking lot of your station or substation. Photo targets
such as those from Omaha Targets can be set up, simulat-
ing an ambush situation. On command, the officer, armed
with a SIRT pistol, can “shoot” through the windshield then
move to safer cover.
Next Level Training also makes a SIRT AR bolt for the
AR family of carbines. These bolts allow officers assigned
a patrol rifle or SWAT team members to engage in dry fire
and other non-firing training sessions.
I’ve been working with my SIRT pistol in my office dur-
ing non-range days and have various photo realistic and
other targets in the armorer’s room across the hall and
taped to the walls in my office. I can practice from a seat-
ed position or work on room clearing. Heck, I even have a
photo target set up in the FATS room where I can practice
my “shooting” on the move or working with a flashlight in
hand in low light.

Choose 18 at www.lawofficer.com/rs.

The author, acting as role player (left), engages a student ver-

bally in stimulus/response training.

LawOfficer.com October 2014 l LAW OFFICER MAGAZINE l 45

1410lo_45 45 9/30/14 10:29 AM

 Firearms
There are no downsides to the SIRT
pistol. As a matter-of-fact, there are
tremendous benefits in obtaining a
few pistols for training your officers
or even purchasing one for yourself
(NextLevelTraining.com).
training company Fist, Feet, Knife,
Gun (FFKG) in Oregon when I pur-
chased his training DVD, Defensive
Handgun Drills, and thought that he
and his training partners really knew
how to integrate Airsoft into a firearms
program by building skills in a train-
ing room with Airsoft that would
transition to the range. Furthermore,
hewas incorporating empty hand strik-
ing and close quarters shooting into his
program doing stuff you simply can’t

Airsoft Training
When Airsoft first hit the market, I
purchased a cheap “cocking” pistol that
bore little resemblance to an actual
firearm. A battery operated pistol was
next—once again, maybe good for the
kids to shoot in the backyard, but of
little training value. Then I learned
about the green gas Airsoft pistols. I
bought one for myself and found them
exceedingly accurate based on the
“back spin” created by a little bump in
the barrel as the .20 gram plastic BB
travels down the barrel. I purchased
several Airsoft pistols that duplicated
Glock pistols for my own training busi-
ness and my agency.
I came across Rich Daniel and his An airsoft pistol is great for the moving/move drill between cover postions.

HONOR your FINEST

with SOLID BRONZE
QUALITY

...made in the USA

888-411-7744 libertyartworks.com

Choose 20 at www.lawofficer.com/rs. Choose 19 at www.lawofficer.com/rs.

46 l LAW OFFICER MAGAZINE l October 2014 LawOfficer.com

1410lo_46 46 9/30/14 10:29 AM

 do with live firearms.
His second DVD, Legitimate Train-
ing with Airsoft is cutting edge in
terms of realistic movement and shoot-
ing training using Airsoft.
I’m not the only one to think so, by
the way—Seattle Police sent trainers
to Daniel to work with his program.
These SPD trainers presented at a
training conference I attended. After
corresponding with Daniel via email,
we met in Albuquerque and got to train
with the SPD folks to see what they
were doing with Airsoft. That training
and meeting led to my incorporating
Airsoft into my programs, as well as
programs I taught for my state acad-
emy on subjects such as low light pis-
tols and officer survival. Airsoft ammo
costs fractions of a cent and allows
mass repetitions in life-saving fire-
arms skills, as well as programming
“stimulus-response” training, working
with role-players who draw training
knives and guns from concealment.
LawOfficer.com
1410lo_47 47
About the only issues with Airsoft
is that the guns used are still pretty
flimsy and the magazines (which actu-
ally contain the green gas) are pricey
at about $30 a pop and can break if
dropped on a concrete floor.
By the way, Daniel now works
for the Oregon Department of Pub-
lic Safety, Standards & Training as a
member of their defensive tactics staff.
For more information about Rich and
FFKG, visit FFKGVideos.com.
Wrap Up
Imagine someone walks in off the street
to a boxing gym to learn the “sweet sci-
ence.” They would be taken through a
process of training that may start with
learning the basics through shadow
boxing, then to throwing punches on
bags to develop skill and power. They
would then work out on the mitts with
a coach, focusing on footwork, defense,
counters and combinations. All of this
long before they put on sparring gear
Choose 21 at www.lawofficer.com/rs.
October 2014 l LAW OFFICER MAGAZINE l 47
and step into the ring with a sparring
partner—and well in advance of their
first match.
In law enforcement firearms train-
ing, we give the basics in a quick fash-
ion but then focus on punching holes
in paper versus training for the real
life-or-death encounters our officers
will face. That “in-between” has been
neglected and needs to become the
focus once the basics are learned. Let us
take our firearms training off a static
line, (“Ready on the right. Ready on the
left…”) and place it in context, in actual
environments and situations where our
officers will be forced to respond. That
will better prepare them so after they
win an armed encounter they will say,
“That was just like training!” LOM
KEVIN R. DAVIS is a full-time officer with more
than 25 years in law enforcement. Previous assign-
ments include patrol, corrections and plainclothes
narcotics investigations. He’s a former SWAT operator,
team leader and instructor currently assigned to the
training bureau where he specializes in use of force,
suspect control and firearms training.
9/30/14 10:29 AM
 Train the Trainer by R.K. Miller

The Solitary Officer

How to face the reality of violent
conflict when responding alone

I
n the movies, the law enforce-
ment hero is often depicted as
one man or one woman, winning
out against incredible odds and
deadly adversaries. These depictions
are not oriented toward a street cop’s
world but instead a Star Wars fictional
perspective: It takes place in a gal-
axy far, far away from what normally
is encountered during a patrol shift.
In our business, this is recognized as
pure fiction because we typically come
together to solve major problems. An

AP PHOTO/THE SALT LAKE TRIBUNE, DANNY CHAN LA

active shooter is one such scenario
during which we literally want a “flash
mob” of cops on scene as soon as pos-
sible to stop the violence and save
lives. What cop worth his or her salt
wouldn’t respond to such a challenge?
However, there has been a growing
discussion about single officers arriv-
ing on scene and making the decision
to immediately hunt down the suspect
and stop the killing rather than wait
for backup. This is an especially press-
ing issue if the other officers have an
extended ETA and shots are being
fired inside the location.
While strategically positioned just
outside a local Starbucks, my friend
Doug McGeachy (Santa Ana, Calif.,
Police) and I went back and forth about
this topic. One of McGeachy’s sticking
points was that, while law enforce-
ment’s endorsement of such a tactical
option has been growing, not much is
being done to train our officers for that
possibility. That got my brain working
and led to this article.
An opening comment starts with
the department leadership. It lends
credibility and inertia to the solo
officer concept if the chief or another
authority understands and endorses
A police officer takes cover behind a tree while searching for possible shooters
following a shooting at the Trolley Square Mall in Salt Lake City, Utah. A gunman
opened fire on patrons in the mall. Master Officer Ken Hammond, while off duty,
was the first to confront the gunman, keeping him from shooting others.
such a response to an active shooter. essence of what we want from respond-
Granted, this is not a best practice. ing police officers: “I’m a sheepdog. I
The best practice would be something live to protect the flock and confront
akin to the immediate commitment of the wolf.” In a literal translation,
the First Marine Division to stop the cops protect the community by hunt-
threat and save the good folks. But ing down the active shooter as soon as
a reality-based reaction is for that possible. This commitment to the legal,
single cop or group of cops to find the moral and ethical demand for law
threat and put a stop to it. The official enforcement’s quick response should
word from the chief ’s or sheriff ’s desk instill a sense of purpose in the officers’
approving the solo officer tactic would minds.
create a greater acceptance. Mental preparation is part of the
mindset equation. A contact team of
Mindset one is the basic concept. A good street
Next on my list would be the all impor- cop who buys into this will run sce-
tant aspect of mindset. A good train- narios through his or her mind play-
ing read in this context is Lt. Col. Dave ing out the “what ifs.” Taken to anoth-
Grossman’s On Sheep, Wolves and er level, this preparation may even
Sheepdogs. I think that it captures the include “gaming” appropriate tactics

48 l LAW OFFICER MAGAZINE l October 2014 LawOfficer.com

1410lo_48 48 9/30/14 10:29 AM

 and techniques while making routine
visits to high profile epicenters such as
schools, malls and theaters.
On Scene
That brings us to the first officer who
arrives on scene at an ongoing mass
casualty situation. Again, one option
is for that officer to wait outside. But
I’m going to suggest that you also con-
sider training officers for an individual
response. In such a case, the decision
making should be based on key factors:
• Are there shots being fired or oth-
er indicators that the violence is
ongoing?
• Are there indications of where the Some cops may fail to apply this
suspect is?
• Is the officer courageous enough entirely. While Grossman’s sheepdog were Sgt. Alvin York (World War I) and
and capable enough to go through
that door and start hunting down
the perpetrator?
AP PHOTO/THE SALT LAKE TRIBUNE, DANNY CHAN LA
“You must firmly believe in what you
are doing and why you are doing it.”
A focus point that does not always
get the emphasis it should is that
a training program should address
some basic facts: First, the sooner law
enforcement arrives on scene, the more
likely it is that the suspect will either
commit suicide or turn the violence
away from the victims and toward the
officers. That’s a good thing. Secondly,
the advantages (body armor and tac-
tics, for example) that law enforcement just individually responding to the
personnel bring with them are force
multipliers when combined with prop-
er mindset.
awareness or even forget about it
approach should be in play, there is
also the element of experience. To one
degree or another, good street cops
stories like that of Sgt. Kimberly Mun-
ley at Fort Hood, Texas, it may help.
In this case, Munley arrived on scene
while Nidal Hassan was still trying
to kill soldiers and civilians. Basically
“winging it,” she found this traitor to
the uniform he wore and exchanged
shots until she was wounded. Another
lone officer—Sgt. Mark Todd—quickly
arrived and finished it by severely
wounding Hassan. Munley and Todd
weren’t acting as a team—they were
violence.
History
There are also plenty of examples
drawn from our armed forces. Two
Lt. Audie Murphy (World War II). We
don’t have time to go over their exploits
here other than to tell you that in each

• What is the ETA of other law have encountered dangerous suspects case these men acted by themselves
enforcement personnel? in the past. This can include actions in a manner consistent with a solo
such as searching for criminals and at response: There was a deadly threat
To get officers to this decision, train- least taking them into custody at gun that they recognized and took on until
ers should emphasize it has to be point if not actually engaging in the it was neutralized. Each justly received
based on the prioritization of human use of lethal force. The active shooters the Medal of Honor. An Internet search
life. We’re cops. We’ve taken an oath, will most likely be at a definite disad- will tell you more about these acts of
and when called upon, we risk our vantage in this context as they do not courage by capable young men.
lives to save others. Some officers may have similar experiences to draw on.
argue that this is suicidal. I disagree. Application of single officer tactics Tactical Awareness
Training should make the difference should be nothing new for us. Patrol The decision to intervene is followed by
between such an erroneous “no win” work often requires an officer to con- the question of where. Often the clos-
perspective and a cognitive response stantly monitor the environment, dis- est public entrance may be the portal
where the officers recognize that they cern and decide between cover and of choice. However, that brings with it
have a high probability of winning. I concealment and move from point to some problems. Based on the increas-
would also counter with the additional point. This includes going through ing sophistication of active shooter
question: “What would you do if it were doors and searching through rooms. suspects, at least some consideration
your loved ones inside?” I hope every Dealing with a variety of people rang- should be given to what they may have
officer knows the answer. ing from the calm and healthy to the done—booby traps, chained doors, etc.
Unfortunately, some cops are not catatonic and hysterical and on to the —to prevent cops from gaining access.
that brave. Others are what I call criminal heathens all fall within the Alternatives include looking for other
“CAVE” cops (Cops Against Virtually range of our shared experiences. They doors close by or opening a window
Everything) who are all about them- should be emphasized as part of the even to the point of breaking it to get
selves and nothing else. Training in preparation for officers responding to in. Tactical awareness should, however,
advance and peer pressure will, in some an active shooter regardless of if they kick in with this latter point. Shards of
cases, turn these folks into effective act alone or as a team. glass, especially hanging from above
responders. If they fail to do so, I would are a very real danger. The concept of
hope that they wouldn’t still be officers Role Models using windows, however, rather than
at your department. A quote from Paul Role models can play a big part in train- just relying on doors to make entry, is
Howe’s book, Leadership and Training ing our officers to have the right mind- a viable tactical option. In a worst case
for the Fight, offers a timely thought: set for a solo response. If we emphasize resolution, using the back end

LawOfficer.com October 2014 l LAW OFFICER MAGAZINE l 49

1410lo_49 49 9/30/14 10:29 AM

 Train the Trainer
of a patrol car as a quick breaching tool
on a secured door may also work. Such a
radical technique requires thought and
caution, but it could be effective under
the right circumstances.

Open the Door

Whether exterior or interior, opening a
door requires thought rather than just
action alone. “Reading” a door is the
first step to determine features such as
whether it opens in or out. That aware-
ness, in turn, helps facilitate the entry
that may come next. It’s suggested
that officers consider opening and then
pausing next to the door for a moment
to see what happens in response. The
suspect and/or the victims may be just
inside. If a cop is trained to open the
door and immediately move in, that
may place the officer directly in the
path of deadly fire from the suspect.
Similarly, victims could try to make
their escape. That means that they
could come busting out the door just
as an untrained officer starts to go
in. Whether bullets or bodies, kinetic
energy is in play. To avoid this, train-
ers may want to emphasize the value
of a momentary pause to see what hap-
pens after a door is opened rather than
immediately rushing in.

Go On In?
This pause may also include a moment

PHOTO R.K. MILLER

to assess what is on the other side of
the door. One part of this is to “pie”
the opening. If a room can be cleared
from the outside, it may make the deci-
sion to move on to the next door easier.
Admittedly, a thorough search might
be appropriate, but even so, that initial
visual sweep prior to entry is a tacti-
cal plus. Teaching officers to “read” the
room beyond by again using the door’s
characteristics would be helpful to a
solo officer, as well as a team. One real
aspect would be recognizing whether it
is a center fed door (meaning in the cen-
ter of a room) or a corner fed room with
its obvious hard corner orientation.
The Hunt Is On
Training should emphasize when to
go into a building or area rather than
bypass it. Whether searching the room
When responding to an attack solo, properly identifying yourself as a member of law
enforcement is key. Combine your badge and gun, as shown, using two-handed carry.
or just doing a visual check from out-
side, the fact is that this is just one
room. Unless something significant is
inside—a suspect or victims—then the
officer needs to move on quickly. The
goal is, again, to find and stop the sus-
pect. Shots fired are always a clue but
they will not be consistent. Dispatch
relaying information may work to a
degree but it may not be accurate and/
or current. Other indicators would be
fleeing civilians or the wounded on the
ground, who may also be a source of
information. Still another option may
be unarmed security personnel who
point the way and know the layout.
There is more to discuss, but we are
EOA—End of the Article. We will wrap
this up next month with some addi-
tional issues. Until then, train safe and
God bless America. LOM
R.K. MILLER retired from the Huntington Beach
(Calif.) Police Department as a lieutenant after 30
years of service in a variety of assignments, includ-
ing FTO, trauma support, beach detail, detective,
SWAT and field supervisor. He serves on the staff
at the Golden West College Police Academy as an
instructor and SWAT Academy coordinator, and as
an instructor for the NRA Law Enforcement Activities
Division and his own company, National Training
Concepts, Inc. (www.ntc-swat.org). Miller holds a
bachelor’s degree and is a Marine Corps Vietnam
veteran. Contact him at rkmiller@socal.rr.com.

50 l LAW OFFICER MAGAZINE l October 2014 LawOfficer.com

1410lo_50 50 9/30/14 10:29 AM

 The Law Offcer Family of Products:
Stay Informed, Stay Safe
Law Offcer LawOffcer.com
Magazine Website
Available in print Your online connection to the
and digital editions, world of law enforcement,
Law Offcer is the LawOffcer.com gives you
magazine that provides information on:
solution-oriented • News
information on • Products
tactics, technology • Jobs
and training. • Training
… and much more

LawOffcer.com Buyer’s Guide

eNewsletter
The LawOffcer.com
eNewsletter gives you
breaking news, articles
and product information.
It’s free to subscribe ...
stay informed of the
latest news!
Giving you the detailed
product information
you need, when you
need it. We collect all
the information from
manufacturers and put
it in one place, so it’s
easy for you to fnd and easy for you to read.
Go to BuyersGuide.LawOffcer.com

Archived Webcasts
• Finding The Leader In You
• Turning the Tide in Memphis:
Using data to help combat rising
crime and sinking budgets
• The Fatal Four
• Breaking Silos Without Breaking
the Bank: Leveraging Information
in Law Enforcement Networks
• Combat Aggressive Driving
in Your Community
• Top 5 Ways an In-Vehicle
Router Improves Offcer
Effciency and Safety
• Drive to Survive: Training, mindset
& policies that enhance safety
Free …
• Digital In-Car Video: Research Available
and Implementation 24/7!

Choose 22 at www.lawofficer.com/rs.

Choose xx at www.lawofficer.com/rs.
For more information on the Law Offcer
TM Family of Products: www.LawOffcer.com

1410lo_51 51 9/30/14 10:29 AM

 Police in riot gear responded to crowds of protestors in Ferguson after protests became violent and
looting was reported in areas of town.
CONTEXT: CRITICAL
Mobile data, deployment levels & the challenge of
public perception By Nick Selby
T
he most indelible image of this summer’s unrest in
Ferguson, Mo., was that of a battle-clad officer atop
an armored vehicle aiming his rifle at protesters.
Perhaps more than any other, that single image
helped forge a battle line in a national debate over “police
militarization.” That’s exactly the wrong place to start
the conversation. In reality, the issues highlighted around
the country this summer were less about Mine-Resistant
Ambush Protected (MRAP) vehicles and military gear used
than they were about the policies and procedures governing
their use, and the transparency of investigations into how
they were used. Cops know acutely how perception becomes
reality. And no one can deny that MRAPs look, well, scary.
(One can work to change the optics: a San Diego (Calif.)
school district placed red crosses and the word, “Rescue” on
its MRAP to make it look more like an emergency response
vehicle and less like a tank.) Like you, I carry “scary” equip-
ment all the time. It doesn’t affect my ability to effectively
patrol or investigate. But if I were to arrive at a witness
interview in black pajamas, Oakley wraparounds, a back-
ward ball cap, an earpiece and my kitted-out M4 slung over
my external armor carrier—eyebrows would rise.
The cost of over-deployment is huge. The perception of
a body armor encased, armored personnel carrier driving
police force is doing us a lot of harm. It’s costing us cycles
in the media, putting us on the defensive to explain why we
have the tools we need. It’s costing us hard-won and crucial
community relations, as civic leaders—either genuinely or
52 l LAW OFFICER MAGAZINE l October 2014
1410lo_52 52
AP PHOTO/CHARLIE RIEDEL
opportunistically—say they feel faced-down in their own
homes and streets.
We can do better through effective training, efficient use
of technology and common sense. Bottom line: Using an
MRAP when it’s not called for is nothing short of a failure of
intelligence, policy and leadership.
Equipment & Intent
There’s no question communities have needed armored vehi-
cles since well before the phrase “Homeland Security” became
part of common vernacular. Civilians and officers under fire
require safe, rugged transport to safety. That’s our job. Period.
So, how do you determine when the deployment of mili-
tary-grade equipment and tactics is justified?
Rather than seeking a litmus test for go/no-go deployment,
we must rise above talk of specific equipment—armored
cars, uniform styles and caliber and so forth—and get to
what truly matters: tactics, techniques and a policing pro-
gram that takes into account the single greatest indicator of
appropriateness—context. Officers responding out of context
will do one of two things: overreact or underreact. Either way
they will appear to bystanders as just what they are in that
situation: clueless. That’s very unfair to the officers, and it
degrades community trust in them and their judgment.
The challenge of today’s officer is to translate the context
of street-level experience and hunches into useable data. The
real challenge is actually the ease with which this can be
done. We live in a world drowning in digital data—a world
LawOfficer.com
9/30/14 10:30 AM
 drowning in devices and software for storing and sharing
that data, with multiple perspectives on any single event.
And, although it’s complicated, surrender is not an option.
When it comes to mobile data specifically, law enforce-
ment, in a mirror image of public scrutiny of tools like
MRAPs, tends to get caught up discussing equipment rather
than intent. Management must support intelligence first—
its gathering as well as its analysis. The platform from which
this intelligence is derived and delivered is, although note-
worthy, secondary.
Take Your Data with You
Mobile technologies—body and dash cams, smartphones,
microphones, laptops and surveillance cameras—and, espe-
cially, the mobile broadband capabilities to transmit them,
are no longer “nice to have.” These are table stakes. Equally
important are the policies that will support and encourage
their use and make the data more useable.
Some of the best intelligence gathered on and transmit-
ted to mobile devices isn’t collected through traditional
police investigations. It comes from protestors on mobile
devices. Case in point: An incident becomes a crowd, a crowd
becomes a mob and a robust program of social media moni-
toring can mean the difference between a protest and a riot.
Your officers need to be, at a minimum, aware of this.
Context includes intent—and many misunderstandings
of intent can occur when law enforcement sees a large group
that seems angry. Crowds are hard to read. But individu-
als have shown time and again that they are specific about
intent when speaking on social media channels. Fail to lis-
ten to these individuals at the peril of your community.
Conclusion
Mobile devices put the “reality” in real-time. They stream
video, display images and transmit audio and text to wher-
“Why Did You Deploy That MRAP?”
mong the veteran administrators we spoke with,
A the only concrete advice they could agree on
regarding when to deploy tools like an MRAP is
that agencies should consider outcomes rather than tools
to achieve those outcomes—and never allow tactics to
overcome strategy. Politicians who seize upon police mili-
tarization as a rhetorical device understand, perhaps better
than most, that it’s very difficult to answer general questions
about specific deployments. Similarly, it’s easy for a protester
or a news commentator to ask for a list of rules about when
an agency will deploy an armored vehicle or a certain type of
response. It’s quite another thing to try and create one.
America is a diverse place, and there are vast differences
between urban, suburban and rural departments. How any
tool is deployed in Des Moines will vary from how it will be
LawOfficer.com
1410lo_53 53
ever you or your officers may be. To put it more broadly,
used together with the software they support, they are the
media of our age. Without these tools and a culture of intel-
ligence in your department, it’s nearly impossible to have
the context to deploy appropriately.
AP PHOTO/JEFF ROBERSON, FILE
Images like this, of police tactical teams responding to rioters,
helped spread the story of Ferguson globally.
Don’t be clueless. It’s much easier to lose a community’s
trust with a rude show of force than it is to earn its respect
through recurrent acts of service and heroism. On the oth-
er hand, respond too late and with too little force, and it’s
your officers who will pay. An agency that claims to not
need, or not have the money to invest in these life-saving
technologies should consider the cost of not having them
when needed. LOM
NICK SELBY is a detective at a police department in the Dallas-Fort Worth area.
He is also CEO and co-founder of StreetCred Software, which makes software that
helps law enforcement agencies find fugitives, get them out of the community and
bring the officers home safely each day.
deployed in Los Angeles—location is a large part of context.
Vehicles like MRAPs are also widely used as rescue and
protective responses to civil emergencies such as natural
disasters. Still, agencies are being put on the defensive as
questions surrounding decisions to deploy are posed in a
manner that presupposes an answer that is unsatisfactory
to community members. This is where the recording of data,
information and intelligence from the field, from the commu-
nity and from social media goes a long way in both support-
ing the decision to deploy and justifying that decision later.
It’s important that agencies be able to trace back the
decision-making process when deciding whether or not to
deploy, and provide documentation of the process at the
request of the public or media. Transparency goes a long
way toward settling angst.
October 2014 l LAW OFFICER MAGAZINE l 53
9/30/14 10:30 AM
 Product Spotlight

KNIVES & VEHICLE ACCESSORIES

What you need, at your fingertips
Hi-def for Motors with fast, easy access. The organizer’s adjustable brackets
The practical approach of fit to just about any car seat and a built-in handle allows
WatchGuard’s 4RE high def- for easy transport.
inition video is now available Galls Police Gear
for motorcycles. By redesign- Galls.com; 800-876-4242
ing the easy-to-use touch Choose 202 at LawOfficer.com/rs
screen display, integrating
a weatherproof camera and
a special focus on cabling 350 Overhaul
and brackets, the new 4REm Benchmade’s new 530 Pardue
can withstand the harsh Plain Edge Knife is based on the
environment and unique Mel Pardue designed Model
needs of any police motorcycle fleet. The product can be used 350. The basic looks are the
with video management tools, such as the included Evidence same with the spear-point,
Library Express software or the enterprise-class Evidence 154 CM 58–61 HRC blade and coffin-style handle design,
Library 3 software supporting wireless uploads, case manage- but the AXIS lock was incorporated for added performance.
ment, hands-free updates and live-streaming video. The overall design, which features a reversible black stain-
WatchGuard Video less steel clip, was slimmed down for a low profile, low drag
WatchGuardVideo.com; 800-605-6734 carry and the weight is still incredibly light at 1.88 ounces.
Choose 200 at LawOfficer.com/rs Benchmade
Benchmade.com; 800-800-7427
Choose 203 at LawOfficer.com/rs
Special Ops Sharp
The SWHRT3 HRT Military Boot Knife by Smith &
Wesson is designed to meet the specific needs of mili- Secure Your Shotgun
tary and law enforcement applications, especially in Transport your guns safely in any
tactical and crisis situations. With a 3.5-inch stain- police vehicle with the Tufloc Muz-
less steel, double-edged spear blade, this knife fea- zle Down Gun Rack and Lock Sys-
tures a full tang black rubber handle and comes with tem. The kit includes a mount, rack
a molded boot sheath, too. and small gunlock with electric, as
Smith & Wesson well as an eight-second timer and
Smith-Wesson.com; 800-331-0852 independent key entry. The design
Choose 201 at LawOfficer.com/rs keeps the muzzle down toward the
floor for safety and quick access. Featuring powder-coated
steel construction, this gun rack fits most shotguns securely.
Get it Together Esmet, Inc.
Galls’ molded one-piece orga- Esmet.com; 800-321-0870
nizer with eight equipment Choose 204 at LawOfficer.com/rs
compartments is the perfect
vehicle accessory to keep sup-
plies in order while on patrol. Spearpoint Performance
The design keeps supplies Functionally identical to the original manual version of
securely in place, even at high the Mark 1, the Blackhawk CQD Mark 1 Type E Knife fea-
speeds and has room for clip- tures the same
boards, forms, maps, flash- high-strength
lights, handcuffs and other button-lock
equipment needed for partol mechanism

54 l LAW OFFICER MAGAZINE l October 2014 LawOfficer.com

1410lo_54 54 9/30/14 10:30 AM

 and secondary safety, recessed seatbelt/cord cutter and
carbide glass breaker. Its handle is constructed of preci-
sion injection-molded reinforced nylon mounted to a 420J
stainless steel frame. A spearpoint AUS8A stainless steel
blade boasts improved edge geometry for increased cutting
performance.
Blackhawk
Blackhawk.com; 800-379-1732
Choose 205 at LawOfficer.com/rs
wearing heavy vests and gear. Just attach CoolCop to your
vehicle’s A/C and it directs cool, dry air behind your vest,
where you need it most. The system installs to any vent on
the Ford Crown Victoria, Dodge Charger, Chevy Impala and
most Ford SUVs and trucks, while the soft vinyl vest attach-
ment fits comfortably between your vest and undershirt.
CoolCop Body Armor
CoolCop.com; 408-832-0602
Choose 208 at LawOfficer.com/rs

Added Security Survival Tool

The IntelliSkin by RAM offers The LMF II Infantry Black Combo Edge Fixed
swift, one-handed operation Blade Tactical Knife is one of the tough-
ideally suited for public safety est military survival knives ever made.
professionals on the move. The With a single serration, 4.84-inch
RAM Tough-Dock with Global blade, single strap for belt or leg
Docking System (GDS) tech- and an included tactical sheath,
nology features a spring loaded the LMF II is the tool you’ll
mechanism which enables the want to have at your side
quick, one-handed removal of when survival counts.
the docked device. The rubberized skin protects your tablet Gerber Gear
from drops, scratches and other debris. The RAM Tough- GerberGear.com; 800-950-6161
Dock is available with a keyed lock to provide an added level Choose 209 at LawOfficer.com/rs
of security for the docked device.
RAM Mounts
RamMount.com; 800-497-7479 Clearly Organized
Choose 206 at LawOfficer.com/rs The Pro-gard D3825 Custom Fit Trunk Organizer with
Clear Lid is a durable trunk orga-
nizer which includes inserts
Make the Cut to allow for custom
There is nothing delicate about the Delica. compartment
Sized just right for everyday carry, it’s adjustment.
small enough not to raise eyebrows, The organizer is
yet big enough for any job. The built to withstand
FRN handle is paired up with a severe temperatures
modified-skinning style blade and will not warp or crack.
made of VG-10 stainless steel. Clear-view polycarbonate tri-fold hinged lid and the heavy
It comes in PlainEdge and ABS plastic with three removable dividers allow for quick,
sports a black reversible easy access and plenty of storage.
ambi-clip. Pro-gard Products
Spyderco Pro-gard.com; 800-480-6680
Spyderco.com; 800-828-1925 Choose 210 at LawOfficer.com/rs
Choose 207 at LawOfficer.com/rs

Join the 400,000 Law Officer fans on Facebook to see the latest
Beat the Heat product-related news, spotlights and articles.
Be comfortable in your bal-
listic vest, even when it’s hot
or humid with the CoolCop You Tell Us Are there Knives, Surveillance Tech or
Vehicle Accessories you think other officers must know about?
Body Armor Air Condition-
E-mail Alanna Maya at alannam@pennwell.com and, space
ing system. CoolCop gives you
providing, we’ll include it in our next spotlights.
relief from stifling heat while

LawOfficer.com October 2014 l LAW OFFICER MAGAZINE l 55

1410lo_55 55 9/30/14 10:30 AM

 THETHIRDDEGREE

Vertx Tactical Pants

The perfect design for
everyday & range wear
By Jeff Chudwin & Kimberly Heath
My first view of Fechheimer’s
Original Tactical Vertx pants was
at the ILEETA Conference in 2009.
The company representative told me
they were trying out a new design
and asked if I would do a wear test.
These two pairs of black Vertx pants
became my primary pants for range

PHOTOS COURTESY XXXXX

and training wear. Built with medi-
um-weight 98% cotton and 2% span-
dex fabric, I was able to use them in
all but the hottest range and field
conditions. I could kneel, squat or
go prone without any binding in the
legs or crotch and the waist has a
small elastic expansion area so that
in winter cold I could tuck in an addi-
tional shirt or sweater without hav-
ing to go up a size.
I wanted to see how long they
would last under very hard use and
I literally wore them out after four
hard years of service. I rubbed holes
through the fabric and then had
them patched. I also purchased a
number of additional pairs in khaki
and tan colors and found that I could Ample pocket space and pockets that lie flat when not in use make the Vertx tacti-
cal pants ideal for any situation. The right side hip pocket even has a second hidden
wear them in nearly any setting,
pocket with a zipper closure that conceals and protects important papers or gear.
from the rough field stuff to everyday
work and travel. The design includes that conceals and protects important the calf and lower thigh. The mesh
side pockets that are made to lay papers or gear. These pants have the openings are also built into the
flat under a low profile top flap. This look and fit of quality clothing with side cargo pockets. Called the Vertx
keeps everything secure and, unlike an air of understated readiness. Phantom OPS, this design allows
military type BDUs, does not stand When the Vertx Phantom LT for a cross flow of air through the
out as a “tactical pant.” lightweight pants were offered, I legs. My first thought was that the
Sewn inside the large pocket is a jumped on those for hot weather mesh could not be very comfortable
smaller one that will hold a badge wear and, with a 65% poly and 35% on contact with the skin, but my con-
case, cellphone or extra handgun cotton blend, these have been my cern about the mesh was unfounded
magazines. The hip pockets are a go-to pants for hot weather. Then I when I put them to work in one of
slash type with a square-cut bottom heard about a breakthrough in Vertx our near 90-degree days. The Vertx
for use with a folding knife pocket design at the Center Mass National Original and Phantom LT model
clip like my Spyderco Rescue. The Patrol Rifle Conference this year. pants come in both even and odd
right side hip pocket has a second On display were pants with a mesh waist sizes but the Phantom OPS is
hidden pocket with a zipper closure panel sewn into the inner leg along sewn in even sizes only. The OPS is a

56 l LAW OFFICER MAGAZINE l October 2014 LawOfficer.com

1410lo_56 56 9/30/14 10:30 AM

 real innovation and sure to be a great appearance the pants have thanks to Even after shooting drills from kneel-
choice for hot and humid weather. their lack of Velcro and floppy pocket ing, prone and picking up brass, the
From the female officer’s stand- flaps. They look utilitarian without pants stayed put and I found I didn’t
point, I asked for comments on the screaming “tactical.” need to pull them up as I do with
Vertx design from my training part- The second feature I noticed when other pants. The crotch is gusseted
ner for classes and competitions, Will I donned my first pair of Vertx pants and there is ample thigh room so they
County (Ill.) Sher- was that the fit was move with the wearer.
iff ’s Deputy Kim- VERTX TACTICAL PANT right on for me. The The third feature I noticed was
berly Heath, who is waist was tailored the function of the pockets. The front
also the president of to fit just below thigh pockets are full-sized and the
the Women’s Tacti- APPROXIMATE the hip bones and rear pockets are perfect in my opin-
cal Association. Her STREET PRICE: taken in slightly to ion. Rear pocket sizing and placement
thoughts: Original Tactical pant & avoid that annoy- is something that may not seem like
Phantom LT: $54.95 (men
“The first fea- ing gap at the back. a big deal on women’s pants (to the
and women)
ture I noticed when The rise was low men who design them), but they can
Phantom OPS: $109.95 (men
introduced to Vertx enough to be hip- make or break a good aesthetic and
and women)
pants was the friendly, but high we actually do put things in them, so
finished appear- CONTACT enough to provide they need to be sized appropriately.
Vertx
ance. I liked the ample coverage The problem with large cargo pock-
(844) 932-7889
cleaner lines and WearVertx.com
through an entire ets is that they function more like a
more professional day of rifle training. dump pouch—everything

FIGHT CRIME
with
wi
i th P
Prevention
r ve
re vent
n t iio
nt o n Ed
Education!
d uc
ucat
atio
at
t iio
o n!
n!

Specializing in Robots,
Costumes, Puppets and
Printed Educational
Materials.
Mention code LOS14 when ordering ffor SPECIAL OFFERS!

The Leader In Safety Education Products

www.robotronics.com - (800) 762-6876 - sales@robotronics.com

Choose 23 at www.lawofficer.com/rs. Choose 24 at www.lawofficer.com/rs.

LawOfficer.com October 2014 l LAW OFFICER MAGAZINE l 57

1410lo_57 57 9/30/14 10:30 AM

 SECURE THE BEST

JANUARY 20–23, 2015

SANDS EXPO CENTER | LAS VEGAS, NEVADA
The SHOT Show provides a one-of-a-kind opportunity to experience the best in firearms,
ammunition, safety and tactical gear for law enforcement. Discuss in-field challenges,
get hands-on with the latest equipment, and find real-world solutions to reinforce safety
and effectiveness among your department or unit. Plus, participate in FREE training
from SHOT Show’s Law Enforcement Education Program.

More than 65,000 attendees. The largest dedicated exhibit for law
enforcement agencies. FREE training.

TOO GOOD TO MISS OWNED BY: PINNACLE SPONSOR:

APPLY
SHOTSHOW.ORG/LOM IN PARTNERSHIP WITH:

The SHOT Show is a trade-only event. Proof of professional affiliation required.

Promo Code: PA15LO

Choose 25 at www.lawofficer.com/rs.

1410lo_58 58 9/30/14 10:30 AM

 lays in a pile, falls out when you run
and bounces all over the place. The
Vertx cargo pockets are large enough
to hold spare pistol magazines and/
or a spare rifle magazine, but small
enough to hold them in place. The
pockets lay flat when empty and
maintain their shape, even after
years of hard use.
I like pants that are functional,
durable and comfortable, but I do
also want them to look good. My
uniform pant of the day is either the
Vertx Phantom LT pant or Original
Tactical pant, and my EDC cargo
pocket load is a leather card case
and small notebook in the left cargo
pocket and full range key set, Glock
tool, Streamlight Microlight and
wallet in the right cargo pocket.
Even with all of those items in the
pockets, they are not bulky and still
maintain clean lines.
The material of the Original Tacti-
cal Pants is thick, soft and durable,
with a little more give than that of
the Phantom LT Pants. The lack of
the 2% spandex in the Phantom LT is
the only thing stopping the Phantom
LT from being “the perfect pant,” in
my opinion.
I have found both models of pants
to be very durable. I have worn my
first pairs of Original Tactical Pants
for several years of hard rifle range
use and they are still in service.
I’ve been the Range Master for my
department for the past year, and
after a year of range use, setting
things up, tearing things down and
copious amounts of pistol and rifle
shooting, my Phantom LT pants look
as good as new.
Summary
Comparing the Vertx design to all
the other tactical or duty use pants
Deputy Heath and I have worn over
the years, we both rate them the
best. Others may be good but the
Vertx stands alone in fit and design
and, most importantly, they take the
hardest use and hold up. Final note
to company: add the spandex to the
LT weight and then we’ll have all we
need. LOM
JEFF CHUDWIN is the 2009 Law Officer Trainer of
the Year and retired chief of police at the Olympia
Fields (Ill.) PD. He is the president of the Illinois
Tactical Officers’ Association.
KIMBERLY HEATH is a Will County (Ill.) Sheriff’s
deputy and president of the Female Tactical Offi-
cers’ Association.

Advertiser Page RS#

5.11 Tactical 9 7
ATK Sporting 5 4
ATK Sporting 3 3
Bell Helicopter C4 27
Columbia Southern University 46 20
Dickies Manufacturing Co 25 12
Digital Ally 47 21
Ear Phone Connection 57 23
Family of Products 51 22
Federal Signal Corporation 41 17
Ford 30-31 14
Fox Outdoor Products 33 15
IES Interactive Training 7 5
Liberty Art Works Inc 46 19
Lind Electronics Inc 8 6
Morovision Night Vision 15 10
Orion Safety Products Inc 27 13
Pelican Products 13 9
Rally Point Alpha 37 16
Robotronics 57 24
SHOT Show 58 25
Spillman Technologies C2 1
Surefire 2 2
Truspec by Atlanco C3 26
University of Phoenix 11 8
Vigilant Solutions 45 18
Watchguard Video 19 11

LawOfficer.com October 2014 l LAW OFFICER MAGAZINE l 59

1410lo_59 59 9/30/14 10:30 AM

 Bullethead
The Right Team for the Job?
Dangerous scenarios require a
SWAT team, everyday calls don’t
I
’m gonna skip the questions this
month. It’s been a crazy past few
weeks for law enforcement and we
need to talk about it. I’m not gonna
get into any particulars on what went
down in Ferguson. Unlike a lot of people
out there running their mouths, I recog-
nize that I wasn’t there and I don’t know
the details. What I am up on is the press
coverage and the reaction to that cov-
erage on a larger scale; specifically the
militarization of law enforcement.
The place to start looking at the
militarization of law enforcement is the
SWAT community. Some say the Phila-
delphia Police were the first to start
using the term SWAT. Most people in
the community believe the Los Ange-
les PD was the first but others say the
cops in L.A. saw the Delano (Calif.) PD
put together special units to deal with
the Farm Workers Union protests and
then ran with the idea. Regardless, it is
SWAT, with their green, black or camo
colored uniforms, heavy vests, military
helmets and machine guns that remind
people of the military and are at the
front of the argument when it comes to
militarized police.
In Ferguson, cops were surrounded
by serious civil unrest, looting and full-
on riots. What they needed were cops
with a higher level of training and the
ability to focus and deal with issues
without getting emotional. I was check-
ing out a national newspaper and saw
an awesome photo of a sniper sitting
on top of an armored vehicle. He had
a sweet looking scoped rifle on a tri-
pod and he was behind the scope with
a master grip. The caption said some-
thing to the effect of “Ferguson police of-
LAW OFFICER, ISSN 1553-9555, USPS 023-566, is published 10 times a year (monthly with two combined issues in June/July and November/December) by PennWell Corporation, 1421
S. Sheridan Road, Tulsa, OK 74112; phone 918-835-3161. COPYRIGHT 2014 PennWell Corporation. POSTMASTER: Send address changes to Law Officer, P.O. Box 3425, Northbrook, IL
60062-9912. Claims of non-receipt or damaged issues must be filed within three months of cover date. Periodicals postage paid at Tulsa, Oklahoma and at additional mailing offices.
60 l LAW OFFICER MAGAZINE l October 2014
1410lo_60 60
ficer monitoring peaceful protestors.” I
don’t care what the cop was actually do-
ing—by placing that photo in a national
publication, the whole world now thinks
he was aiming a .308 rifle at peaceful
protestors and that isn’t okay.
Before you all turn tail on me, don’t
think I’ve gone to the side who thinks
we should wear slacks and blazers to do
police work. I’m a huge supporter of the
training, gear and equipment police use
When all you have
is a SWAT team,
every problem
starts looking like
something that
requires an armored
vehicle.
to accomplish our mission. The prob-
lems arise when we don’t look at every
mission critically and decide what we
really need. It’s sort of like the idea that
when all you have is a hammer, every
problem starts looking like a nail. When
all you have is a SWAT team, every
problem starts looking like something
that requires an armored vehicle and
a machine gun. It’s hard to think about
grants written years ago to get these
vehicles or money spent to get flash
bangs and machine guns when you’re
planning an operation. If you were to go
back and dig up those grants or propos-
als to the head shed, you would likely
see things like “hostage rescue,” “officer
and citizen rescue” and “active shooter”
written all over them. Those missions
absolutely require these tools.
On the other hand, you might have a
fortified stash house with armed guards
and pounds of cocaine or meth and a
ton of cash. This mission also requires
some pretty heavy tools. Next, you have
a house for a street level dealer. He has
only some burglary and drug convic-
tions, he likes to run but has no history
of violence. The narcs need help because
they are short-handed. The SWAT guys
are smart, they refuse to do a mixed
stack with narcs and operators, so they
take the mission. The guy planning it
remembers the last one and just inserts
the new address into the plan. Now
we have operators with machine guns
sneaking through yards to get to their
perimeter spots, we have the armored
vehicle pulling up on the front lawn. We
have multiple bangs making this street
sound like a 4th of July celebration and
we have serious-looking cops in heavy
vests, balaclavas, helmets and toting
machine guns breaking down this dop-
er’s door and throwing everyone on the
floor. This is called drift.
When we drift off of our standard
procedures and get a little lazy with the
application of those tools and tactics, we
get into trouble. What we don’t want is
a drawback on the availability of those
tools. To accomplish that, we need to
use them only when they are needed
and get creative the rest of the time.
LOM
Got a question or complaint?
Let Bullethead hear about it. He’ll give
you his opinion with both barrels.
Contact him via email at:
bullethead@lawofficer.com
or fax him at 858-638-2601.
LawOfficer.com
9/30/14 10:30 AM
 Choose 26 at www.lawofficer.com/rs.

1410lo_C3 3 9/30/14 10:31 AM

 READY TO SERVE
© 2014 BELL HELICOPTER TEXTRON INC.

The Bell 429 provides a new level of versatility for your

Parapublic operations with its spacious cabin, large doors and
exceptional speed, range and hover performance. Whether
delivering command and control to officers on the ground,
tactical teams to their location or responding to critical care
patient needs, the Bell 429 is ready to serve.
Visit us at the IACP | Booth 1958

BELLHELICOPTER.COM

Choose 27 at www.lawofficer.com/rs.

1410lo_C4 4 9/30/14 10:31 AM

 WHEN TIME TM

MATTERS ®

MOST
OCTOBER2014

Care at active shooter

& high threat incidents

An exclusive editorial supplement to JEMS, Law Officer, FireRescue and Fire Engineering.

1410JEMSSupp_C1 1 9/8/14 9:40 AM

 FOR IMMEDIATE HEMORRHAGE CONTROL

Clamp and seal

se the wound
with minimal pain
p

Contained hem
hematoma places direct
pressure on th
the
h injured vessels

Control your patient’s

p
emergency in seconds

APPLIES EASILY & CONTROLS BLEEDING WITHIN SECONDS.

Falls & Accidental Wounds Penetrating Wounds Industrial or Occupational Trauma

iTraumaCare.com

1410JEMSSupp_C2 2 9/8/14 9:40 AM

 • c o n ten ts •
2
Introduction
The reason for this focus on Active Shooter
Incidents & Tactical Emergency Casualty Care
By A.J. Heightman, MPA, EMT-P

4
Improving Survival 22
in Active Shooter Events Transitioning to Warm
The FBI’s view two years after Sandy Hook
Zone Operations
By William P. Fabbri, MD, FACEP
Boston EMS makes operational changes after the
Boston Marathon bombing
By Ricky Kue, MD, MPH, FACEP
& Brendan Kearney, EMT-P, MPA

28
Preparing for the Unthinkable
Tactical Emergency Casualty Care pediatric guidelines
By Joshua P. Bobko, MD, FAAEM,
10 David W. Callaway, MD, FACEP
Tactical Emergency Casualty Care & E. Reed Smith, MD, FACEP
The need for & evolution of civilian
high threat medical guidelines 34
By E. Reed Smith, MD, FACEP Being Ready to Deploy
& David W. Callaway, MD, FACEP Interoperable core skills for training
to respond to violent incidents
16 By Michael Meoli, EMT-P,
Selecting Hemostatic Dressings & David Rathbun, EMT-P
The decision-making process for wound clotting agents
41
18 Tools of the Trade
Stop the Bleeding Rapidly deployable products
New external hemorrhage control for TECC & Active Shooter Incidents
evidence-based guideline
By Peter P. Taillac, MD, FACEP

SENIOR VICE PRESIDENT/GROUP PUBLISHER Lyle Hoyt SENIOR EDITOR Lisa Wolf
EDITOR-IN-CHIEF A.J. Heightman, MPA, EMT-P ADVERTISING SALES Amanda Carlton, Cindi Richardson
EDITORIAL DIRECTOR Kristina Ackermann ART DIRECTOR Josh Troutman
MANAGING EDITOR Ryan Kelley COVER PHOTO Chris Swabb

WHEN TIME MATTERS MOST: CARE AT ACTIVE SHOOTER & HIGH THREAT INCIDENTS is a sponsored editorial supplement published by PennWell Corporation, 1421 S. Sheridan Road,
Tulsa, OK 74112; 918-835-3161 (ISSN 0197-2510, USPS 530-710). Copyright 2014 PennWell Corporation. No material may be reproduced or uploaded on computer network services without the
expressed permission of the publisher. Subscription information: To subscribe to JEMS, visit www.jems.com. Advertising information: Rates are available at www.jems.com/about/advertise or by
request from JEMS Advertising Department at 4180 La Jolla Village Drive, Ste. 260, La Jolla, CA 92037-9141; 800-266-5367.

OCTOBER2014
1 A Special PennWell Supplement

1410JEMSSupp_1 1 9/8/14 9:40 AM

 •introdu ctio n•
The reason for this special focus on Active Shooter
Incidents & Tactical Emergency Casualty Care
By A.J. Heightman, MPA, EMT-P
High-profile and high-fatality events have put substantial
pressure on public safety agencies to respond and miti-
gate threats rapidly, quickly treating injured responders
and victims as close to their point of injury as possible.
Following the Sandy Hook Elementary School active
shooter incident (ASI) in Newtown, Conn., the Ameri-
can College of Surgeons and the FBI collaborated to
respond to the ongoing threat of ASIs by assembling
specialists in surgery and emergency medicine. Their
goal was to quickly identify a plan of action to increase
victim survival using concepts and actions supported by
the medical literature and by military and civilian opera-
tional experience.
The group met in Hartford, Conn. Thus, the product of
this important effort is called “the Hartford Consensus.”
With solid evidence from the military on the effec-
tiveness of rapid care at the point of conflict, and new
techniques and products to rapidly stem active bleed-
ing in combat situations, the Hartford Consensus calls
for a coordinated response by law enforcement, rescue
and EMS, and receiving hospitals with the goal of con-
trolling hemorrhage as quickly as possible.
Similar to the approach used by the Hartford Consen-
sus, PennWell, publisher of the Journal of Emergency
Medical Services (JEMS), Law Officer, Fire Engineering,
FireRescue Magazine and Public Safety Communica-
tions, convened experts in the field of ASI medicine and
tactical emergency casualty care (TECC) to focus on the
need for, and delivery of, rapid care for officers, crews
and patients involved in incidents that have a high prob-
ability for injuries and fatalities so that we, as a response
community, can reduce morbidity and mortality.
This special editorial supplement presents not just
the results and recommendations of the Hartford Con-
sensus, but also the latest data and techniques on how
to care for yourself, your co-workers and victims of vio-
lent and fast-moving incidents.
To exhibit why this is so important, I want to point
out some key facts presented in research of ASIs from
2000 to 2012 conducted by Texas State University
through examination and cross-referencing of police
reports, public records and media reports. This data
serves as a blueprint for why we must focus on early
and rapid emergency care in the field:1
• The frequency of events is increasing, from approxi-
mately one every other month between 2000 and
2008 (five per year) to more than one per month be-
tween 2009 and 2012 (almost 16 per year). In 2013,
72 people were shot and 39 were killed in an ASI.
• Schools were the second-most attacked locations
OCTOBER2014
Focus on Active Shooter Incidents and Tactical Emergency Casualty Care
1410JEMSSupp_2 2
(29%), and approximately 20% occurred in outdoor
environments. Responders must be trained to operate
in both outdoor and indoor (i.e., close quarters) envi-
ronments, recognizing the tactics for each are different.
• The median number of people shot per event was
five, exhibiting why multiple tourniquets and hem-
orrhage control supplies must be available early at
all ASIs. One tourniquet per ambulance will be inad-
equate. Recommendations are that all responders
carry tourniquets, learn to “pack” wounds and have
hemostatic (wound-clotting) bandages and dressings
as well as dressings that can seal open chest wounds.
• Shooters brought multiple weapons in 33% of the at-
tacks. In 3% of the cases, perpetrators brought IEDs to
the attack site and wore body armor 5% of the time.
• In 51% of the cases, the ASIs were still ongoing when
law enforcement arrived. Of these, attackers stopped
themselves when police arrived 40% of the time,
most commonly by committing suicide.
• In 7% of the cases, the attacker shot the respond-
ing officers. If you look at the 53 shootings that were
“active” at the time police arrived, officers were shot
in 15% of events. That makes ASIs among the most
dangerous in law enforcement.
• In 18 events, solo officers arrived and engaged the
shooter; 72% were still ongoing when solo officers
arrived on scene. However, in solo incidents officers
were more likely to be injured during these events,
with 17% of officers shot.
Make no mistake about it, active shooter events are
dangerous and challenging for all emergency respond-
ers and require a systematic search of the attack loca-
tion to mitigate the threat, find and treat victims and
confirm there’s not another shooter. In a large attack
site, this search can take hours. During this time, victims
may bleed to death or die from shock.
We must train and equip law enforcement officers to
provide care at the points of impact. Many areas are in-
corporating the rescue task force concept and including
EMS personnel in entry teams to stabilize and rapidly
remove the injured while a ballistic or explosive threat
may still exist.
Read this supplement and then work with all the
agencies that will be on the scene of ASIs and other inci-
dents requiring TECC so that you’re prepared to protect
and perhaps save yourself while saving others at these
fast-moving, high-risk events.
Reference
1. Blair JP, Martaindale MH, Nichols T. (Jan. 7, 2014.) Active shooter
events from 2000 to 2012. FBI Law Enforcement Bulletin.
Retrieved July 31, 2014, from http://leb.fbi.gov/2014/january.
2
9/8/14 9:40 AM
 RESEARCH Innovation and Versatility in
2013: Tourniquets and occlusion: the
pressure of design.
Military Medicine: May 2013
Conclusion: The SWAT-Tô performed better than the
CAT (Combat Application Tourniquet). The SWAT-Tô
In a class by itself, the SWAT-T ô is a
had safer pressures, and was more effective.
multi-function trauma care device.
2012: Lighting did not affect self-
application of a stretch and wrap
style tourniquet.
Multiple Documented Saves!
Journal of Special Operations Medicine: Fall 2012
Conclusion: The SWAT-Tô stretch and wrap style
tourniquet can be self-applied properly even in
darkness. When properly applied, it stops limb

 


2012: Stretch and wrap style tourniquet

effectiveness with minimal training.
Military Medicine: November 2012
Conclusion: The SWAT-Tô can easily be properly

  
    
      
of extremity locations. Proper application is

 
   


2010: An Evaluation of the SWAT-T

Presented at the 2010 Annual meeting of
the Special Operations Medical Association
- Douglas M. Kleiner, PhD
Conclusion: The SWAT-Tô rated very well in the Designed by a former Operator/Medic, the SWAT-T will treat a variety of life-threatening
variables evaluated and was rated comparable   ! ! !  !
!! !  !

 
to, or better than the C-A-T for size, versatility Contractors, Federal and Military (Conventional and Special Operations medical and
intuitiveness, durability cost and comfort. non-medical personnel).

ìSWAT-T saved 2 lives during a horrific scene at the Boston Marathon.î -RE
ì3 SWAT-Ts used after Boston blast worked amazingly wellî -NM
ìThe ultimate trauma multi-tool.î -HA US Navy, SEAL
ìWorked great after windlass failure (high axillary wound).î -CY - US Border Patrol
ì The SWAT-T saved my K9 partner! As a tactical team member, I will never deploy without a SWAT-Tî -NL
ìIt was soaked in blood and it held up great, still plenty of friction. Successful application, bleeding terminated.î -SV

GSA Available
SWAT-T ô TRAINING VIDEOS@:
NSN Pending
Patents Pending SWAT-T.com

1410JEMSSupp_3 3 9/8/14 9:40 AM

 ✚

EMS actions must not degrade the

police response or place either EMS
or the police at increased risk by
complicating the tactical situation.

PHOTO COURTESY FBI

Improving Survival
in Active
Shooter Events
The FBI’s view
A
n active shooter is an individual actively engaged in killing
or attempting to kill people in a confined and populated
two years area.1 Recent active shooter incidents have underscored
the need for a coordinated response by public safety agencies to
after Sandy Hook save lives.
As we approach the second anniversary of the Sandy Hook Ele-
mentary School shooting, which resulted in the murder of 27 chil-
By William P. Fabbri, MD, FACEP dren and adults in Newtown, Conn., it’s sensible to take stock of
the lessons learned and actions taken by public safety agencies as a
result of that extraordinary tragedy.

A Challenge to Every Community

Mass casualty shooting incidents aren’t new in the United States. The 1966 “Tower Sniper” incident
at the University of Texas, Austin, left 14 dead and 31 injured at the hands of a single gunman.2 The
1999 Columbine, Colo., incident was perpetrated by two assailants who killed 13 and wounded 24.3
Since Columbine, active shooter incidents have become more frequent. In the eight-year period
after Columbine, an average of five active shooter events occurred per year. Since 2009, that figure
has increased threefold.4
While the reason for this increase is unclear, the layperson’s impression that active shooter in-
cidents have become more frequent appears valid. A recent study by Texas State University (TSU)
examined and cross-referenced police reports, public records and media reports for the period 2000–
2012.5 The increased frequency of incidents seen in the TSU study isn’t explained by changes in case
definition or solely on the basis of increased case reporting.
The FBI is actively collecting and analyzing detailed data on these incidents. This ongoing effort

OCTOBER2014
Focus on Active Shooter Incidents and Tactical Emergency Casualty Care 4

1410JEMSSupp_4 4 9/8/14 9:31 AM


is a source of periodic guidance to improve ac-
tions to prevent, prepare for and respond to ac-
tive shooter mass casualty incidents (MCIs).
The TSU study also observed that most ac-
tive shooter incidents (40%) occurred in places
of business including offices, stores and indus-
trial locations. Schools and colleges were the
next most common locations for these events at
29%. The assailant moved between multiple lo-
cations in almost 20% of the incidents and had
no apparent connection to the shooting loca-
tion almost 50% of the time.
These findings emphasize the need for all
communities to develop response plans for an
active shooter event. These incidents have oc-
curred in municipalities of all sizes, raising the
possibility of similar MCIs occurring without
warning in communities with limited police,
rescue and emergency medical resources.
From the standpoint of definitive care, anoth-
er significant finding of the TSU analysis is that
the median number of shooting victims was five
per incident. This translates to 58 incidents over
a 12-year period in which at least five victims were
shot. In preparing for active shooter incidents,
hospital emergency and surgical departments
must address the major challenge of providing
timely treatment to multiple victims of gunshot
wounds to the chest and abdomen.
So, almost two years after Sandy Hook, what
has been accomplished?
The Hartford Consensus
In the period following Sandy Hook, the Ameri-
can College of Surgeons (ACS) and the FBI col-
laborated to respond to the ongoing threat of
active shooter events by assembling a group of
surgery and emergency medicine specialists. The
goal was to quickly identify a plan of action to
increase survival of victims of these events, using
concepts and actions supported by the medical
literature and by operational experience.
These recommendations were developed
and presented as apolitical and achievable
within the existing budgets of communities of
any size. The product of this effort is the Hart-
ford Consensus.6
The bottom-line imperative of the Hartford
Consensus is that “no one should die from
uncontrolled bleeding.” Citing evidence of the
effectiveness of actions taken in military medi-
cine over the past decade, the Consensus calls
for a coordinated response by law enforcement,
fire/rescue, EMS and receiving hospitals with
the goal of controlling hemorrhage as quickly
as possible.
5 A Special PennWell Supplement
1410JEMSSupp_5 5
✚
While victims who receive immediately le-
thal wounds can’t be saved, as was the unfor-
tunate case in Sandy Hook, rapid control of
hemorrhage in victims of otherwise survivable
wounds will have the greatest impact in total
lives saved.
An acronym describing the required actions
by responders at all levels is THREAT. (See Fig-
ure 1.) Each THREAT step is critical to victim
survival in fast-moving active shooter or MCI
incidents. These steps are: Hemorrhage control,
either by prevention of further injuries or by
rapid recognition and control of the subset of
life-threatening hemorrhage treatable on scene;
extraction and triage of victims with internal
hemorrhage for prioritized transport; and de-
finitive surgical treatment at a hospital for
those victims with internal hemorrhage.
Figure 1: THREAT acronym
T = Threat suppression
H = Hemorrhage control
RE = Rapid Extrication to safety
A = Assessment by medical providers
T = Transport to definitive care
By the time of its second meeting in July
2013, the Hartford Consensus group had ex-
panded to include representatives of law en-
forcement, emergency, surgical and military
medicine, fire/rescue and EMS as well as repre-
sentatives of the Federal Emergency Manage-
ment Agency and the White House National
Security Staff.
This larger group focused on how their or-
ganizations could assist their colleagues in the
field in implementing the THREAT concept in
their communities. Another goal was to identify
educational tools and performance measures to
ensure that programs to reduce death and inju-
ry in active shooter/MCIs were sustainable and
their effectiveness validated.
Intended to develop broadly acceptable con-
cepts for countermeasures to the active shooter
problem, the Hartford group worked for weeks,
hoping to harness the motivation for action
that followed the Sandy Hook tragedy. At the
same time, the ACS, FBI and others pursued
parallel projects over a longer term.
Benchmarks of Progress since Sandy Hook
Since Sandy Hook, a number of national pub-
lic safety organizations have advocated for im-
OCTOBER2014
9/8/14 9:31 AM
 ✚
During the 2013 Boston Marathon bombing, rapid control of hemorrhage in victims of otherwise survivable
wounds was critical to saving lives.
proved response to active shooter and intention-
al MCIs, incorporating the basic concepts of the
Hartford Consensus in their recommendations.
In September 2013, following collaboration
with leaders of public safety agencies and profes-
sional organizations, the U.S. Fire Administra-
tion (USFA/FEMA) released detailed operational
guidance for fire and EMS agencies in develop-
ment of local active shooter response plans.
Following the Boston Marathon bombing the
previous April, this project expanded its scope
to include similar contingencies. The resulting
manual assists local agencies in using existing
incident command and control concepts in the
context of active shooter and MCI events.7
In addition to the efforts of USFA/FEMA and
participation in the discussions previously men-
tioned, the Department of Homeland Security
(DHS) brought together authorities in medi-
cine, law enforcement, fire/rescue and EMS at
all levels with specialists in the private and pub-
lic sectors to develop collaborative guidance for
active shooter and MCI planning.
In February 2014, the DHS Office of Health
Affairs assembled over 250 representatives to
continue this process, working collaboratively
on specifics of hemorrhage control, protective
equipment, interoperability of responding au-
thorities and advocating for a role for citizen by-
standers in MCIs.8 Recommendations in these
important areas of concern are expected in the
near future.
As part of President Barack Obama’s directive
to expand access to federal active shooter train-
OCTOBER2014
Focus on Active Shooter Incidents and Tactical Emergency Casualty Care
1410JEMSSupp_6 6
AP PHOTO/KENSHIN OKUBO
ing, the Department of Justice (DOJ) launched
its active shooter response training initiative.9–11
A central component of the initiative is Ad-
vanced Law Enforcement Rapid Response Train-
ing (ALERRT), a program partnership between
Texas State University, the San Marcos (Texas)
Police Department and Hays County (Texas)
Sheriff’s Office.
ALERRT and the DOJ have been associated for
more than a decade. In June 2013, the FBI estab-
lished ALERRT as the recommended national
standard for active shooter response training.12
ALERRT includes training in emergency hem-
orrhage control and recognizes this skill as a law
enforcement function. This training has been
provided at no cost to over 50,000 police officers.
With additional DOJ support under the active
shooter initiative, an additional 30,000 officers
are to receive training in the next 18 months.13
Beginning in March 2013, the FBI’s 56 field of-
fices hosted active shooter workshops for more
than 10,000 police commanders from approxi-
mately 4,400 agencies. More than 7,600 leaders
from more than 3,000 public safety agencies at
all levels of government have attended tabletop
exercises in active shooter response and recovery
since that time. And, in an internal effort, the
FBI expanded medical first aid training empha-
sizing immediate hemorrhage control to all of
its 12,000 special agents.13
Progress on the Street
Since the beginning of 2013, more than 30 po-
lice departments across the country, varying in
6
9/8/14 9:31 AM

size and available resources, have provided lo-
cal training in emergency hemorrhage control
to approximately 82,000 law enforcement offi-
cers.14 Encouraged by organizations like the Ma-
jor Cities Chiefs Association and others, these
efforts complement federally sponsored law en-
forcement medical training.
These programs can be incorporated into ex-
isting plans and budgets, and when supported
by the agency medical authority, can serve as a
bridge to their colleagues planning active shoot-
er response in the fire/rescue and EMS commu-
nities and at destination hospitals.
The national EMS community is more diverse
than law enforcement, making integration of
EMS into active shooter response a complex
task. While inclusion of hemorrhage control in
police doctrine can gain ready acceptance as an
officer safety issue, bringing EMS closer in time
and space to an active shooter scene is a more
difficult concept to implement.
In the minority of communities where the po-
lice provide EMS services, rapid suppression of
the threat can be followed by entry of medically-
trained law enforcement officers performing
the rapid extrication and first medical assess-
ment of victims.
In the majority of communities where EMS
isn’t a police service function, public safety offi-
cials must develop a response plan that’s work-
able within the resources and risk tolerance of
that community.
A number of national organizations, includ-
ing the International Association of Fire Chiefs
and the International Association of Fire Fight-
ers have encouraged the Rescue Task Force
(RTF) concept.15,16 RTFs are a means of provid-
ing faster medical access to an active shooter
scene, after elimination or isolation of the
shooter threat, before completion of the labori-
ous process of fully clearing the location of pos-
sible hidden threats.
While this approach is unlikely to become
universal, a number of communities have devel-
oped joint RTFs, and have conducted critically
important field training exercises to implement
and fine tune the complex process of rapid ac-
cess, reassessment and evacuation of victims tri-
aged in order of severity. (Editor’s note: For more
on RTFs, see “Inside the Warm Zone: Blacks-
burg Volunteer Rescue Squad partners with po-
lice to create a rescue task force” in May JEMS.)
The Continuing Challenge
A number of recurring concepts were noted by
the group at the first and second meetings of
7 A Special PennWell Supplement
1410JEMSSupp_7 7
✚
the Hartford Consensus. First, because the next
active shooter event can occur anywhere in the
U.S., local public safety in all communities must
incorporate active shooter planning into their
operations. The ability to respond immediately
and effectively is critical if the number of victims
and loss of life are to be minimized. This means
all elements of a coordinated public safety re-
sponse to an active shooter must be available at
all times, on every shift, and integrated into the
routine operations of fire/rescue and EMS ser-
vices as well as the police.
Regular training and review by leaders across
public safety agencies are required to ensure
a practiced, coordinated response by police,
fire/rescue services and EMS without advance
notice. We must remain capable of deploying
special teams to critical incidents, as the pos-
sibility of complex attacks involving multiple
assailants and unconventional threats certainly
exists. However, experience over the past decade
and a half demonstrates that the vast majority
of incidents involve one assailant armed with
conventional firearms.11
This is partly the basis of the change in police
tactics advocating immediate engagement of
the shooter by patrol officers. Like law enforce-
ment, fire/rescue and EMS agencies must be ca-
pable of rapid action without the delay required
to marshal special operations teams.
Second, hemorrhage control actions by the
police must be taught and applied in a manner
consistent with law enforcement tactics. These
skills must augment rather than degrade the pri-
mary police mission of stopping the wounding
of additional victims while managing the risk to
responding officers, who are at statistically high
risk for injury as they engage the shooter.5
The same requirement applies to support-
ing actions by fire/rescue and EMS. Their ac-
tions must not degrade the police response or
place themselves or the police at increased risk
by complicating the tactical situation any more
than necessary.
Coordinated active shooter responses by
police, fire/rescue and EMS are complex, and
don’t lend themselves to a cookie cutter ap-
proach. To be effective they must be tailored
to the resources and level of risk tolerance of a
given community.
Third, if community-based active shooter
plans are to become a long-term capability, edu-
cation and training in the skills and concepts
underlying these plans must be provided con-
sistently over the long term.
Existing training programs such as the
OCTOBER2014
9/8/14 9:31 AM
 ✚
Prehospital Trauma Life Support (PHTLS)
course and the military equivalent Tactical
Combat Casualty Care (TCCC) course are
examples of medical analogs to the special
training available to our law enforcement col-
leagues. The recent ACS guideline for prehos-
pital hemorrhage control is an example of the
evidence-based guidance needed to improve
the uniform effectiveness of emergency care
prior to arrival at the hospital.17
Development of similar training and guidance
applicable to critical incidents is one means of
maintaining an effective, agile medical response
to active shooter and other criminal MCIs.
Training applicable to critical incidents is one means
of maintaining an effective, agile medical response
to active shooter/MCIs.
PHOTO COURTESY FBI
Finally, it’s important that access to surgical
care is in place at the end of the continuum of
public safety response to active shooter events.
While appropriate emphasis is placed on field
tourniquet control of extremity hemorrhage,
victims of penetrating chest and abdominal
wounds require priority triage and evacuation
to a surgical suite. In parts of the country with
limited hospital resources, surgeons and their
emergency medicine colleagues will play an
important role by ensuring that the hospital
contingency plans required for accreditation
include the capability to provide damage con-
trol surgery to multiple victims of an active
shooter event.
While trauma center designation isn’t an
option for some smaller hospitals, a basic
emergency surgical capability for all hospitals
OCTOBER2014
Focus on Active Shooter Incidents and Tactical Emergency Casualty Care
1410JEMSSupp_8 8
similar to that in place in hospitals in Israel is a
concept worth consideration in areas with lim-
ited services.18,19
Emergency hemorrhage control techniques
employed in the field, such as a pressure dress-
ing, hemostatic dressing or a tourniquet require
definitive treatment at the ED or in the surgical
suite. Penetrating wounds to the chest or abdo-
men require the services of the surgeon.
It falls upon emergency physicians to maintain
familiarity with current recommendations for
hemorrhage control and initial hospital trauma
treatment. And, like their emergency medicine
colleagues, general surgeons who don’t treat
penetrating trauma frequently may benefit
from continuing education and training in this
area offered by ACS and other institutions.20,21
Maintaining basic trauma receiving capabil-
ity at all potential receiving hospitals is a criti-
cal part of active shooter and mass casualty
response. The role of the receiving hospital is
deserving of increased recognition.
Seeing the Whole Picture
Professionals in public safety, prehospital and
hospital-based medical care might also ask,
“Two years later, what do we do next?”
As all segments of our community continue
robust efforts to prepare for and respond to
active shooter events and incidents like the
Boston Marathon bombing, we would be well
served to find ways to measure the effectiveness
of these efforts.
The professions of law enforcement, EMS and
hospital care are resource intensive, and both
monetary and human resources are limited.
The validity and effectiveness of the counter-
measures we propose can only be proven if we
collect data. The U.S. military improved the sur-
vival of its wounded members by changing their
approach to life-threatening hemorrhage across
the spectrum of care from field medic and casu-
alty evacuation to trauma surgeon and combat
support hospital.22
Change of this magnitude was made in large
part because our medical colleagues in the De-
fense Department masterfully collected and
interpreted patient data to develop an evidence-
based reason for change.
Our civilian medical care system doesn’t lend
itself to easy collection of data on patient out-
comes. Patients move through the care contin-
uum from first responder to EMS to the vari-
ous departments of one or more hospitals, each
modality with different ownership, supervision
and data management. Important legal protec-
8
9/8/14 9:31 AM

tions to personal medical information have the
unfortunate side effect of impeding collection
of data, either by law or by misinterpretation.
The majority of medical evidence support-
ing our current effort to improve survival from
these events is derived from the military. While
anecdotal reports of survival of wounded police
officers and civilian victims is highly motivating
and a source of encouragement, methods to col-
lect treatment and outcome data on victims of
these events are needed.
Detailed injury and treatment information
is required at each phase of the emergency care
continuum in order to know which techniques,
procedures and equipment provide the best
chance for survival. This process is critically
important to making informed decisions on
where to devote finite human and financial re-
sources. The need for data supporting evidence-
based trauma treatment is well recognized in
the medical community. Incorporating data on
the use of tourniquets, hemostatic agents and
junctional hemorrhage control devices within
trauma registries and similar databases will sig-
nificantly enhance the ability to evaluate and
improve what we do.
It’s important that data from all points in
the patient care continuum be included, in a
manner preserving medical confidentiality and
in compliance with the law, while presenting a
complete picture of the progression of patient
care in statistically useful ways.
Conclusion
Considerable progress has been made since
the tragic events at Sandy Hook prompted an
increased focus on response to active shooter
events in the U.S. It’s critical to recognize that
the most important response to these incidents
is local, and that continued support of local
public safety agencies in all parts of the country
is key to improving survival for victims of these
tragic events. ✚
William P. Fabbri, MD, FACEP, is medical director
of the Emergency Medical Support Program of the
Federal Bureau of Investigation. Fabbri served as a
member of the committee responsible for the Hartford
Consensus document.
References
1. Active shooter/mass casualty incidents. (n.d.) Federal Bureau
of Investigation. Retrieved July 1, 2014, from www.fbi.gov/
about-us/cirg/active-shooter-and-mass-casualty-incidents.
2. McDowall K. (Aug. 1, 2012.) Remembering the UT tower shoot-
ing 46 years later. Alcalde. Retrieved July 1, 2014, from
http://alcalde.texasexes.org/2012/08/remembering-the-ut-
9 A Special PennWell Supplement
1410JEMSSupp_9 9
✚
tower-shooting-46-years-later.
3. Victims of the Columbine High School shooting. (n.d.) A Columbine
Site. Retrieved July 1, 2014, from www.acolumbinesite.com/
victim/injured.html.
4. Attorney General Eric Holder delivers remarks at the Interna-
tional Association of Chiefs of Police annual conference.
(Oct. 21, 2013.) U.S. Department of Justice. Retrieved July
1, 2014, from www.justice.gov/iso/opa/ag/speeches/2013/
ag-speech-131021.html.
5. Blair JP, Martaindale MH, Nichols T. (Jan. 7, 2014.) Active shooter
events from 2000 to 2012. FBI Law Enforcement Bulletin.
Retrieved July 1, 2014, from http://leb.fbi.gov/2014/january.
6. Jacobs LM, Wade DS, McSwain NE, et al. The Hartford Consensus:
THREAT, a medical disaster preparedness concept. J Am Coll
Surg. 2013;217(5):947–953.
7. Fire/emergency medical services department operational
considerations and guide for active shooter and mass
casualty incidents. (September 2013.) U.S. Fire Administration.
Retrieved July 1, 2014, from www.usfa.fema.gov/downloads/
pdf/publications/active_shooter_guide.pdf.
8. Department of Homeland Security Office of Health Affairs. (May
16, 2014.) Event summary: Stakeholder engagement on
improving survivability in IED and active shooter events.
NAEMT. Retrieved July 1, 2014, from www.naemt.org/Files/
LEFRTCC/Improving%20Survivability%20in%20IED%20
and%20Active%20Shooter%20Incidents.pdf.
9. Training first responders and school officials on active shooter
situations. (n.d.) The White House. Retrieved July 1, 2014,
from www.whitehouse.gov/sites/default/files/docs/fact_
sheet_training_first_responders_and_schools_on_active_
shooter_situations.pdf.
10. Active shooter response training. (Oct. 31, 2013.) United States
Department of Justice. Retrieved July 1, 2014, from
www.bja.gov/ProgramDetails.aspx?Program_ID=106.
11. Schweit KW. (May 7, 2013.) Addressing the problem of the active
shooter. FBI Law Enforcement Bulletin. Retrieved July 1, 2014,
from www.fbi.gov/stats-services/publications/law-enforcement-
bulletin/2013/May/active-shooter.
12. Bureau of Justice Assistance’s active shooter response training
initiative. (n.d.) ALERRT Texas State. Retrieved July 1, 2014,
from www.alerrt.org/StaticPages/view/31.
13. FBI Active Shooter Initiative. (n.d.) Email interview.
14. Eastman AL. (n.d.) Email interview.
15. Active shooter and mass casualty events position statement.
(Oct. 10, 2013.) International Association of Fire Chiefs.
Retrieved July 1, 2014, from www.iafc.org/files/1ASSOC/
IAFCPosition_ActiveShooterEvents.pdf.
16. IAFF position statement: Active shooter events. (n.d.) International
Association of Fire Fighters. Retrieved July 1, 2014, from
www.iaff.org/Comm/PDFs/IAFF_Active_Shooter_Position_
Statement.pdf.
17. Bulger EM, Snyder D, Schoelles K, et al. An evidence-based pre-
hospital guideline for external hemorrhage control: American
College of Surgeons Committee on Trauma. Prehosp Emerg
Care. 2014;18(2):163–173.
18. Einav S, Feigenberg Z, Weissman C, et al. Evacuation priorities
in mass casualty terror-related events: Implications for contin-
gency planning. Ann Surg. 2004;239(3):304–310.
19. Frykberg ER. Principles of mass casualty management following
terrorist disasters. Ann Surg. 2004;239(3):319–321.
20. Advanced trauma life support. (n.d.) American College of Sur-
geons Trauma Programs. Retrieved July 1, 2014 from
www.facs.org/trauma/index.html.
21. Advanced trauma operative management. (n.d.) American
College of Surgeons Trauma Programs. Retrieved July 1, 2014,
from www.facs.org/trauma/atom/.
22. Kotwal RS, Montgomery HR, Kotwal BM, et al. Eliminat-
ing preventable death on the battlefield. Arch Surg.
2011;146(12):1350–1358.
OCTOBER2014
9/8/14 9:31 AM

Tactical Emergency
Casualty Care
The need for & evolution of civilian high threat medical guidelines
By E. Reed Smith, MD, FACEP & David W. Callaway, MD, FACEP
T
he multiple mass killing events over
the past five years have become game-
changers for the first responder com-
munity. Events that were commonplace in
other parts of the world have, unfortunately,
become an almost routine occurrence in the
United States.
The emergency response community has been
tackling these events since 9/11. This is the new
reality and first responders must be properly
prepared to face the challenge.
Despite the evolution in the risk, the prepara-
tion and paradigm of civilian operational medi-
cal response as a whole hasn’t evolved. Consider
the traditional teaching for the reconnaissance
and subsequent rescue of wounded victims
in scenarios where there’s an ongoing threat.
The overwhelming guidance and culture has
OCTOBER2014
Focus on active shooter incidents and tactical emergency casualty care
1410JEMSSupp_10 10
AP PHOTO/BRENNAN LINSLEY
been scene safety first for medical providers—
“staging and waiting” for the all clear.
Considering the past few years and the sub-
sequent knowledge first responders have on
both the threat and the rapid nature of the
fatalities, it would be reasonable to wonder if
the first responders will actually follow the safe
staging guidance.
The vast majority of fire and EMS responders,
as has been demonstrated several times over the
past few years, aren’t satisfied to stand by. They
know there are injured in need of immediate care.
They know the risk, and with that knowledge
they’ve demonstrated a predilection for action.
First responders are heroes and, as a whole, they’re
going to go to work even when the risk is high.
If these first responders decide to effect life
rescue and enter the scene, do they carry in the
10
9/8/14 9:31 AM

same items they would bring to a routine medi-
cal call—all the different medical bags piled on
top of the stretcher with a monitor and oxygen
bottle? Are they carrying the right medical and
rescue equipment for high threat scenarios?
Has the traditional EMS medical training
properly prepared these first responders to pro-
vide care under these conditions? There are mul-
tiple wounded and dead with the potential for
additional explosions or other threats to safety.
Are they trained to approach the patient in this
scenario? Do they know how to appropriately
change from their everyday medicine to a prac-
tice that is efficient and appropriate given the
ongoing threat?
In essence, the question is whether a gap exists
in how civilian first responders both train and re-
spond to operational scenarios with an ongoing
threat, direct or indirect, to provider and patient?
The answer is simply yes. When considering medi-
cal and rescue operations in high threat scenarios,
there’s an absolute gap in the traditional training
and guidance to medical first responders.
Rejecting the Old Paradigm
Stage and wait? In trauma, time counts. Essen-
tially, every minute with uncontrolled life-threat-
ening traumatic injury decreases the casualty’s
chance of survival. This is just common sense,
but it also holds true in high threat scenarios.
The Wound Data and Munitions Effective-
ness Team (WDMET) study completed in the
early 1970s was the first dataset that clearly
demonstrated the unique timing of battlefield
deaths and emphasized the need for forward
medical care. In the examination of a cohort
of Vietnam era battlefield deaths, conclusions
from WDMET showed that the greatest oppor-
tunity for lifesaving intervention on the battle-
field is early on. The study showed that 90% of
the studied deaths on the battlefield occurred
before designated medical care was given to the
injured: 42% immediately, 26% within five min-
utes and 16% within five to 20 minutes.1 That
means 84% of the fatalities on the battlefield
died quickly, within 30 minutes of their injury.
Additionally, only 10% of the fatalities in the
dataset received medical care. The natural as-
sumption then is that those who received care
were less likely to die. The summary results
from the WDMET study echoed common sense
conclusions, “The greatest benefit is achieved
through a tactical configuration that puts the
caregiver at the patient’s side within a few sec-
onds to minutes of wounding.” 1
This conclusion doesn’t endorse the current
11
1410JEMSSupp_11 11
✚
paradigm of “stage and wait until everything is
safe.” Instead, the operational response needs
to be configured to get the caregiver to the pa-
tient’s side within a few seconds to minutes of
wounding. Far-forward placement of medical
assets is lifesaving.
Has the traditional EMS medical training properly prepared first
responders to provide care under high threat conditions, such as
the 2013 Boston Marathon bombing where there are multiple
wounded and dead with the potential for additional explosions?
PHOTO COURTESY BOSTON EMS
The dataset used to define the need for a medi-
cal response paradigm shift in the military was
actually combined from the WDMET study and
Arnold and Cutting’s 1978 paper, “Causes of
Death in United States Military Personnel Hos-
pitalized in Vietnam,” 2 and published by Cham-
pion in 2003 in the Journal of Trauma.3
All causes of battlefield deaths were reported
and included devastating injuries such as sur-
gically uncorrectable torso trauma, injury to
the central nervous system and blast/mutilat-
ing trauma. These injuries cause battlefield fa-
talities even immediate advanced medical care
couldn’t prevent.
However, included in the epidemiology of
combat deaths was 9% caused by exsanguina-
tion from an extremity wound.3 Also included
was 1% from airway obstruction and another 5%
from tension pneumothorax, both of which are
relatively easy to diagnose and simple to man-
age in the acute setting. So, 15% of the combat
OCTOBER2014
A Special PennWell Supplement
9/8/14 9:31 AM
 ✚
fatalities from three etiologies (exsanguination
from an extremity wound, tension pneumotho-
rax and airway obstruction) were readily pre-
ventable with simple interventions if applied
soon after wounding.
Rapid application of simple, appropriate, sta-
bilizing treatment at or near the site of wound-
ing plus expedient evacuation to closest appro-
priate medical facility, equals maximal survival
rate for those injured. It’s just common sense.
Evolution of Combat Care
Essentially, the current concept is point of
wounding care; rapidly provide stabilizing treat-
ment where the wounded lies before evacuating
to care. As with all advanced concepts in trauma
care, the military leads the way through care of
the wounded on the battlefield. U.S. military
medics have been deploying to provide com-
bat rescue and medical care since Union Army
surgeon Jonathan Letterman deployed his am-
bulance corps during the Civil War’s Battle
of Antietam.4
However, prior to the 1990s, there was no
truly defined set of medical guidelines or rules
specific to the battlefield. Combat medics were
taught to manage battlefield injury using the
same medical paradigm that was taught to civil-
ian EMTs and paramedics.
The problem was that civilian prehospital trau-
ma life support (PHTLS) and advanced trauma
life support (ATLS) courses were developed to
manage the common injuries and operational
considerations encountered in the civilian trau-
ma setting. Although the pathophysiologic pro-
cess of dying is the same, these civilian medical
courses failed to account for the unique consid-
erations around trauma resuscitation in combat:
the high lethality and high energy wounding pat-
tern, multiple causes of wounding, preponder-
ance of penetrating injury, persistence of threat,
austere and resource constrained environment,
and delayed access to definitive care.
As a result of several high-profile, high-fatality
operations in the military special operations
community, the U.S. Navy funded a study in the
early 1990s to examine the military paradigm of
combat medicine and the application of civilian
medical standards in the combat environment.
The results demonstrated significant issues
with the application of civilian medical princi-
ples to the battlefield, especially the lack of pro-
visions to allow for prioritization of the man-
agement of casualties with the ongoing threat
and the ongoing combat mission.
The study’s conclusion was that the military
OCTOBER2014
Focus on Active Shooter Incidents and Tactical Emergency Casualty Care
1410JEMSSupp_12 12
needed a new paradigm for combat medicine
and, in 1996, Frank Butler Jr., MD; Colonel
John Hagmann and Ensign George Butler cre-
ated and published military-specific combat
medical guidelines called “tactical combat casu-
alty care” (TCCC).5
The TCCC guidelines represented an opera-
tional paradigm that allowed for the prioritiza-
tion and application of medical care on the bat-
tlefield addressing the three preventable causes
of death identified in the post-Vietnam fatal-
ity studies while accounting for limitations and
conditions of ongoing combat.
TCCC was quickly adopted throughout the
special operations community, and, since the mid-
2000s, was adopted throughout all branches of
the military for deploying military personnel.
TCCC guidelines have been one of the major
factors in reducing preventable death on the
modern battlefield: the case fatality rate in cur-
rent combat operations has decreased from ap-
proximately 15% in Vietnam to 7.6–9.4% during
Operation Iraqi Freedom and Operation Endur-
ing Freedom.6
In a memorandum dated Aug. 6, 2009, the
Defense Health Board made note of several spe-
cial operations where all members were trained
in TCCC and had no reported incidents of pre-
ventable battlefield fatalities during the entirety
of their combat deployments. American forces
are now down from 9% to 2–3% killed in ac-
tion due to exsanguination from an extremity
wound; down from 5% to less than 1% killed
from open/tension pneumothorax; and remain
around 1% killed in action from airway obstruc-
tion (but these airway issues are more complex
than those of the past).7
More than 10 years of data have presented
continuing evidence to support TCCC. The
guidelines are well known, well supported and
ingrained throughout the military. The proven
success of TCCC on the battlefield has led the
civilian medical community, both tactical and
conventional, to closely examine the tenants and
consider integration of TCCC into civilian trau-
ma care.
From Combat to Civilian
Is TCCC the right fit as a new civilian operation-
al paradigm? It’s clear that current fire and EMS
operational medical response is inadequate for
atypical high-risk emergencies, and it would
seem that because the bullets and bombs are
the same, TCCC principles and practices should
work in civilian operations as well. However,
when truly considering the inherent differences
12
9/8/14 9:31 AM

Table 1: Characteristics that distinguish civilian
from military high threat prehospital environments
• Scope of practice and liability
• Wide breadth and differences in medical
care protocols
• Patient population including pediatrics, geriatrics,
and special populations
• Differences in barriers to patient access
and evacuation
between civilian and military operations, battle-
field guidelines don’t seamlessly translate to ci-
vilian operations.
TCCC is based on evidence gleaned for an over-
all young and healthy 18–45-year-old military
combat population. These soldiers aren’t obese.
They don’t have diabetes or asthma or take as-
pirin, Motrin, Coumadin or Plavix. They aren’t
pregnant. They aren’t elderly and they aren’t kids.
TCCC was written for the military combatant
treating the military population in the combat
environment, working under military rules, mil-
itary liability and military laws. Thus, applying
en bloc the military TCCC medical guidelines
to civilian settings has the same fundamental
inadequacies, albeit in reverse, as applying civil-
ian ATLS and PHTLS to the combat environ-
ment. Combat doctrine doesn’t account for the
civilian specificities, even for high-speed SWAT
and tactical law enforcement operations.
Table 1 lists some of these differences that are
unaccounted for in TCCC. To begin with, each
branch of the military is essentially one system
with one scope of practice and one set of pro-
tocols applied across the board. In the civilian
system, from jurisdiction to jurisdiction, region
to region and state to state, there are different
scopes of practice, protocols, operations, cul-
ture and liability. The civilian patient demo-
graphics are much wider and include pediatrics,
geriatrics and other special populations.
The baseline health of the civilian population
is much worse and is complicated by polyphar-
macy, which has a direct effect on and is affect-
ed by trauma interventions. The medical supply
resources and availability of transport assets
and barriers to evacuation are also different.
Wounding patterns are different. Even equip-
ment and supply acquisition is much different.
The military can dictate what all providers in all
areas of operations and services have to use. For
civilians, the selection and acquisition of equip-
ment alters jurisdiction by jurisdiction, agency
by agency.
13
1410JEMSSupp_13 13
✚
• Availability of personnel and resources
• Baseline health of the patient population
• Wounding patterns
• Chronic medication use in the injured
• Equipment acquisition and distribution
• Training mandates
• Budgetary constraints
Finally, the inherent military combat language
of TCCC is different than civilian language. Ci-
vilians need a framework utilizing common op-
erating language that can be applied across all
first responder disciplines. Terms such as “care
under fire” and “tactical field care” may be ac-
ceptable for law enforcement operations but are
easily misunderstood to imply an unacceptable
conditional threat and are thus easily rejected
by other response disciplines.
Common language is essential across all disci-
plines during high threat response. Although a
common argument by military TCCC personnel
to civilians is to emphasize the principles and not
to “get caught up in the language,” those with
true civilian multidisciplinary operational expe-
rience understand the need for even the most
simple generic common operating terms.
In 2005, several civilian first responder enti-
ties began discussing how TCCC could be tran-
sitioned into a civilian-appropriate format. In
2008, the George Washington University and
Arlington County (Va.) Fire Department coined
the term “Tactical Emergency Casualty Care
(TECC)” for the translation of TCCC into a set
of guidelines for use by civilian first responders
in high threat scenarios. Emergency is a civilian
term; combat is a military term.
The concepts in each set of guidelines are the
same, but the language and the focus are dif-
ferent. As part of the process, development and
continued evidence-based and best-practice-
based growth of the civilian TECC guidelines,
the founders of the TECC concept established
the Committee for Tactical Emergency Casualty
Care (CTECC)—a nonprofit committee of civil-
ian operational experts. These experts first met
in 2011 and established the first set of TECC
guidelines by changing TCCC to civilian lan-
guage and focus.
CTECC works as a nonprofit and nonpropri-
etary grassroots effort to create and maintain
a set of high threat medical guidelines that are
open to and shared with all first responders.8
OCTOBER2014
A Special PennWell Supplement
9/8/14 9:31 AM
 ✚
TECC is a medical care framework for high
threat operations based upon the military dog-
ma of TCCC, but adapted to allow for civilian
language, protocols, population, scope of prac-
tice and operational constraints.
TECC isn’t in competition with TCCC, it’s
the evolution of TCCC into the civilian realm.
They’re the same principles and practices trans-
lated and evolved for civilian use and operations.
Adaptable Guidelines
Given the need for diverse operational protocols
and considerations, TECC can be considered to
be a set of bricks. As a whole, the military TCCC
is dogma, applied without change despite op-
erational or provider considerations. For civilian
application, TECC is designed to allow for dif-
ferent agency-specific adaptations. Each agency
should take the TECC “bricks” that fit into their
protocols, scope, culture, liability, mission and
operational considerations to build a high threat
medical response program. In addition, each
agency must select the right equipment and hem-
orrhage control items that best suit their clinical
and operational needs. (See “Selecting Hemo-
static Dressings: The decision-making process for
wound control” that follows this article, as well as
“Tools of the Trade: Rapidly deployable products
for TECC & Active Shooter Incidents,” p. 43).
By using only the parts of the guidelines that
fit into the agency’s needs, each TECC applica-
tion will be slightly different and specific to the
agency. However, overall, the application be-
tween agencies will be the same.
Although there are some generic TECC cours-
es currently being taught, there’s no official
TECC course, no need for instructor certifica-
tion or for an official TECC provider course or
card. TECC is less about what to do and more
about when (or when not) to do something.
The medical interventions inherent to TECC
are common everyday trauma interventions
standard to almost all prehospital providers.
It’s the integration of these guidelines into an
agency’s standard operating procedures that’s
the foundation of TECC. Instead of a premade
course, operationalizing TECC should be done
in a manner unique to each agency.
The goals of TECC are to establish a medical
care framework that balances the threat, the ci-
vilian scope of practice, the differences in civil-
ian population, the medical equipment limits
and variable resources for all atypical emergen-
cies and mass casualties, to provide aggressive
forward deployment and principles for point of
wounding care in high threat and mass casualty
OCTOBER2014
Focus on Active Shooter Incidents and Tactical Emergency Casualty Care
1410JEMSSupp_14 14
High threat medical principles apply widely across
multiple agencies including law enforcement, fire
and EMS.
PHOTO COURTESY E. REED SMITH
environments, to provide care guidelines and
account for the ongoing threat in operations
and minimize the provider and patient risk
while maximizing patient benefit.9
To address needs of the civilian population
and mission that differ from the military, the
TECC guidelines specifically address the care of
pediatric patients in high threat environments.
(See “Preparing for the Unthinkable: Tactical
Emergency Casualty Care pediatric guidelines,
p. 30.) There’s emphasis on the treatment of
civilian-specific conditions such as smoke inha-
lation and civilian-specific operational consid-
erations, such as priority and destination triage
and establishing casualty collection points. And,
similar to the “all hazards” approach of civilian
fire and EMS service, TECC is a set of high threat
principles for all operational hazards to be ap-
plied in any operational scenario where there’s
an ongoing threat to the provider and patient.
TECC guidelines aren’t only for trained medi-
cal personnel. They can be easily limited to any
scope and should be taught to all provider levels.
In mass casualty scenarios, uninjured citizens of-
ten step forward to initiate care for the wounded.
These “first care providers” are one of the
most important links in the TECC chain of
survival for victims. Teachers, librarians and
office workers should be taught appropriate
level TECC principles. Law enforcement patrol
officers are an untapped medical resource in
mass casualty incidents and should be taught
as well—not only for injured citizens but to also
care for injured officers.
14
9/8/14 9:31 AM

PHOTO A.J. HEIGHTMAN
Individual first aid kits—with all supplies visible—
are invaluable when care is needed rapidly.
There are programs being implemented across
the United States to do just that. In northern
Virginia, during the second half of 2013, every
patrol officer in northern Virginia law enforce-
ment agencies—more than 4,000 total officers—
were taught the TECC principles modified to the
patrol officer scope of practice and were given a
personal TECC individual first aid “blow out”
kit, also referred to in many departments as an
“individual first aid kit.”
Because the word “tactical” is in the name,
many civilian operational personnel are under
the misconception the intended audience is only
law enforcement or specialized SWAT medical
providers. “Tactics” are operational consider-
ations and are used every day in normal fire and
EMS operations. The word “tactical” is used not
to limit TECC application to law enforcement
operations, but to mean medical decisions that
both have an effect on and are affected by any
high threat operation.
15
1410JEMSSupp_15 15
✚
Conclusion
The TECC guidelines are multiagency, multi-
specialty evidence- and consensus-based. TECC
is civilian driven and civilian appropriate.
Its guidance, appropriate for use by all disci-
plines of first responders and first care provid-
ers in any scenario where there’s significant
ongoing operational risk to providers and pa-
tients. It’s vetted, evolving and a great venue for
future research.
The implications of high threat medical prin-
ciples apply widely across law enforcement, fire
and EMS operations. The principles should be
built into the operational response for incidents
including, but not limited to, active shooter/
active killing events, medical response to ex-
plosive mass casualty, patrol officer first aid,
SWAT/tactical medicine programs, technical
rescue operations, wilderness medicine settings
and large-scale mass casualty to identify and
treat those casualties with preventable causes of
death as soon as possible at or near the point of
wounding to improve survivability and keep the
victim alive long enough to get them to defini-
tive medical care. ✚
E. Reed Smith, MD, FACEP, is the medical director for
Arlington County (Va.) Fire Department and its rescue
task force. Contact him at rsmith@arlingtonva.us.
David W. Callaway, MD, FACEP, is co-chairman of
the Committee for Tactical Emergency Casualty Care.
References
1. Wound Data and Munitions Effectiveness Team: The WDMET
Study. Uniformed University of the Health Sciences: Bethesda,
Md., 1970.
2. Arnold K, Cutting RT. Causes of death in United States
military personnel hospitalized in Vietnam. Mil Med.
1978;143(3):161–164.
3. Champion HR, Bellamy RF, Roberts CP, et al. A profile of combat
injury. J Trauma. 2003;54(5 Suppl):S13–S19.
4. Musto R J. The treatment of the wounded at Gettysburg: Jona-
than Letterman: The father of modern battlefield medicine.
Gettysburg Magazine. 2007;Issue 37.
5. Butler FK Jr, Hagmann J, Butler EG. Tactical Combat Casualty Care
in Special Operations. Mil Med. 1996; 161(Suppl 3): 1–16.
6. Gerhardt RT, De Lorenzo RA, Oliver J, et al. Out-of-hospital com-
bat casualty care in the current war in Iraq. Ann Emerg Med.
2009: 53(2): 169–174.
7. Eastridge BJ, Mabry RL, Sequin P, et al. Death on the battlefield
(2001-2011): Implications for the future of combat casualty
care. J Trauma Acute Care Surg. 2012;73(6 Suppl 5):
S431–S437.
8. Callaway DW, Smith ER, Cain J, et al. The Committee for Tactical
Emergency Casualty Care (C-TECC): Evolution and application
of TCCC guidelines to civilian high threat medicine. J Spec
Oper Med. 2011; 11(2): 84–89.
9. Callaway DW, Smith ER, Cain J, et al. The Committee for Tactical
Emergency Casualty Care (C-TECC): Evolution and application
of TCCC guidelines to civilian high threat medicine. J Spec
Oper Med. 2011; 11(3): 104–122.
OCTOBER2014
A Special PennWell Supplement
9/8/14 9:31 AM
 ✚
Selecting Hemostatic Dressings
The decision-making process for wound clotting agents
A dvanced hemostatic (wound clot) dress-
ings and agents have proven to be a critical
component of EMS and fire service trauma kits as
well as law enforcement officers’ individual first-aid
kits. So, selecting the best dressing for your needs is
a decision to thoughtfully consider.
The major brands (Celox, QuikClot and HemCon)
will all work in a three-minute “hold in place”
product model. But rarely do we have the luxury of
a three-minute stay and treat environment at active
shooter or other mass casualty incidents. So, product
review must be a multifactorial decision.
Hemostatic technology and capabilities have
advanced considerably over the past few years. In
addition, this is no longer just a pure “clinical data”
argument, as the stakes are considerably higher in
deployment of these products in the tactical law en-
forcement environment. While budgets and personal
experience are relevant decision-making points,
there are a set of key variables to consider.
Despite the rapid increase in acceptance in the
tactical law enforcement communities, a stan-
dardized, quality decision-making process that
focuses on the three key variables of the clinical,
tactical and economical aspects hasn’t existed.
So, what follows is a non-biased set of standards
(benchmarks) to assist you in your decision-making
process for these products.
1Clinical Considerations
Sufficient data now exists to evaluate the per-
formance of wound clot products in the context of
survivability and total blood loss.
Most of this data has been performed on products
using three-minute “hold” times after dressing ap-
plication. However, some dressings now dramatically
reduce the need for three minutes of post-application
compression because they can control active bleeding
in seconds rather than minutes.
So, the primary clinical concerns for those in the
tactical space are mechanism of action (how it works)
and time to hemostasis (how fast it works).
Mechanism of clotting agent action: Stop-
ping the flow of blood is paramount. The faster
bleeding is stopped (hemostasis), the less blood is
lost and there’s less chance of a patient going into
OCTOBER2014
Focus on Active Shooter Incidents and Tactical Emergency Casualty Care
1410JEMSSupp_16 16
difficult-to-manage or irreversible shock.
Some products rely on or are dependent on the
body’s clotting factors and ability to form a stable
clot. These are the mineral-based ingredients such as
Kaolin (Combat Gauze) and Smectite (WoundStat).
Other wound clot products work independent
of the body’s intrinsic clotting pathway. These are
the chitosan-based products such as Celox and Hem-
Con’s ChitoGauze.
The bottom line is that relying on the body’s ability
to provide the factors necessary to stop bleeding can
be problematic in a life or death environment. If an
emergency care provider comes across a casualty with
diminished clotting capabilities due to hemorrhage
and the person is taking aspirin or using blood-thin-
ning prescription medications like warfarin (Cou-
madin), products dependent on the patient’s body
systems will be less effective than those that aren’t.
2 Tactical Considerations
Data from recent mass violence and active
shooter events presented in this supplement dem-
onstrate that you don’t have three minutes to hold
pressure on wound clotting agents or bandages be-
cause these events are high-speed scenarios where
seconds—not minutes—matter.
The concept of tactical hemostasis is centered
around “hands free—faster.” As stated, although
multiple products can stop bleeding in a three-
minute model, several wound clot products can stop
bleeding faster, thereby freeing up the hands of
emergency providers to treat other wounds or treat
other casualties. Perhaps more important is the abil-
ity to free up the hands of law enforcement officers’
to “fight back” when under fire. So, the products
that free up the caregivers’ hands the fastest, can
dramatically impact the casualty or rescuer’s safety
and security.
3 Economic Considerations
Economic considerations round out the decision-
making process. Product cost and shelf life represent
a “cost per month” for products that may sit unused
in kits and vehicles for extended time periods. The
longer the shelf life, the more the savings on restock-
ing expense.
16
9/8/14 9:31 AM
 ✚

Ballistic PPE Packages for

Rescue Task Force Teams

PACKAGES STARTING AT $988

AVAILABLE IN MULTIPLE BALLISTICS

FOR MORE INFORMATION CALL US

1-877-MES-FIRE WWW.MESFIRE.COM

1410JEMSSupp_17 17 9/8/14 9:31 AM

 ✚

In an active shooter incident you may

be required to rapidly assess, triage and
use a tourniquet to immediately stop
life-threatening hemorrhage.

PHOTOS A.J. HEIGHTMAN

Stop E
xternal hemorrhage is a common prob-
lem encountered in the management of
prehospital trauma. The vast majority
of hemorrhage is relatively minor and easily con-
trolled by simple maneuvers, such as direct pres-

the sure and the application of a pressure dressing.

Occasionally, such hemorrhage can be brisk

Bleeding
and life threatening. Military research shows
that extremity hemorrhage is responsible for
approximately 9% of battlefield deaths and rep-
resents the largest preventable cause of death
in combat.1,2
The mortality from extremity hemorrhage in
New external hemorrhage control civilian EMS is much lower, estimated at 2.8% of
trauma patients.3
evidence-based guideline However, despite the relative rarity of such in-
juries in civilian EMS, the appearance of military-
type injuries are a possibility in every community,
By Peter P. Taillac, MD, FACEP with mass shootings (Columbine, Aurora, Sandy
Hook) and bombings (Oklahoma City, Boston
Marathon) making the news more frequently.
In such cases, early management of hem-
orrhage by first responders can mean the

OCTOBER2014
Focus on Active Shooter Incidents and Tactical Emergency Casualty Care 18

1410JEMSSupp_18 18 9/8/14 9:32 AM


difference between life and death by exsangui-
nation. So, despite the infrequency of such hor-
rific events, we must be ready to respond when
disaster strikes our communities. First response
in such situations may be by bystanders, law en-
forcement personnel or EMS.
In response to these incidents, federal and
state authorities have convened panels of EMS
and law enforcement experts to reevaluate our
combined responses to such domestic mass
casualty incidents. As part of these conversa-
tions, there developed a realization that some
of the lessons learned from our combat trauma
management experiences could be applied to
minimize the morbidity and mortality of these
tragic events.
One such effort was a National High-
way Traffic Safety Administration Office of
EMS-funded request to the American College
of Surgeons (ACS) to develop an evidence-based
guideline (EBG) for initial hemorrhage con-
trol by first responders, whether they be lay-
person bystanders, law enforcement or trained
EMS providers.
This effort culminated in the recent publi-
cation of Evidence-Based Prehospital Guideline for
External Hemorrhage Control: American College of
Surgeons Committee on Trauma.4
Evidence-Based Guidelines
An EBG is a recommendation for treatment
that’s developed using a structured process to
evaluate the existing medical literature to an-
swer specific treatment questions. For the cur-
rent hemorrhage control EBG the Grading of
Recommendations, Assessment, Development
and Evaluation (GRADE) process was utilized.
This is a standardized process for such EBG
development. GRADE is part of the Model Pro-
cess for Development of Prehospital EBGs that
has been established as a standard model process
for the development of prehospital EBGs by the
Federal Interagency Committee on EMS and the
National EMS Advisory Committee (NEMSAC).5
Simply stated, the GRADE process begins
by developing very specific questions to be an-
swered. In addition, the values and preferences of
the group regarding these questions are defined.
For example, the expert panel felt that guidelines
should guide care in the prehospital environ-
ment and should improve patient outcomes.
After these “ground rules” are established, the
available medical literature is collected and re-
viewed to answer the defined questions. Each of
the relevant articles is then reviewed, evaluated
and graded based on the quality of the research.
19
1410JEMSSupp_19 19
✚
Articles are ranked as strong, moderate, weak or
very weak evidence.
Finally, after all of the evidence is reviewed
and graded for answers to the research ques-
tions, guideline recommendations are made.
Based on the strength of the evidence, and the
likelihood that the recommendations are going
to do more good than harm to the patient, these
final recommendations are considered either
“strong” or “weak.”
A strong recommendation is based on good-
quality evidence and is considered very likely to
provide more good than harm. A weak recom-
mendation is based on weaker evidence and is
thought likely to provide more good than harm.
The prehospital hemorrhage control guide-
line described below was developed after review
of all of the available medical literature on hem-
orrhage control and using this rigorous model.
As new medical evidence becomes available, this
guideline could change. However, at this time
it’s based on the best available evidence as as-
sessed by the ACS expert panel. The panel was
made up of experts in trauma care, hemorrhage
control, emergency medicine and EMS. It in-
cluded both military and civilian members.
Figure 1: Prehospital external
hemorrhage control protocol
Apply direct pressure or pressure dressing to injury
Direct pressure effective Direct pressure ineffective or impractical
(hemorrhage is controlled) (hemorrhage is not controlled)
Wound amenable Wound not amenable
to tourniquet placement to tourniquet placement
(e.g., extremity injury) (e.g., junctional injury)
Apply a topical hemostatic agent
Apply a tourniquet
with direct pressure
The findings of the expert panel are summa-
rized in Figure 1. In summary, the first step in
hemorrhage control is direct pressure and ap-
plication of a pressure dressing. If that results
in cessation of bleeding, then you’re done. How-
ever, if direct pressure is either “ineffective” or
“impractical,” then more advanced hemorrhage
control techniques are required.
Indications for More Advanced Techniques
“Ineffective” is pretty simple: Despite your ef-
forts to apply direct pressure and a pressure
dressing, the bleeding continues.
OCTOBER2014
A Special PennWell Supplement
9/8/14 9:32 AM
 ✚
In line with the new external hemorrhage control protocol, effective wound packing should be added to the
standard prehospital and first responder skill set.
“Impractical” means these measures can’t be
immediately applied or sustained because: a)
the nature of the wound doesn’t allow effective
hemorrhage control by this technique; or b) you
don’t have sufficient hands, equipment or time
to apply an effective pressure dressing.
This could occur, for example, because you’re
first on the scene of an incident involving a pa-
tient with multiple injuries who needs attention
(airway, breathing, circulation) in addition to a
severe extremity hemorrhage.
Applying direct pressure and applying an ef-
fective pressure dressing may require more time
or supplies than you have immediately at your
disposal, since you also need to manage the un-
stable airway, decompress the tension pneumo-
thorax, get lines started, etc.
In this case, the pressure dressing is impracti-
cal and the rapid placement of a tourniquet or
hemostatic gauze may be required to stem the
severe hemorrhage while other priorities are at-
tended to.
Alternatively, in a mass casualty situation like
a shooting at a shopping mall, you may be re-
quired to rapidly assess, triage and begin lifesav-
ing treatment for multiple patients.
Until further rescue personnel arrive, the pri-
orities must be to immediately stop obvious life-
threatening hemorrhage, provide simple airway
management maneuvers and to evaluate, triage
and categorize all of the injured at the scene.
This is the current military model for mass
casualty management and is at the heart of the
SALT (sort, assess, lifesaving interventions and
treatment/transport) triage system.6
In this situation, it’s “impractical” to apply
OCTOBER2014
Focus on Active Shooter Incidents and Tactical Emergency Casualty Care
1410JEMSSupp_20 20
direct pressure or a proper pressure dressing
to each patient until all patients have been as-
sessed and triaged. So advanced hemorrhage
control techniques, such as tourniquets or he-
mostatic gauze, should be utilized, which may
prevent exsanguination while the patients await
further treatment and transportation to defini-
tive care.
The next step of the hemorrhage control
algorithm divides wounds into those “ame-
nable to tourniquet placement” and “not ame-
nable to tourniquet placement.” In general,
this divides wounds into extremity wounds
(for which tourniquet placement is possible),
“junctional” wounds (wounds to the groin,
axilla, neck, or scalp) and torso wounds (chest,
abdomen, pelvis).
These latter two areas preclude secure tourni-
quet placement and require other means, such
as the packing of hemostatic gauze to control
severe hemorrhage.
The expert panel, based on the evidence avail-
able, felt that the strength of the recommenda-
tion for tourniquet use was “moderate,” because
of the preponderance of beneficial effect and
minimal harm in the literature, the vast major-
ity of which were retrospective military studies.
The strength of the recommendation for the
use of hemostatic gauze was considered to be
“weak,” because it consists entirely of animal
studies on these hemostatic products; there are
no human studies to date. However, in these
animal studies, including a standardized swine
model developed by U.S. military researchers,
the benefit of hemostatic gauze consistently
outweighs the risks of its use.
20
9/8/14 9:32 AM

Several specific points made by the expert
panel regarding the use of these advanced hem-
orrhage control techniques should be reviewed.
Regarding tourniquet use, the committee
suggests that a commercially-produced wind-
lass, pneumatic or ratcheting device, which has
been demonstrated to occlude arterial flow, be
used; that narrow, elastic or bungee-type devices
be avoided; that improvised tourniquets be uti-
lized only if no commercial device is available;
In animal studies, including a standardized swine model
developed by U.S. military researchers, the benefit
of hemostatic gauze consistently outweighs the risks of its use.
and that, in short urban transports, a properly
applied tourniquet not be released until the pa-
tient reaches the hospital.
In longer transports, or in austere or complex
situations (for example rural, wilderness or an
entrapped patient with an extended extrica-
tion), on-line medical control should be con-
tacted to consider replacing the tourniquet with
an effective pressure dressing when/if possible.7
Regarding the use of hemostatic agents for
junctional or torso injures, the expert panel sug-
gests utilizing only hemostatic agents which are
available in a gauze format, which support firm
packing of the bleeding wound and have been
determined to be effective and safe in a stan-
dardized laboratory injury model.
It should be noted that the federal Depart-
ment of Transportation standardized curricu-
lum and most prehospital training programs
don’t currently teach wound packing as a re-
quired skill. We would suggest, based on this
evidence, that effective wound packing be
added to the standard prehospital and first
responder skill set and that training in this
lifesaving technique be added to EMS training
programs nationwide.
Similarly, effective tourniquet use should be
added to all first responder training programs,
including training for law enforcement person-
nel, as they are often the first on the scene of
active shooter or other disaster scenes.
More civilian prehospital research is needed
to better define the use of tourniquets and
hemostatic agents in the patients that we see
daily. As was mentioned, much of the research
on these techniques has been performed by the
U.S. military, whose patient population is gen-
erally young, fit and healthy soldiers.
We need to know if these techniques are safe
21
1410JEMSSupp_21 21
✚
and effective for our typical civilian EMS pa-
tients, including children, the elderly and those
with chronic cardiovascular and other diseases.
Such research is currently underway in several
large EMS systems.
Conclusion
The publication of this external hemorrhage
control EBG will provide EMS medical di-
rectors and field providers the guidance and
confidence they need in the training and
implementation of local hemorrhage control
protocols and the deployment of tourniquets
and hemostatic gauze.
These advanced hemorrhage control tech-
niques won’t be frequently required in civilian
EMS situations. However, when needed, they
can be lifesaving and are, therefore, important
“tools in the toolbox” for the EMS responder. ✚
Peter P. Taillac, MD, FACEP, is a clinical professor in
the Division of Emergency Medicine at the University of
Utah School of Medicine. He’s also the state EMS medi-
cal director for the Bureau of Emergency Medical Servic-
es and Preparedness in the Utah Department of Health
and medical director for West Valley City, Utah, Fire and
EMS. He can be contacted at ptaillac@utah.gov.
References
1. Eastridge BJ, Mabry RL, Seguin P, et al. Death on the battlefield
(2001–2011): Implications for the future of combat casualty
care. J Trauma Acute Care Surg. 2012;73(6 Suppl 5):S431–
S437.
2. Kauvar DS, Sarfati MR, Kraiss LW. National trauma databank
analysis of mortality and limb loss in isolated lower extremity
vascular trauma. J Vasc Surg. 2011;53(6):1598–1603.
3. Dorlac WC, DeBakey ME, Holcomb JB, et al. Mortality from
isolated civilian penetrating extremity injury. J Trauma.
2005;59(1):217–222.
4. Bulger EM, Snyder D, Schoelles K, et al. An evidence-based pre-
hospital guideline for external hemorrhage control: American
College of Surgeons Committee on Trauma. Prehosp Emerg
Care. 2014;18(2):163–173.
5. Lang ES, Spaite DW, Oliver ZJ, et al. A national model for develop-
ing, implementing, and evaluating evidence-based guidelines
for prehospital care. Acad Emerg Med. 2012;19(2):201–209.
6. Lerner EB, Schwartz RB, Coule PL, et al. Mass casualty triage:
An evaluation of the data and development of a proposed
national guideline. Disaster Med Public Health Prep.
2008;2(suppl 1):S25–S34.
7. Doyle G, Taillac PP. Tourniquets: A review of current use with
proposals for expanded prehospital use. Prehosp Emerg Care.
2008;12(2):241–256.
OCTOBER2014
A Special PennWell Supplement
9/8/14 9:32 AM
 ✚
Transitioning
to Warm Zone
Operations
Boston EMS makes
operational changes after
the Boston Marathon bombing
By Ricky Kue, MD, MPH, FACEP
& Brendan Kearney, EMT-P, MPA
I
t was a beautiful spring day in Boston the
morning of April 15, 2013; ideal weather
conditions for the 117th running of the
prestigious Boston Marathon, the oldest an-
nual marathon in the world. Unlike the previ-
ous year when temperatures reached 90 degrees
F and resulted in 2,000 runners seeking medical
attention along the course, the weather was cool
and comfortable for the 27,000 registered run-
ners and 500,000 spectators cheering them on.
But then, at 2:49 p.m., everything changed.
Two improvised explosive devices were inten-
tionally detonated in the crowd resulting in the
deaths of three spectators and the serious injury
and maiming of scores of others. One hundred
eighteen patients were transported from the
scene by ambulance to nine area hospitals. All
would survive.
It was the beginning of a week unlike any
other in the Boston area: a terrorist attack in
the city’s Back Bay neighborhood, a presidential
visit, the murder of a Massachusetts Institute
OCTOBER2014
Focus on Active Shooter Incidents and Tactical Emergency Casualty Care
1410JEMSSupp_22 22
of Technology police officer, a gunfight with
the two bombing suspects during which a Mas-
sachusetts Bay Transit Authority police officer
was shot, a suspect was killed, a 12-hour “shelter
in place” request for a major metropolitan area
and the eventual capture of the second suspect.
Challenging the universal first responder tenet
of scene safety, the Boston bombings represented
a response that required a rapid, but thoughtful
plan which took into account a fluid and dynam-
ic threat, while mitigating as much risk to first
responders as possible.
While the Boston bombing response didn’t in-
volve an active shooter, it had many of the same
concepts and components: multiple patient inju-
ry locations, a scene that wasn’t able to be totally
secured by law enforcement in which critically
injured patients were literally bleeding to death
and requiring rapid treatment and transport.
Had Boston EMS personnel, active bystand-
ers and other professional rescuers not imme-
diately rendered aid, more lives would’ve been
22
9/8/14 9:32 AM

lost. Initial actions focused on identifying vi-
able patients, providing hemorrhage and airway
control and rapidly clearing patients from an
unsafe scene to areas of lower threat, and ulti-
mately to definitive care.
Video taken by a Boston Globe sports videogra-
pher at the finish line with Boston EMS radio
traffic overlaid on it illustrates what Boston
EMS personnel were doing and thinking in the
moments after the explosions. (Watch the video
at http://youtu.be/7j7LkuPzT1c.)
Incident command positions were already es-
tablished as part of the special event planning, so
radio traffic was minimized. The nature and exact
location of the incident was confirmed and units
in the area were instructed to hold their positions.
Boston EMS’ mass casualty incident (MCI) plan
was put into effect, area hospitals were notified
and put on alert, a secondary staging area was
established and mutual aid plans were seamlessly
implemented. These immediate actions didn’t oc-
cur by chance; they were years in the making.
23
1410JEMSSupp_23 23
✚
2013 Boston Marathon bombing
scene on Boylston Street.
AP PHOTO/CHARLES KRUPA
Identifying the Problem
The response to active shooter incidents (ASIs) in
the United States has historically involved a seg-
mented, sequential public safety operation. Pa-
trol officers were commonly trained to “contain
and wait” at an ASI until more specially trained
personnel (e.g., SWAT) arrived.
The mass shooting at Columbine (Colo.) High
School has been widely viewed as the water-
shed moment in law enforcement that brought
about a major tactical shift and reinforced the
need for an immediate, aggressive response to
active shooters. Since then, law enforcement re-
sponse to ASI no longer focuses on threat con-
tainment, but instead emphasizes a rapid and
immediate response by first arriving units to
neutralize the shooter as quickly as possible.1,2
In the years preceding the Boston bombing,
Boston EMS had begun training in conjunction
with the Boston Police Department on how both
agencies would coordinate a response to ASIs.
Full-scale, active shooter exercises in the
OCTOBER2014
A Special PennWell Supplement
9/8/14 9:32 AM
 ✚
metropolitan Boston area demonstrated to both
law enforcement and EMS officials that despite
best efforts to bring lifesaving medical care to
victims after a threat had been neutralized, the
time to first tourniquet or bandage placement
remained unacceptably high. According to the
FBI, a typical ASI lasts on average 12 minutes
with 37% lasting less than five minutes.3
Recognizing the significant time delay to de-
finitive care for victims during an ASI until the
scene is rendered “clear,” Boston EMS began de-
veloping a joint EMS/law enforcement “rescue
task force” response model described by other
first response agencies, such as Arlington Coun-
ty (Va.) Fire Department.4
While training, Boston EMS focused specifi-
cally on the active shooter threat, and many of
the same principles found immediate applica-
tion at the bombing incident that occurred on
Boylston Street.5
Military experiences over the past decade have
demonstrated improved outcomes to victims of
traumatic bleeding with early hemorrhage con-
trol techniques employed at the point of injury.6–8
This type of focused intervention, described
in military-based medical training programs
such as Tactical Combat Casualty Care (TCCC),
has been integrated into an early and coordinat-
ed response with law enforcement.4
Defining the Operational Environment
The “warm zone” concept represents a shift
in law enforcement and EMS response tactics,
equipment needs and incident command prac-
tices. Boston EMS recently developed a policy to
provide departmental guidance for EMS opera-
tions in the warm zone, defined as an area of in-
direct threat that has been swept by law enforce-
ment and cleared of any immediate threats.
A key component to successful warm zone
operations is joint command and control
by all disciplines involved at an incident. In
OCTOBER2014
Focus on Active Shooter Incidents and Tactical Emergency Casualty Care
1410JEMSSupp_24 24
Left: Boston EMS personnel train with Boston
Police Department patrol officers on active shooter
response tactics.
Above: EMTs join Boston Police Department SWAT
during active shooter response training to enter a
large college cafeteria to assess multiple victims with
the understanding a potential threat was still present.
PHOTOS COURTESY BOSTON EMS
Boston, all major events and incidents are op-
erated through a unified command process
made up of command staff from the primary
response agencies within our jurisdiction.
Operations in a warm zone can only be suc-
cessful when leaders recognize the roles of partic-
ipating disciplines as well as the overall objective.
As areas are cleared and resources permit, law
enforcement operations may initially include de-
ployment of rescue teams that focus on extrac-
tion of wounded victims to a designated casualty
collection point for EMS to render initial aid.
EMS personnel may be requested to join a
law enforcement rescue team, thereby forming
a “rescue task force” for operating in the warm
zone to provide medical operations including
triage, primary point-of-wounding treatment
(hemorrhage control and airway), and assist
with extraction of victims based on available re-
sources and capabilities.
EMS personnel are instructed not to enter an
area that hasn’t been cleared without law enforce-
ment consent and protective escort. EMS provid-
ers wear issued ballistic body armor and function
within the force protection structure provided by
accompanying law enforcement personnel.
Training conventional EMS providers to oper-
ate in what has been traditionally considered a
“tactical” operation has focused on developing
a mindset to operate jointly with law enforce-
ment and focus medical interventions based on
nationally recognized recommendations such as
the Committee for Tactical Emergency Casualty
Care (C-TECC) and the Hartford Consensus.9,10
Active shooter training for Boston EMS per-
sonnel has included an understanding of the
tactics, techniques and procedures of our law
24
9/8/14 9:32 AM
 ✚
PHOTO COURTESY BOSTON EMS

Boston EMS active

shooter response
training with the
Boston Police
Department SWAT
team, U.S. Navy
and National
Park Service
Police at the USS
Constitution in
Charlestown, Mass.

enforcement partners responding to an ASI, de-
veloping common terminology among all the
responding disciplines and adopting focused
medical care our providers will deliver in the ac-
tive shooter environment.
EMS provider comfort and ability to respond
jointly with law enforcement to ASIs is directly
related to the knowledge and experience devel-
oped during training. With the Boston EMS
experience, 89% of providers felt adequately
prepared to respond to an ASI after specialized
training, compared to 41% of providers who felt
this way prior to the training.11
The decision by EMS personnel to jointly op-
erate under the force protection of law enforce-
ment for the preservation of lives must be judged
carefully against the risk of injury or harm to
operate in such an environment. Boston EMS
personnel operating at an incident are trained to
constantly assess for secondary devices or other
threats. Should threats be identified, it would
necessitate upgrading the area to one of direct
threat (“hot zone”) requiring rapid evacuation of
all EMS personnel and surviving patients.
Medical Treatment in the Warm Zone
The importance of integrating early lifesaving
medical interventions in the response to an ASI
is an integral component to victim survival.10
Boston EMS has long recognized the critical im-
portance of aggressive hemorrhage control along
with rapid transport to an appropriate receiving
facility in the case of severe trauma.
Since the late 1970s, Boston EMS EMTs and
paramedics have used surgical tubing tourni-
quets for extremity hemorrhage control suc-
cessfully.12,13 In the last few years, all Boston
EMS field response units have added hemostat-
ic gauze dressings to their hemorrhage control
kits. And since the 2013 bombings, commercial
windlass-type tourniquets have been issued to
all department members in addition to the sur-
gical tubing tourniquets.
Boston EMS has also developed response
kits that focus on hemorrhage control and ba-
sic airway measures based on TCCC & TECC
guidelines.8 These compact kits include rapid
deployment items such as tourniquets, hemo-
static gauze and pressure bandages that focus
care primarily on hemorrhage control.
Additional warm zone treatment interven-
tions include MCI triage review, rapid sweep
triage tagging with colored triage tape and
rapid extrication techniques. Boston EMS has
also incorporated use of an armored tactical re-
sponse rescue unit into joint training exercises
with the Boston Police Department and other
regional tactical teams to provide force protec-
tion and a relatively safe location to provide ini-
tial patient care.
The focus of medical care in this environment
isn’t based on conventional basic trauma life
support standards, rather, it accounts for the
dynamic situation of an event, such as a terror-
ist bombing or active shooter, and limits care to
high-yield, best practices while providing rapid
extrication of victims to a safer environment
more appropriate for further medical care.
Surgical tubing
tourniquets
carried by
Boston EMS
crews since
the 1970s
for extremity
hemorrhage
control.
PHOTO A.J. HEIGHTMAN

OCTOBER2014
25 A Special PennWell Supplement

1410JEMSSupp_25 25 9/8/14 9:32 AM

 ✚
PHOTOS A.J. HEIGHTMAN
Boston EMS major incident response kit.
PHOTO A.J. HEIGHTMAN
Armored tactical response rescue unit used by Boston Police and
EMS to extract injured patients.
A Paradigm Shift for EMS
The 1999 Columbine school shooting was a turn-
ing point for law enforcement response tactics to
ASIs. A realization had been made that the time
delay for specialized law enforcement assets to ar-
rive and manage a dynamic event wouldn’t work.
The Boston bombings in 2013 have been
viewed as an affirmation that current recom-
mendations for EMS operations at mass bomb-
ing and ASIs do indeed work. Similar to the law
enforcement paradigm shift, EMS has now seen
a major change in the way we assess the level of
threat of an incident and develop an appropri-
ate, logical response to maximize the number of
lives saved.
The EMS response mindset is undergoing
change; rather than asking, “Is the scene com-
pletely safe?” the more appropriate question
should be, “Is the scene safe enough?” based on
OCTOBER2014
Focus on Active Shooter Incidents and Tactical Emergency Casualty Care
1410JEMSSupp_26 26
what’s known at the time.
EMS agencies need to consider how they will
operate in a warm zone environment with other
responding agencies. Regular training with law
enforcement partners is a key component to a
successful response, with all agencies knowing
how they’ll work with one another. This is done
through the sharing of ideas, understanding
common tactics, techniques and procedures,
developing common terminology and under-
standing both capabilities and limitations. ✚
Ricky Kue, MD, MPH, FACEP, is associate medical di-
rector of the Boston EMS, Police and Fire Departments,
an assistant professor of emergency medicine at Bos-
ton University School of Medicine and a Major in the
Medical Corps of the U.S. Army Reserve.
Brendan Kearney, EMT-P, MPA, is superinten-
dent-in-chief of Boston EMS. He can be contacted at
Kearney@bostonems.org.
References
1. USFA. (September 2013.) Fire/EMS department operational
considerations for active shooter and mass casualty incidents.
Retrieved Oct. 17, 2013, from www.usfa.fema.gov/downloads/
pdf/publications/active_shooter_guide.pdf.
2. State of Colorado. (May 2001.) The report of Governor Bill Owen’s
Columbine review commission. Retrieved Aug. 7, 2013, from
www.state.co.us/columbine/Columbine_20Report_WEB.pdf .
3. Schweit K. (May 2013.) Addressing the problem of the active
shooter. FBI Law Enforcement Bulletin. Retrieved May 23,
2013, from www.fbi.gov/stats-services/publications/
law-enforcement-bulletin/2013/May/active-shooter.
4. Smith ER, Iselin B, McKay WS. Toward the sound of shooting:
Arlington County, Va., rescue task force represents a new
medical response model to ASIs. JEMS. 2009;34(12):48–55.
5. Biddinger P, Baggish A, Harrington L, et al. Be prepared: The
Boston Marathon and mass-casualty events. N Engl J Med.
2013;368(21):1958–1960.
6. Mabry R, McManus J. Prehospital advances in the management
of severe penetrating trauma. Crit Care Med. 2008;36(7
Suppl):S258–S266.
7. Kotwal R, Montgomery H, Kotwal B, et al. Eliminating preventable
death on the battlefield. Arch Surg. 2011;146(12):1350–1358.
8. Butler F. Tactical combat casualty care: Update 2009. J Trauma.
2010;69(1 Suppl):S10–S13.
9. Callaway D, Smith R, Shapiro G, et al. The committee for tactical
emergency care (C-TECC): Evolution and application of TCCC
guidelines to civilian high threat medicine. J Spec Ops Med.
2011;11(3):95–100.
10. Jacobs L, McSwain N, Rotondo M, et al. Improving survival from
active shooter events: The Hartford consensus. J Trauma Acute
Care Surg. 2013;74(6):1399–1400.
11. Jones J, Kue R, Mitchell P, et al. Emergency medical services re-
sponse to active shooter incidents: Provider comfort level and
attitudes before and after participation in a focused response
training program. Prehosp Disaster Med. 2014;29(4):1–8.
12. Kalish J, Burke P, Feldman J, et al. The return of tourniquets:
Original research evaluates the effectiveness of prehospital
tourniquets for civilian penetrating extremity injuries. JEMS.
2008;33(8):44–46.
13. Kue R, Dyer KS. Tourniquet use in a civilian EMS Setting: A
descriptive analysis of the Boston EMS experience. Prehosp
Emerg Care. 2014;18(1):162.
26
9/8/14 9:32 AM
 ✚

 


  

 

  
 
  
  

 

 


 


  

incidents and/or active shooter incidents.

 QuikClot

  """ "


"
""" "
"
" "
"

 "
" 
" "

"

 QuikClot 


     """
"


" 
""
" 
" "
"
" " "



 QuikClot


 ""
"


"
"
" "


"

"  "
"  "" 
"
"" "!!"




*Short and long term rental programs available.

For more information and to purchase:

z-medica, llc
www.z-medica.com
MADE IN THE USA
203-294-0000  


  

1410JEMSSupp_27 27 9/8/14 9:32 AM

 ✚

AP PHOTO/JESSICA HILL
Preparing
for the
Unthinkable
O
n a typical school day morning, school bus
Tactical Emergency Casualty 17, carrying 42 elementary school students
through suburban roads and main thor-
Care pediatric guidelines oughfares, suddenly strikes metal debris in the road
blowing out the bus’s right tire and sending the bus
By Joshua P. Bobko, MD, FAAEM, careening off the road and into a tree.
David W. Callaway, MD, FACEP The bus lands on its side and the passengers are
& E. Reed Smith, MD, FACEP trapped inside. After a frantic 9-1-1 call by a commut-
er, law enforcement arrives on scene, followed closely
by the first fire and EMS units. They quickly establish
incident command, declare a mass casualty incident (MCI), order additional resources and begin tri-
aging the casualties. The responding medics find numerous school-age casualties in varying degrees
of injury, criticality and distress.

Shifting the Paradigm of Treating Pediatric Trauma

The rise in Active Violence Incidents (AVIs) is a concerning trend facing EMS.1 While we shouldn’t
let AVIs dominate discussions regarding trauma care, the increased awareness offers opportunities to
drive a paradigm shift in the prehospital training and treatment of pediatric trauma casualties.2

OCTOBER2014
Focus on Active Shooter Incidents and Tactical Emergency Casualty Care 28

1410JEMSSupp_28 28 9/8/14 9:32 AM


Training that was once the domain of only
specialized law enforcement teams and their
medical components is slowly but steadily tran-
sitioning to street-level first responders.3,4 In the
past five years, fire-based systems have driven
much of this expansion.5,6 The traditional EMS
community is now racing to catch up.
It’s important to recognize that threats don’t
simply include active shooters or terrorists;
threats can include a burning bus, structural col-
lapse, gas leaks, etc. The case above highlights two
distinct gaps in the prehospital care in the high
threat environment. First, although the system-
level training of the civilian Tactical Emergency
Casualty Care (TECC) principles has begun to
reach the ground level with the recent Interna-
tional Association of Fire Fighters and United
States Fire Administration/Federal Emergency
Management Agency position papers, tradition-
al EMS trauma education (e.g., BTLS and PALS)
falls short on the treatment of the pediatric casu-
alty in today’s high-threat environment.
Although these protocols are helpful in most
cases of blunt trauma or medical arrest, they
aren’t sufficient in the setting of multiple, high
acuity penetrating trauma patients.
Second, the teaching and use of triage proto-
cols without guidance on intervention may be
due to the previous lack of literature regarding
the treatment of the critically injured child.7
For example, an EMS provider encountering a
situation with multiple children suffering criti-
cal bleeding is currently being taught to respond
via MCI declaration and triage protocol such as
JumpSTART. However, in many cases this ap-
proach may subject the pediatric casualty to un-
necessary delays in hemodynamic stabilization.8
Currently there are no critical care pediatric
programs that deal with critically injured pedi-
atrics within the austere environment of mass
casualties involving predominantly pediatric
patients. This differs markedly from the litera-
ture base and approach taken with adult MCI
and poly-trauma casualties.9
Recognizing this gap in rescue operations,
the Committee for TECC began an effort to de-
velop a set of evidence-based pediatric casualty
care guidelines.
Beginning in 2011, the committee formed a
special populations subcommittee and pediat-
ric working group to address the less represent-
ed demographics in our casualty population.
These guidelines were developed using the same
methodology employed for the development of
the adult guidelines combining expert agree-
ment, best evidence and current practices.10
29
1410JEMSSupp_29 29
✚
Beginning with an extensive literature review,
the pediatric working group analyzed the lit-
erature for current evidence regarding pediatric
casualty treatment. Given the significant lack of
prehospital pediatric trauma data, the literature
review included ED, operating theater and pedi-
atric critical care data as well as prehospital and
international disaster response research. The
findings were presented for consensus review
and published as the initial pediatric appendix
to the TECC guidelines in 2013.
How the Pediatric Guidelines Apply to EMS
While modern law enforcement and EMS train-
ing frequently focuses on the response to dy-
namic threats, there’s wide variability in the
preparation for pediatric casualties. Addition-
ally, multiple sources confirm that children are
often overlooked in disaster response, which
may be resultant from inadequacy of current
pediatric training.8,11
Within the past two years, events involving
public locations (e.g., schools, churches and
theaters) have attracted the attention of the
national media. Most, if not all, have involved
pediatric casualties.12 The guidelines proposed
by the TECC committee will greatly empower
first responders of all types to improve familiar-
ity and confidence with care for the pediatric
trauma while in the high-threat scenario.
Understanding the current recommendations
for an efficient and effective approach to the in-
jured child incorporates not just mitigation of
the physical injury but a holistic approach to
minimize emotional distress in the casualty and
improve understanding and thus compliance
with direction given by responders.9 Integration
of this approach into current protocols will go
far to eliminate the confusion and uncertainty
that often accompany these situations.
Approaching the Injured Child
The response to pediatric AVIs or MCIs is a
poorly researched topic. As a result, we have
incorporated data from several related fields
including literature from experts in disaster/
refuge care and child life specialists for general
guidance on broad themes. Because of the diffi-
culty writing guidance for a patient population
ranging from infant to young adult, particular
attention was paid to methods for improving
communication with pediatric casualties and
minimizing exposure to emotional distress.
Understanding that a child’s ability to re-
spond to a stressful event is directly related to
their development level and is critical to prepar-
OCTOBER2014
A Special PennWell Supplement
9/8/14 9:32 AM
 ✚
ing providers to meet this challenge.
Because stress comes in many forms and is
the summation of an emotional response to
an event, it’s incumbent upon EMS and safety
providers to minimize distress. Improper or in-
effective management of the pediatric casualty’s
distress will damage trust, complicate medical
care and create difficulty in communication
with the patient.
This perceived loss of control has operational
consequences for the tactical response element.
A child’s information processing ability is im-
paired under moderate stress. The extra time
that’s required to engage a patient in a state of
“frozen watchfulness” may have direct and se-
vere consequences on the immediate operations
of the response team.13 Moreover, the younger
the child’s age, the more likely the child is to de-
volve into a state of undifferentiated threat and
generalized distress.14
Not only might a child in this state be non-
compliant with instruction or treatment, but
this may limit information valuable to respond-
Strategies for Communicating
with Children During Trauma
• Approach from eye level.
• Use “minimally threatening” or “soft” language.
–Use direct phrases (i.e., an incision should be
described as “making a small opening” rather
than a “cut” or “hole”).
–Avoid using the word “hurt” because it has
nonspecific connotations, and doesn’t convey
helpful information. Try “sting” or “prick” when
preparing children for an IV.
• Give analogy for medical terms (e.g., shot, pres-
sure dressing, stretcher or butterfly). When using
a tourniquet describe it like a “big rubber band”
(something familiar to most children).
• Don’t provide explicit detail.
–Only provide children with the information that
they will directly experience.
–Too much information may confuse or
frighten children.
• Have child repeat back what they’ve heard.
• Allow child to make choices.
–“Some kids say it feels like a pinch and others
say a sting. What do you think?”
• Restore sense of control.
• Give child autonomy over his or her body.
• Enable children to play an active role.
–“Your job is to hold his hand” or “sing the Air
Force Song.”
OCTOBER2014
Focus on Active Shooter Incidents and Tactical Emergency Casualty Care
1410JEMSSupp_30 30
ers. As such, incorporating simple techniques
can improve the chances of a cooperative pa-
tient and improve transition into post-event
care. These techniques have been incorporated
into the updated TECC pediatric appendix.
Pediatric vs. Adult TECC Guidelines
Pediatric care guidelines for the TECC phases of
care as a whole mirror the adult guidelines with
several important distinctions. As with adults,
rapid hemorrhage control and tourniquet ap-
plication is emphasized. The TECC pediatric
guidelines are the first to specifically recom-
mend pediatric tourniquet application. Sup-
ported by the only study to date,15 this recom-
mendation is carried through the direct care,
indirect care and evacuation phase guidelines.
Further recommendations put forth in the
guidelines are important both for the provider
and the management level oversight of response
personnel. Based on physiologic differences in
pediatric patients, changes in management and
equipment are delineated.
Strategies for Post-Trauma
Management of Children
• Assign a single information provider for
pediatric victims.
–The absence of a trusting relationship is a
cause of emotional distress.14
–Provide at least one care provider who is
frequently and readily available.
–Be mindful of nonverbal communications.
• Allow for “play therapy” during evacuation phase
and after the event.
–Facilitate the transmission of complex or
abstract concepts
• Use drawings, medical tools, etc.
• May provide more information post-event than
verbal interviews.
• Allow for family reunification.
–Emphasizing “family-centered care” fosters
return of family unit autonomy.
• Keep parents with children.
• Keep siblings together.
–Increases familiarity for children affected by
events (parental signaling).
–Provide anticipatory guidance.
• Increase familiarity and predictability
–Need to work closely with families to assess
their understanding of the situation.
–Anticipatory guidance will reduce
emotional distress.
30
9/8/14 9:32 AM
 ✚

AP PHOTO/DENIS POROY
Consistent with the adult guidelines, prima-
ry emphasis is again placed on achieving and
maintaining hemostasis. Once achieved, con-
trolling the pediatric airway is the next priority.
Interventions, including positioning, manipu-
lation and ventilation strategies, diverge from
the adult guidelines.
Utilization of bag-valve mask ventilation is
emphasized and shoulder elevation is recom-
mended. Age criteria for invasive airway in-
tervention is delineated and makes use of the
“signs of puberty” method of age delineation
familiar to most prehospital providers.
Other topics addressed in the pediatric
appendix include recommendations for in-
traosseous line placement as primary access,
vigilance in avoidance of hypothermia and re-
suscitation guidelines.
Again, because of the dramatic variance in
size of the pediatric population, thoracostomy
needle sizes in pediatric casualties have yet to
be proven in the literature. As such, the TECC
committee chose to recommend a minimum
catheter gauge size thereby allowing for local
medical direction and provider discretion.
Recommendations regarding the use of
tranexamic acid, hypotensive resuscitation and
whole blood transfusion were deferred pending
establishment of supporting evidence. These
topics were passed to the TECC research sub-
committee to drive future pediatric trauma re-
suscitation studies.

Reducing Post-Event Emotional Distress

Understanding that minimizing additional emo-
tional distress is critical to the post-traumatic
management of pediatric casualties and their
parents, the TECC pediatric guidelines incorpo-
rate strategies directly for this during the evacu-
ation phase.
Information exchange in the post-event set-
ting too often follows a unidirectional flow
from provider to patient. This information, in
the form of announcements or briefings, as-
sumes the message can be clearly understood
and easily processed by the recipient. However,
a child’s ability to process the information is im-
paired under even moderate stress.14
Because the bidirectional information flow
can be useful to both care providers and first
responders alike, care must be taken to ensure
that communications with casualties, witnesses
and parents are presented in a manner that fa-
cilitates processing and retention.
Children, like adults, obtain information
from their surroundings, incorporating visual
Parental absence can be interpreted as a loss of
control and is likely to increase emotional distress.
and other types of nonverbal clues with the ac-
tual message. Preferably, this information can
be provided by the parent. However, in times of
disaster, separation from their parents is likely.
Unfortunately, parental absence or anxiousness
on the part of the providers can be interpreted
as a loss of control and is likely to increase emo-
tional distress.
Accordingly, the TECC guidelines have sug-
gested that first responders or care providers
plan operationally, not only for a “child friendly
space,” but for an individual or group of indi-
viduals dedicated specifically to interaction
with pediatric casualties.
This shouldn’t be interpreted as a requirement
for a pediatric specialist, but for at least one care
provider who’s “frequently and readily available”

OCTOBER2014
31 A Special PennWell Supplement

1410JEMSSupp_31 31 9/8/14 9:32 AM

 ✚
to provide consistency and help offset the per-
ceived loss of control by the children affected.
The final aim of the pediatric guidelines is to
ensure that providers recognize the necessity for
ensuring integrity of the family unit. This will
fulfill two goals. First, it improves communica-
tion between those affected and the providers
caring for them and, second, it’s essential to
mitigating post-event emotional distress. By
emphasizing family-centered care we can return
a sense of autonomy to the family unit.
Too often, mission objectives are prioritized
over patient care. Simple steps such as reuniting
parents with children and keeping siblings and
extended family groups together will improve
operational flow, medical care and pediatric
victim recovery. Improving familiarity will also
improve both the victims’ and families’ under-
standing of a dynamic situation.
Providing prospective guidance to parents
and families will increase predictability in these
situations. This improved familiarity and pre-
dictability has a demonstrable effect on mitigat-
ing emotional distress.14 In this case, reducing
distress can actually help reach mission objec-
tives. Considering that information obtained
by both law enforcement and EMS is obtained
through witness testimonial, reduction of dis-
tress is paramount operationally. Community
resilience is paramount culturally.
Conclusions
There’s no greater challenge to an EMS system or
a society than an MCI involving children. As these
events become a greater concern, systems and
communities must evolve in their preparation.16
Our hope is that family-centered care and
mitigation of emotional distress improves com-
munity and first responder resiliency. The mis-
sion of the Committee for TECC is to improve
the civilian prehospital medical and law en-
forcement response to atypical disasters.
With the publication of the pediatric appen-
dix to the TECC guidelines, we seek to continue
the expansion of these principles of response
to a broader demographic. We hope this article
will empower local jurisdictions to tailor their
response protocols to meet the needs of their
civilian populations. ✚
Joshua P. Bobko, MD, FAAEM, is medical director for
the Westminster (Calif.) Police Department and an as-
sistant professor in the Department of Emergency Med-
icine at Loma Linda University. He may be contacted at
jbobko@valiantresearch.com.
David W. Callaway, MD, FACEP, is director of op-
OCTOBER2014
Focus on Active Shooter Incidents and Tactical Emergency Casualty Care
1410JEMSSupp_32 32
erational and disaster medicine in the Department of
Emergency Medicine at Carolinas Medical Center. He
may be contacted at dcallawa@gmail.com.
E. Reed Smith, MD, FACEP, is operational medical
director for the Arlington County (Va.) Fire Department
and an associate professor in the Department of Emer-
gency Medicine at George Washington University. He
may be contacted at rsmith@arlingtonva.us.
References
1. Blair JP, Martaindale MH, Nichols T. (Jan. 7, 2014.) Active shooter
events from 2000 to 2012. FBI Law Enforcement Bulletin.
Retrieved July 15, 2014, from http://leb.fbi.gov/2014/january/
active-shooter-events-from-2000-to-2012.
2. Thompson T, Lyle K, Mullins SH, et al. A state survey of emergency
department preparedness for the care of children in a mass
casualty event. Am J Disaster Med. 2009;4(4):227–232.
3. Callaway DW, Smith ER, Cain J, et al. Tactical Emergency Casualty
Care (TECC): Guidelines for the provision of prehospital
trauma care in high threat environment. J Spec Oper Med.
2011;11(3);104–122.
4. Smith ER, Iselin B, McKay WS. Toward the sound of shooting:
Arlington county, Va., rescue task force represents a new
medical response model to active shooter incidents. JEMS.
2009; 34(12):48–55.
5. Fire/emergency medical services department operational consid-
erations and guide for active shooter and mass casualty inci-
dents. (September 2013.) U.S. Fire Administration. Retrieved
July 15, 2014, from www.usfa.fema.gov/downloads/pdf/
publications/active_shooter_guide.pdf.
6. IAFF position statement: Active shooter events. (n.d.) International
Association of Fire Fighters. Retrieved July 15, 2014, from
www.iaff.org/Comm/PDFs/IAFF_Active_Shooter_Position_
Statement.pdf.
7. Seid T, Ramaiah R, Grabinsky A. Pre-hospital care of pediatric pa-
tients with trauma. Int J Crit Illn Inj Sci. 2012;2(3):114–120.
8. Seidel JS. Emergency medical services and the pediatric patient:
Are the needs being met? II. Training and equipping emer-
gency medical services providers for pediatric emergencies.
Pediatrics. 1986;78(5):808–812.
9. Bankole S, Asuncion A, Ross S, et al. First responder performance
in pediatric trauma: A comparison with an adult cohort.
Pediatr Crit Care Med. 2011;12(4):e166–e170.
10. Bobko J. Tactical emergency casualty care–pediatric appendix:
Novel guidelines for the care of the pediatric casualty in
the high threat, prehospital environment. J Spec Oper Med.
2013;13(4):94–107.
11. Johnson L, Bugge J. (2007) Child-led disaster risk reduction. In-
ternational Save the Children Alliance. Retrieved July 15, 2014,
from http://resourcecentre.savethechildren.se/library/child-led-
disaster-risk-reduction-practical-guide-part-1.
12. Theater shooting victims are 4 months old to adults. (July 20,
2012.) KMGH-TV/TheDenverChannel.com. Retrieved July
15, 2014, from www.thedenverchannel.com/news/theater-
shooting-victims-are-4-months-old-to-adults.
13. Kempe R, Kempe CH: Child abuse. Harvard University Press:
Cambridge, Mass., 1978.
14. Gaynard L, Wolfer J, Foldberger J, et al: Psychosocial care of chil-
dren in hospitals: A clinical practice manual from the ACCH
Child Life Research Project. Child Life Council: Rockville, Md.,
pp. 15–65, 1998.
15. Kragh JF Jr, Cooper A, Aden JK, et al. Survey of trauma registry
data on tourniquet use in pediatric war casualties. Pediatr
Emerg Care. 2012;28(12):1361–1365.
16. Blair JP, Martaindale MH, Nichols T. (Jan. 7, 2014.) Active shooter
events from 2000 to 2012. FBI Law Enforcement Bulletin.
Retrieved July 31, 2014, from http://leb.fbi.gov/2014/january.
32
9/8/14 9:32 AM
 ✚

  


During an MCI, time is critical.

The ResQGARDÆ Impedance

ce
Threshold Device (ITD) increases
reases
perfusion rapidly by regulating
tin
ng
intrathoracic pressure during
ng inhalation.
Studies show the ResQGARD
RD is a fast,
non-invasive way to increase
se blood pressure
by up to 30%.1,2,3

Studies show the ResQGARD is:

ï A safe and non-invasive way for ALS or BLS providers
to increase perfusion

  

   
  

ï A complement to permissive hypotension

ï An alternative when vascular or IO access is not possible

To learn more, visit

AdvancedCirculatory.com
or call us at 877-737-7763.

1 Smith et al. J Emerg Med 2011;41(5):549-558.

2 Wampler et al. Ann of Emerg Med 2013;62(40):S145-S146.
49-2096-000, 01

3 Convertino et al. J Trauma Acute Care Surg 2012;73(2):S54-S59.

The generally cleared indication for the ResQGARD available for sale in the United States (US) is for a temporary increase in blood circulation during emergency care, hospital,
 !



 



! !
 

 
  
  


  
  
  



 !
    

 ! 

 ! 

1410JEMSSupp_33 33 9/8/14 9:32 AM


Being Ready
to Deploy
Interoperable core skills for training to respond to violent incidents
By Michael Meoli, EMT-P
& David Rathbun, EMT-P
I
n the wake of Columbine, Virginia Tech,
Aurora, Sandy Hook and other recent ac-
tive shooter/mass casualty incidents (ASI/
MCIs), there are numerous federal, state and lo-
cal agencies scrambling to establish operational
guidelines for combining law enforcement, fire
and EMS first responders into rescue task forces
(RTFs) prior to the arrival of tactical teams.1
At the same time, thousands of law enforcement
officers (LEOs) are being violently assaulted each
year and, as a result, there’s a national call for train-
ing and equipping all officers for self-aid and bud-
dy aid (SABA).2 However, unified command and
interagency emergency operations plans will only
work if first responders are properly equipped and
trained to assess, treat and extract casualties much
faster than normal EMS operations.
Therefore, the main purpose of this article is to
identify specific core skills, training and equip-
OCTOBER2014
Focus on Active Shooter Incidents and Tactical Emergency Casualty Care
1410JEMSSupp_34 34
PHOTO CHRIS SWABB
ment necessary to assure that the RTF brings
assets, rather than liabilities, into an ASI/MCI.
This will increase efficiency of operations, there-
by decreasing preventable deaths, rather than
adding more potential casualties.
Tactical Combat Casualty Care
TCCC is currently the only evidence-based stan-
dard of prehospital care rendered to a casualty in
a tactical, combat environment from the point
of injury until they arrive at the medical treat-
ment facility. A comprehensive study of prevent-
able deaths in Vietnam and Somalia concluded
the three most common causes of preventable
battlefield death are exsanguination from ex-
tremity wounds (60%), tension pneumothorax
(33%) and airway obstruction (6%).6
Although battle-proven TCCC principles on
potential causes of death that can kill within 20
minutes from the point of injury clearly apply to
civilian tactical trauma care, the terminology is
military, which can sometimes be controversial.
34
9/8/14 9:32 AM

Tactical emergency medical support (TEMS)7
or tactical emergency casualty care (TECC) are
civilian terminology for TCCC. The Commit-
tee for Tactical Emergency Casualty Care (C-
TECC) used the military battlefield guidelines
of TCCC as the evidence-based starting point in
the development of TECC terminology.8
TCCC/TECC doctrine states three distinct
threat levels or “phases” which indicate the kind
of care that should or shouldn’t be rendered.
Recognizing that nothing is aboslute, these are
guidelines where “tactics drive medicine.”
1. Hot zone (care under fire/direct threat): The
casualty is exposed to effective or potentially
effective enemy fire. Either there is a clear
and present active shooter, or the casualty is
still in the line of fire where a perpetrator can
pop up and start shooting again. All efforts
are directed at eliminating the threat and/
or getting the casualty and the team out of
the line of fire. Assuming the team has estab-
lished fire superiority, the only appropriate
treatment would normally be to stop uncon-
trolled extremity hemorrhage with a tourni-
quet in less than 20 seconds. If fire superior-
ity can’t be reasonably assured, the casualty
should be immediately extracted using stan-
dardized techniques without medical aid.
2. Warm zone (tactical field care/indirect
threat): The casualty is still on the inner
perimeter of a live mission, but is in a posi-
tion of cover and concealment, not directly
exposed to enemy fire. Appropriate actions
at this stage include tourniquet application,
wound packing, hemostatic agents, com-
pression bandaging, chest sealing and/or de-
compression and advanced airway control.
3. Cold zone (tactical evacuation/evacuation):
The casualty and the medic are now out of
the inner perimeter.
RTF Basics, Configuration & Movement
In May 2001, the Colorado Governor’s review of
the Columbine massacre called for a new para-
digm shift where police officers should no longer
simply stage and contain active shooters. They
should immediately call SWAT, but not wait for
their full response. Rather, they should “be trained
at the concepts and skills of rapid deployment.” 9
This ushered in the concept of the rapid re-
action team, or contact team, where first arriv-
ing officers team up, typically in a four-man
diamond, but maybe two‐man or even solo, to
move to “the sound of shooting.” 10
In 2008, the Arlington (Va.) Police Department
entered into an agreement to train with Arlington
35
1410JEMSSupp_35 35
✚
Fire Department to form RTFs that will trail con-
tact teams into warm zone areas they cleared to
treat and/or extract victims.11 This innovative ap-
proach led to a nationwide shift now supported
by the U.S. Fire Administration and the Federal
Emergency Management Agency.12
The RTFs see first arriving street medics (usu-
ally not tactical medics) team up with at least two
patrol officers to move quickly into warm zone
areas along cleared corridors to initiate treatment
and evacuation of casualties. It will be a rare occur-
rence for a full SWAT team to arrive with all their
tactical officers and tactical medics before local
patrol officers and local fire/EMS. Still, in many
systems, among the first responding officers will
be one or more SWAT officers and among fire/
EMS, there may be one or more tactical medics.
In these cases, the first SWAT officer will usually
form a contact team with one or more patrol of-
ficers and lead the team in to eliminate the threat.
Similarly, if a tactical medic is among the first
responders, he or she would be the right person
to become part of the first RTF.
The minimum configuration of an RTF would
include two patrol officers for front and rear se-
curity and two paramedics with the same level
of ballistic personal protective equipment as the
officers and be equipped with tactical medical
equipment. If there are enough RTF trained re-
sponders, a more robust RTF can be formed into
a “diamond.” (See Figure 1.)
The first RTF will advance in warm zone area
already cleared by the contact team and treat and
extract victims. If there are more victims in other
cleared warm zones, then other RTFs can leap-
frog past the first RTF to attend to the victims in
those areas.
Figure 1: RTF diamond confguration
Wingman
Rear guard Pointman
Law enforcement offcer
Paramedic
Wingman
Direction of travel
OCTOBER2014
A Special PennWell Supplement
9/8/14 9:32 AM
 ✚

All movement into or out of warm zones are
tactical decisions made by the LEOs who are
providing cover for the medics.
It should also be clearly stated that warm
zones can suddenly turn into hot zones when
the prime suspect, additional suspects or poten-
tial explosive devices are encountered unexpect-
edly. Therefore, all team members should be
prepared to immediately evacuate on the com-
mand of the law enforcement officers.
Building Motor Memory Core Skills
Specific tactical medicine core knowledge and
skills should be taught to all levels of emergency
responders and should be done prior to multia-
gency drills, scenarios and actual tactical missions.
The most important part of this is repeti-
tive practice of core skills. Once this is accom-
plished, there will be true interoperability and
minimum time-on-target during ASIs/MCIs or
any life-threatening penetrating trauma.
Certain core skills, such as effective tourniquet
application within 20 seconds, automatic extrac-
tion handholds, etc., can only be performed un-
der pressure if the skill is stored and able to be
instantly retrieved from memory. This is called
“procedural memory” or “motor memory.” 13
In training literally thousands of first respond-
ers, the authors have found that motor memory
of the complex-motor skill of applying a combat
application tourniquet (CAT) in less than 20 sec-
onds requires 15–25 repetitions (depending on
the student) under various conditions.
The best way to repeat the skill is to actually
practice it from top to bottom. Once the student
is confident in the skill in a well-lit room with
no pressure, it should be repeated under a com-
pressed time frame in low light with their pulse
rate elevated (as is likely in a real-life scenario).
Once a complex motor skill has been per-
formed correctly several times during core train-
ing, it can be visualized and practiced mentally
step-by-step and this will be 85–90% as effective
as physically repeating the same skill.

PHOTOS CHRIS SWABB AND A.J. HEIGHTMAN

Figure 2: Fore-and-aft lift and carry

1. Move tactically to casualty and 2. Treat immediate life threats. 3. Fore grabber wraps arms around
assume best positions to cover chest locking wrists. Aft grabber
casualty and grabbers. backs into legs and lifts under knees.

Alternate position for aft grabber

USES:
• Most common EMS/law enforcement lift when Code-4.
• Loading onto litters (side-by-side is a better TRE in some cases).
• Best/only TRE for “pancake” into backseat of patrol cars/sedans.
• Trunk loading casualty.
• Carrying to cover.
–Best TRE carry for narrow hallways or through narrow doors.
–Drags may be faster if casualty has secure drag holds, handles,
straps.
–Shoulder/belt carry is faster over longer distances in open space.
• If casualty has fractures, consider litter carries when tactically
feasible.
1. Cross victim’s legs.
2. Place casualty legs on hip with one arm,
leaving other arm free.

OCTOBER2014
Focus on Active Shooter Incidents and Tactical Emergency Casualty Care 36

1410JEMSSupp_36 36 9/8/14 9:32 AM

 ✚
Saves Time. Saves Blood. Saves Lives.

People who know choose

TACTICAL HEMOSTASIS
MAKE E VERY SECOND COU NT

Contact us at www.biostatllc.com
844-BIO-STAT
844.246.7828
facebook.com/tactical.biostat ALL
CELOX™ GAUZE
GOOD FOR
FOUR
Saves Time. Saves Blood. Saves Lives.
YEARS!

• Works independent of the

patient’s clotting cascade
• Efective on blood containing
blood thinners such as Heparin
& Coumadin
• Even clots hypothermic blood
• Highest observed survival rates
in US DoD tests1,2
• Safe and mineral free; no non-
degrading mineral ingredients
(kaolin, smectite, or zeolite)
(1) Rall JM et al. Comparison of Novel Hemostatic gauzes
to Quikclot Combat Gauze in a standardized swine model
of uncontrollable hemorrhage. TR-2012-22 (2) DoD test
results reference based on 10’ Celox™Gauze

Contact us at www.biostatllc.com
844-BIO-STAT facebook.com/tactical.biostat
844.246.7828

1410JEMSSupp_37 37 9/8/14 9:32 AM

 ✚

There are many different tactical medical cours- state offices of emergency services. They can range
es taught by various certifying agencies such as in length from four hours to several days.
the National Association of EMTs (NAEMT), Na-
tional Tactical Officers Association (NTOA) and Victim Movement
PHOTOS CHRIS SWABB
Figure 3: Side-by-side lift and carry AND A.J. HEIGHTMAN
USES:
• Loading onto litters.
• Vehicle rescue—loading
into vans, SUVs, bears,
bearcats.
• Carrying to cover.
–Drags may be faster
if casualty has secure
drag holds, handles,
straps, but if not, this
is quickest for short
distance carry.
–Shoulder-belt carry usu-
1. After moving in tactically and ensuring coverage, grabbers
ally faster over longer
draw their forearms under victim’s armpits and lock the distances in open space.
wrists (underhand or overhand). • If casualty has fractures,
2. Grab under knees and lift casualty, and signal cover officers consider litter carries
they’re ready to move. Then move tactically to safety. when tactically feasible.
PHOTOS COURTESY MICHAEL MEOLI
The key to effective and rapid casu-
alty extraction is also repetitive prac-
tice of interoperable skills within
each agency and between agencies
in a given region.
If there’s no uneven terrain or
long stairways to climb, stretchers
or drag litters might be the most
expedient way to get victims out of
the warm zone. If there’s only one
or a few victims in an outside, open
area, and an armored vehicle is
available, it can be used as a tactical
extraction vehicle. If the victim is a
police officer or firefighter or any-
one wearing body armor or some
kind of harness and they’re on a
flat surface, then a one- or two-
person drag can be used. (See photo,
p. 36.)

Figure 4: Shoulder/belt (“Seal Team 3”) carry/drag

USES:
• Fastest carry/drag over longer
distances in open space.
• Especially better over uneven
terrain with debris than two-
person drag/carry.
• Doesn’t matter how tall the
casualty is as the feet drag
behind with little friction.
• If casualty has fractures,
1. After moving in tactically and ensuring coverage, grabbers lift casualty to seat consider litter carries when
position with arms over shoulders and grab belt (or top of pants) from behind. tactically feasible.
2. Grabbers lift casualty to feet and signal cover officers they’re ready to move.
Team then moves tactically to safety.
PHOTOS COURTESY MICHAEL MEOLI

Figure 5: Modified fireman (“Hawes”) carry

USES:
• Limited personnel
where only one rescuer
can be used for actually
carrying casualty.
• Rescuer carrying casu-
alty can provide limited
cover with own weapon
during extract.
• Casualty’s weight is on
rescuer’s hips rather
than back as in tradi-
1. Two rescuers bring casualty to standing position using standard “shoulder/belt” lift. tional “Fireman’s.”
2. One rescuer crouches and slides in front of casualty. Rear rescuer helps facilitate casualty’s • If only two rescuers,
there will be a brief
arms around front rescuer, who pins casualty’s elbows across chest with non-dominant hand.
period with no cover.
3. Communicate with cover officer to move tactically to safety.

OCTOBER2014
Focus on Active Shooter Incidents and Tactical Emergency Casualty Care 38

1410JEMSSupp_38 38 9/8/14 9:32 AM

 ✚

However, there may be multiple victims and

they may be strewn in far-flung areas with un- Figure 6: Pancake rescue

PHOTOS CHRIS SWABB AND A.J. HEIGHTMAN

even terrain, or they may need to be quickly ex-
tracted through narrow hallways or doors or
quickly loaded into various vehicles of differ-
ent configuration.
A national focus group under the National Tac-
tical EMS Council (NTEMSC) recently identified
four manual lifting techniques, referred to as
tactical rescue extractions (TREs), which can be
useful in these circumstances particularly when
you don’t have various litters or technical rescue
equipment readily available. Figures 2–7 illus-
trate the four basic TREs that should be taught
and refreshed in all tactical medical courses.
The interoperable handholds used in the
manual TREs can be used to lift victims out of 1. Rescuers use fore and aft to lift victim out of the street.
the street into vehicles of various configuration. 2. Trunk rescuer pancakes himself backwards into the backseat.
Leg rescuer pancakes over the top and car speeds away.
Once all personnel learn these, a victim can be
extracted in as little as 12 seconds from the time
the vehicle stops in front of the victim to the

PHOTOS CHRIS SWABB AND A.J. HEIGHTMAN

time it speeds from the potential line of fire. Figure 7: Trunk dump rescue

Core Medical Skills for ALS First Responders

A frequently used treatment acronym for ALS
tactical responders is MARCH (Massive bleed-
ing; Airway obstruction; Respiratory compro-
mise due to penetrating chest trauma, indi-
cating chest sealing; Circulatory compromise
due to tension pneumothorax or hypovolemic
shock; and Hypothermia).
Equipment should be staged in a kit (waist
pack, vest or pockets on the front of body armor)
so it can be accessed with one hand without look-
ing or putting anything down. Even a backpack
is too cumbersome for situations in which you
have to move your victim unexpectedly.

Tactical Medical Equipment for LEOs
A minimum of one tourniquet should be car-
ried at all times by every law enforcement officer
for self-aid, partner- and citizen-aid as recom-
mended by the Hartford Consensus.14
All San Diego County Sheriff’s deputies are
issued an IFAK which is placed in their vehicle
alongside their Kevlar helmet. Many deputies
have built an active shooter vest that they can
throw on prior to forming a Contact Team and
going in on the threat. Those officers mount
their issued IFAK on that vest.
All San Diego Police Department (SDPD) of-
ficers are offered an on-duty four-hour TCCC
class once a month. At the conclusion of train-
ing, they’re issued a tourniquet they can wear at
all times.
All officers are also issued a mini IFAK con-
1. Rescuers use fore and aft to lift victim out
of the street.
2. Victim deposited in trunk.
3. One rescuer covers victim in trunk,
other in back seat.
taining hemostatic gauze and a simple com-
pression bandage that stretches and adheres
to itself with Velcro strips. The mini IFAK is
shrink-wrapped in a tear-open package that can
be carried in their shirt pocket or in the ceramic
plate pocket of their body armor.
Fire/EMS RTF Equipment
There are currently two main models for outfit-
ting line fire/EMS personnel to form RTFs with
their line LEOs. Both models require that the
fire/EMS personnel have the same body armor

OCTOBER2014
39 A Special PennWell Supplement

1410JEMSSupp_39 39 9/8/14 9:32 AM

 ✚
as LEOs. Both models also have fire/EMS per-
sonnel carrying enough medical supplies in their
self-contained waist packs or attached to their
body armor to treat numerous trauma victims.
The first model places the body armor on the
outside of their fire/EMS personnel with special
uniforms that blend in with their local LEOs.
Slightly more expensive, this provides a much
lower profile for these personnel and possibly de-
tracts an active shooter from aiming at the most
visually attractive target.
The second model places the body armor under-
neath the fire/EMS personnel’s normal medical
response uniform which clearly identifies them
to perimeter officers in the initial stage of ASIs/
MCIs. It’s never intended for these personnel to
enter the hot zone where there’s an active shooter.
Conclusion
The paradigm shift of training first responding
LEOs in forming contact teams and “moving to
the sound of the shooting” prior to the arrival
of a full SWAT team happened several years ago.
It may be the same with the RTF concept. Some
fire/EMS personnel may choose to participate
on an ASI/MCI RTF and some may not.
It’s important to use existing tactical medics
and law enforcement agencies in the develop-
ment and implementation of tactical medic
core skills training if they’re experienced and
qualified tactical medical instructors (e.g., NAE-
MT, Specialized Tactics for Operational Rescue
and Medicine, NTOA, CONTOMS).
The key to instilling first responder confi-
dence in these critical situations is the repeti-
tive practice of core skills: tactical movement
with cover officers, rapid application of medical
skills under pressure and effective interoperable
extraction techniques. ✚
Michael Meoli, EMT-P, is a firefighter/paramedic with
the San Diego Fire & Rescue Department and a certified
tactical paramedic for SDPD SWAT and other govern-
ment teams. He’s a retired U.S. Navy SEAL operator chief/
advanced tactical practitioner and is currently training
manager and cofounder of the San Diego Special Tactics
& Rescue Team as well as CEO of Tactical Rescue Options
LLC. He can be reached at mmeoli@sandiego.gov.
David Rathbun, EMT-P, retired after 35 years as a
deputy from the Los Angeles County Sheriff’s Depart-
ment (LASD), where he still serves as a reserve deputy.
For the last 31 years of his career he served as a member
of LASD’s emergency services detail. Rathbun was the
TEMS chairman for the National Tactical Officers Associa-
tion from February 2002 to June 2013.
OCTOBER2014
Focus on Active Shooter Incidents and Tactical Emergency Casualty Care
1410JEMSSupp_40 40
Acknowledgment: The authors acknowledge the following
individuals for their help in obtaining and providing photographs for
use in this article: JEMS Editor-in-Chief A.J. Heightman, photographer
Chris Swabb, Sgt. Jonathan Lowe (SDPD), Capt. Kevin Lynds (Carslbad,
Calif., Fire Department and Cpl. Jason Philpot (San Diego Sheriff).
Bonus Content: See the web version of this article
for additional content, including “The History of Tacti-
cal Medicine,” pictures of the latest tactical medical
equipment, and recent violent incident case studies
with positive outcomes at www.jems.com/tecc.
References
1. UFF position statement: Active shooter and mass casualty
terrorist events. (n.d.) National Fire Protection Association.
Retrieved Aug. 13, 2014, from www.nfpa.org/~/media/Files/
Member%20access/member%20sections/Metro%20Chiefs/
UFFActiveShooterPositionStatement.pdf.
2. Table 71: Law enforcement officers assaulted, 2012. (n.d.) FBI
Criminal Justice Information Services Division. Retrieved Aug.
13, 2014, from www.fbi.gov/about-us/cjis/ucr/leoka/2012/
tables/table_71_leos_asltd_region_geographic_division_
and_state_by_type_of_weapon_2012.xls
3. Fire/emergency medical services department operational consid-
erations and guide for active shooter and mass casualty inci-
dents. (September 2013.) U.S. Fire Administration. Retrieved
Aug. 13, 2014, from www.usfa.fema.gov/downloads/pdf/
publications/active_shooter_guide.pdf.
4. IAFF position statement: Active shooter events. (n.d.) International
Association of Fire Fighters. Retrieved Aug. 13, 2014, from
www.iaff.org/Comm/PDFs/IAFF_Active_Shooter_Position_
Statement.pdf.
5. IAFF position statement: Rescue task force training. (n.d.) Inter-
national Association of Fire Fighters. Retrieved Aug. 13, 2014,
from http://www.iaff.org/Comm/PDFs/IAFF_RTF_Training_
Position_Statement.pdf.
6. Butler FK Jr, Hagman J, Butler EG. Tactical combat casualty care in
special operations. Mil Med. 1996;161(suppl):3–16.
7. Tactical EMS (TEMS). In B Aehlert (Ed.), Paramedic practice today:
Above and beyond, volume 2. Jones & Bartlett Learning:
Burlington, Mass., pp. 801–820, 2011.
8. Callaway DW, Smith ER, Cain J, et al. Tactical emergency casualty
care (TECC): Guidelines for the provision of prehospital
trauma care in high threat environments. J Spec Oper Med.
2011;11(3):104–122.
9. Erickson WH. (May 2001.) The report of governor Bill Owens’ Col-
umbine Review Commissions. Retrieved Aug. 13, 2014, from
www.state.co.us/columbine/Columbine_20Report_WEB.pdf.
10. Miller RK. (2014.) Key responsibilities for the LE rescue team. Law
Officer. Retrieved Aug. 13, 2014, from www.lawofficer.com/
article/training/key-responsibilities-le-rescue.
11. Iselin B, Smith ER, McKay WS. (2009.) Toward the sound of
shooting: Arlington county, Va., rescue task force represents
a new medical response model to active shooter incidents.
JEMS. 2009;34(12):48–55.
12. David KP. (July 2009.) Charlotte Fire Department response to ac-
tive shooter incidents–A critical analysis. U.S. Fire Administra-
tion. Retrieved Aug. 13, 2014, from www.usfa.fema.gov/pdf/
efop/efo43715.pdf.
13. Schmidt RA, Wrisberg CA. Motor learning and performance,
fourth edition. Human Kinetics: Champaign, Ill., 2008.
14. Active shooter and intentional mass-casualty events: The Hart-
ford consensus II. (Sept. 1, 2013.) Bulletin of the American
College of Surgeons. Retrieved Aug. 13, 2014, from
http://bulletin.facs.org/2013/09/hartford-consensus-ii/.
40
9/8/14 9:32 AM
 ✚

TOOLS of the TRADE

Rapidly deployable products for TECC & active shooter incidents

ResQGARD Impedance Threshold Device Advanced Circulatory Systems

The ResQGARD is an impedance threshold device (ITD) that provides a safe, www.advancedcirculatory.com
simple and fast way to treat states of low blood pressure in spontaneously info@advancedcirculatory.com
breathing patients. This is particularly helpful during violent mass casualty 877-737-7763
incidents where blood pressures are falling and
there’s limited time for the establishment of IV or
intraosseous infusions.
The ResQGARD provides therapeutic benefit as soon as a patient
begins to breathe through it and assists in maintaining ad-
equate blood flow to vital organs during hypotension.
The device uses a one-way valve to create a
vacuum that draws more blood back to the
heart resulting in greater cardiac output on
the subsequent contraction, lower intracranial
pressure and lower resistance to blood flow in the
brain. It’s useful in treating hypotension from a variety of causes, including hypo-
volemia/hypovolemic shock, orthostatic intolerance, heat shock, sepsis, anaphylaxis
and dialysis.
The device comes packaged in a compact kit that includes the ResQGARD ITD,
facemask with integral oxygen port, head strap to hold the facemask securely
in place during treatment and transfer, and a mouthpiece and nasal clip for use
with the conscious patient who can’t tolerate the facemask.

Celox RAPID BioStat LLC

Celox RAPID addresses tactical hemostasis by www.biostallc.com Celox-A Accelerated
working rapidly and requiring minimal time 844-246-7828 Celox Delivery Device
holding pressure on a product-packed wound. info@biostatllc.com Celox-A is the first high-speed hemostatic
It therefore serves as a medical force multiplier delivery system for gunshot, blast or stab
at high-speed “treat wounds. The applica-
and move” situations. tor gives the caregiver
With rapid packing a simple and effective
and minimal compres- tool to apply Celox
sion, Celox RAPID’s 5’ to the source of severely
Z-fold packs faster than bleeding wounds.
other 12’ competitive
gauzes, requires minimal post-application com- Celox Gauze
pression and can produce hemostasis in less than When placed directly into a bleeding wound and
a minute, allowing responders and rescuers to subjected to pressure, Celox Gauze
treat and move on rapidly. It’s also been shown to absorbs blood and forms a muco-adhe-
have decreased secondary blood loss and able to achieve sive gel that seals the wound to stop
100% successful transport without rebleeding. The posi- the flow of blood. In a
tively charged activated chitosan in Chito-R rapidly absorbs recent Navy study, Celox
blood and create a robust gel plug over the bleeding source Gauze outperformed
independent of the body’s intrinsic clotting cascade. competitors in several ar-
Celox RAPID maintains its volume and adhesion to wet eas, such as hemostasis (< 3 minute compression period),
tissue during use and also has a four-year shelf life; saving post-application blood loss and, most notably, survival.
you money in restocking expenses.

OCTOBER2014
41 A Special PennWell Supplement

1410JEMSSupp_41 41 9/8/14 9:38 AM

 ✚

TOOLS of the TRADE

Rapidly deployable products for TECC & active shooter incidents

iTClamp Hemorrhage Control System Innovative Trauma Care (iTraumaCare)

The iTClamp is a small, lightweight hemorrhage con- www.itraumacare.com
trol device developed by a special forces info@itraumacare.com
physician that can be used in austere 210-582-5850
conditions to rapidly control bleeding
from the extremities, axilla, inguinal
and scalp. It’s especially useful
in situations where tourniquet
use isn’t possible.
It can be applied in seconds
with minimal pain to the pa-
tient. The device features eight
21-gauge sterile needles that
allow you to clamp and seal the edges of a wound to
create a stable clot to mitigate further blood loss until
the wound can be surgically repaired.
Preclinical trials showed the iTClamp to be superior to wound pack-
ing in terms of patient survival, survival time and total blood loss. It’s an
exceptional device to use in conjunction with wound clot gauze or dress-
ings packed into an active bleeding area.

Level IIIA Rescue Task Force Package Municipal Emergency Services / Lawman Supply Company
The level IIIA rescue task force (RTF) package is www.mesfire.com
intended to provide ballistic personal protective equip- customercare@mesfire.com
ment to EMS personnel assigned 877-MES-FIRE
to rescue task forces (RTFs) when
responding to a mass casualty
incident involving active shooters.
The package consists of two main elements: The first is level IIIA
soft body armor in an external carrier which is manufactured by
Point Blank, one of the leading manufacturers of body armor.
The carrier features multiuse pouches, side-closure and adjust-
able shoulder straps for maximum versatility. It’s available in red, EMS
blue, navy or black with a choice of custom department or agency identifica-
tion placards.
The RTF package also includes a ballistic helmet
manufactured by United Shield Armor. The
helmet is certified for level IIIA protection
and is styled similar to the U.S. military’s
PASGT (personnel armor system for ground
troops) helmets.

OCTOBER2014
Focus on Active Shooter Incidents and Tactical Emergency Casualty Care 42

1410JEMSSupp_42 42 9/8/14 9:38 AM

 ✚

TOOLS of the TRADE

Rapidly deployable products for TECC & active shooter incidents

Combat Application North American

vented channels prevent
airflow into the chest
Tourniquet (CAT) Rescue Products
cavity during inspira-
The Combat Application Tourniquet (CAT) www.narescue.com
info@narescue.com tion while allowing air
is the official tourniquet of the United to escape through the
States Army and has been proven by the 864-675-9800
vent channels during
U.S. Army’s Institute of Surgi- exhalation. Each HyFin Vent
cal Research to be 100% effective in Chest Seal has a large, red tip pull tab for
stopping blood flow in both lower and single-step peel-and-apply application and allows for the
upper extremities. It’s recommended burping of the wound if necessary. Superior adhesion is
by the Committee on Tactical Combat obtained in even the most adverse conditions, including
Casualty Care (CoTCCC). on sweaty or hairy casualties.
It features a reinforced windlass and clip,
a red elliptical tip to aid in locating and threading the Emergency Evacuation Litter (EEL)
tourniquet during application, and a highly visible security
The Emergency Evacuation Litter (EEL)
tab which includes a writeable area to record the time of
is a lightweight, compact and cost-
application. It also features a dual securing system that
effective casualty evacuation platform
prevents the CAT from loosening due to movement dur-
that features a durable nylon construc-
ing casualty evacuation.
tion with a load carriage capacity of
700 lbs. It features eight easy-to-grasp
Hyfin Vent Twin Pack Chest Seal carry handles, a nylon storage pouch
The HyFin Vent Chest Seal Twin Pack provides two vented that attaches to a tactical-type vest via MOLLE/PALS-style
chest seals in one package for treatment of both entry/ connectors and a quick deploy handle that allows the EEL
exit or multiple penetrating injuries to the chest. Its three- to be removed rapidly from its storage pouch.

Emergency Medical Response ment, management of penetrating

to the Active Shooter Incident trauma, casualty evacuation and tri-
age, toxicology/drugs
Specialty training in the medical response
Tac-Med LLC of abuse, excited
to an active shooter/dynamic threat inci- www.tac-med.org delirium, preventive
dent is the key to saving lives. This eight- training@tac-med.org medicine, medical
hour course is de- 610-551-2400 intelligence, pain con-
signed for street
trol, team movements,
medical providers
ballistics/explosives injuries, gear
and law enforcement person-
considerations and sports medicine.
nel that would first respond to
Morning didactic sessions are com-
these events, with a concentra-
plimented by afternoon hands-on
tion on forcing forward urgent
and scenario-based training experiences.
medical care to the victims. This
course involves didactic and
Emergency Preparedness Consulting
hands-on educational activities, with a strong emphasis
on student participation. Tac-Med offers consulting and training services to col-
leagues in education, business and the civilian sector.
Basic Tactical Medicine These activities include reviewing, updating or developing
safety and emergency plans, disaster readiness and plan-
The Basic Tactical Medicine course provides all interested
ning, first aid training for staff members and students,
emergency responders—medical and law enforcement—
and coordinating with local emergency responders in
with the necessary tools and training to operate in a
the command and medical aspects of an active shooter/
tactical environment. Core material taught during this 24-
dynamic threat response.
hour course include: hemorrhage control, airway manage-

OCTOBER2014
43 A Special PennWell Supplement

1410JEMSSupp_43 43 9/8/14 9:38 AM

 ✚

TOOLS of the TRADE

Rapidly deployable products for TECC & active shooter incidents

SWAT-Tourniquet TEMS Solutions LLC

The SWAT-Tourniquet (SWAT-T) is a multipurpose hemorrhage control www.swat-t.com
device that can be used as a tourniquet, a pressure dressing or as swat.tourniquet@gmail.com
an elastic bandage. The name of this product conveniently explains 877-931-6862
how to use it: Stretch, Wrap, And Tuck. It features detailed, easy-to-
follow instructions printed on the bandage itself that help the user to
determine how much stretching is required to achieve either tourniquet or pressure
dressing results.
Unlike many tourniquets, the SWAT-T can be used as a primary tour-
niquet in areas such as the groin or axilla. It can also be used as
a pressure wrap, providing hands-free, direct pressure
wherever needed.
The SWAT-T also works well in other medical situa-
tions including securing ice packs in place, wrapping
a head wound or slinging a shoulder. It has also
been used on injured K9s where traditional windlass
tourniquets are not as easily applied. It’s affordable,
compact and versatile.

QuikClot EMS Z-Medica

The QuikClot EMS product line utilizes the
www.z-medica.com
same proven construction and hemostatic
info@z-medica.com
agent as the original
Combat Gauze and
Combat Gauze LE.
Available in a four-ply
4"x 4" (three individu-
ally wrapped per pack)
and a rolled gauze 3" x
48", the EMS line uses the
same Kaolin hemostatic agent as found in
the Combat Gauze products chosen as the
“Hemostatic Agent of Choice” by the U.S.
military.
The packaging features a high-visibility yellow stripe
across the top for easy visualization when packed into
ambulance cabinets and trauma jump bags.
Bleeding Control Bag
The Bleeding Control Bag, a component of the Large
Event Kit, is integral in responding to any active shooter
or mass casualty incident (MCI). It’s also ideal for schools,
commercial buildings, malls, hospitals or any location
where the potential exists for an active
shooter, IED or other MCI.
The contents include medical components
877-750-0504
proven effective in military combat and
used daily both overseas and domestically.
Designed for use by medically trained
providers, this bag should be a part of
every emergency response plan.
Wound Packing Trainer
The Wound Packing Trainer (WPT)
provides an easy and effective method of teaching
wound packing and pressure application utilizing
biofeedback.
It has a wireless sensor embedded in the wound
simulator along with the WPT App on your smartphone
or tablet to provide real-time
feedback on a student’s perfor-
mance. The app gives a PSI graphic
measurement of the force being
applied to the source of bleed-
ing and the results can be saved
and used for further training or to
certify competency.

OCTOBER2014
Focus on Active Shooter Incidents and Tactical Emergency Casualty Care 44

1410JEMSSupp_44 44 9/8/14 9:38 AM

 ✚

1410JEMSSupp_C3 3 9/8/14 9:38 AM

1410JEMSSupp_C4 4 9/8/14 9:38 AM