Page 144 - Journal of Special Operations Medicine - Fall 2014

up the Pediatric Working Group (PWG) and, in 2013, responders, this work will improve community response
JSOM published the first set of high-threat response to these horrendous incidents. C-TECC members are
guidelines for pediatric victims. Further evaluation has currently involved in initiatives such as School Casualty
identified the need for improved first responder inter- Care in South Carolina and support for the innovative
action with pediatric victims during crisis as well as educator training in Duvall Kings County, Washington.
postevent management. Adopting research from the
Child Life Specialist literature, the C-TECC voted to
add language to the Pediatric Appendix that addresses Training
techniques for streamlining operations with children,
as well as improving postevent care during evacuation FEMA Technical Assistance (TA) Program:
phase. The addenda recommend provision of a single Tactical Emergency Casualty Care
point of communication with children, as well as estab- The FEMA Office of Counterterrorism and Security
lishment of some form of “child-friendly” space during Preparedness continues to support the national roll out
the evacuation phase. Identifying this critical gap in pre- of TECC with three additional FEMA TA programs in
hospital care will help improve both familiarity and pre- the second half of 2014. Chicago, Boston, and San Di-
dictability for children and families and were considered ego will host the final FEMA TECC TA programs of
to have both clinical and operational importance. 2014. The Chicago Police Department SWAT Team in
conjunction with Northwestern Memorial Hospital
Ongoing Working Groups will be hosting a TECC TA in late August 2014. In at-
Psychological threat mitigation: Work continues toward tendance will be representatives from Chicago Police
developing guidelines aimed at best preparing respond- Department, Chicago Fire Department, Northwestern
ers for both the expected and potential psychological Memorial Hospital, Illinois Region XI EMS System,
fallout that may result when responding to critical in- City Colleges of Chicago, Chicago Office of Emergency
cidents. Stakeholders and subject matter experts are be- Management and Communication, and numerous sub-
ing organized to look at how current understanding of urban police and fire agencies. Northwestern Memorial
acute stress response and posttraumatic stress disorder Hospital has graciously offered to host this training at
can be applied to improve responder readiness and re- the Northwestern University Feinberg School of Medi-
siliency as well as minimize effect from psychological cine. The Boston TECC TA will be hosted by Boston
trauma both during and after an event. This effort is EMS for the Metro-Boston Security Region the first part
coinciding with a recently released publication from the of September. Please contact agency representatives in
IACP titled “Breaking the Silence on Law Enforcement Chicago, Boston, or San Diego if you would like more
Suicides.” This document offers that the most impor- information. Further, if you are interested in hosting a
tant objective is the deployment of a “mental wellness future TECC TA, C-TECC should be contacted via our
and suicide prevention programs in police departments updated website to begin the process.
across America.” There is also concomitant work by the
IAFF via task force in multiple cities aimed at develop- TECC in Action
ing wellness initiatives. The C-TECC hopes to identify Jurisdictions and agencies throughout the world con-
any operational strategies (e.g., limiting unnecessary ex- tinue to incorporate TECC as part of their response to
posure to mortally wounded victims) that may mitigate high-threat incident protocol and models. Members of
subsequent first responder psychological crisis. C-TECC were fortunate to attend a full-scale exercise
in London, England, where the London Fire Brigade,
First care provider (FCP) education: As identified in the Metropolitan Police Department (Scotland Yard), and
2014 FBI active shooter report, the majority of the time London Ambulance Service practiced and demonstrated
the shooter has done his or her damage before first re- their program for dealing with AVIs, marauding attacks,
sponders arrive. At every major incident since 2008, a and fire as a weapon. Dr Reed Smith delivered a briefing
community member has been the first to care for the that highlighted additional areas of inclusion for TECC
injured. Since 2012, the C-TECC membership has been for those agencies.
working with a variety of national, regional, and local
agencies to define this population as EMS-extenders and At the June C-TECC meeting, Christopher Baldini, Fire
expand the spectrum of EMS response. Accordingly, Paramedic Captain at the Philadelphia Fire Department,
developing principles to build community resilience in described the “Rapid Assessment Medical Support
the face of active violent incidents has become a primary (RAMS)” program that has recently been operation-
focus of the C-TECC. Founded on a basic understanding alized in Philadelphia. This program is an example of
of risk, techniques for addressing potentially prevent- nontactical EMS providers being trained to provide
able mortality (e.g., tourniquet application) and creation TECC interventions in indirect threat/warm zones while
of common language to interact with professional first being escorted and provided force protection by law

136 Journal of Special Operations Medicine Volume 14, Edition 3/Fall 2014