Page 171 - Journal of Special Operations Medicine - Winter 2015

the immediate need for this equipment in the moments a threat-based approach to operational and clinical ac-
following such incidents, such stockpiles will likely not tions. Having an enhanced preparedness for such in-
be mobilized with enough time to be clinically useful. cidents will heighten a region’s resilience and improve
Prompt access to lifesaving equipment requires strate- the EMS system’s ability to handle casualties from all
gic pre-placement, including the addition of these items hazards.
to standard ambulance and first responder vehicle in-
ventories. Some public safety agencies have elected to
pre- deploy equipment caches in areas of high occupancy References
and mass gatherings, similar to the location of auto- 1. National Association of Emergency Medical Technicians.
matic external defibrillators. TCCC guidelines and curriculum. Available at: www.naemt
.org/education/TCCC/guidelines_curriculum. Accessed June
Other essential medical equipment is recommended in 17, 2015.
resource documents, including the U.S. Department of 2. Committee for Tactical Emergency Casualty Care guidelines.
Available at: www.c-tecc.org. Accessed June 17, 2015.
Homeland Security’s First Responder Guide for Im- 3. Office of Health Affairs. U.S. Department of Homeland Se-
proving Survivability in Improvised Explosive Device curity. First Responder Guide for Improving Survivability in
and/or Active Shooter Incidents. Specialized logistical Improvised Explosive Device and/or Active Shooter Incidents.
3
equipment, including patient-extraction devices, as well June 2015. Available at: http://www.dhs.gov/sites/ default/files
as ballistic and personal protective equipment also may /publications/First%20 Responder%20Guidance%20June%20
2015%20FINAL%202.pdf. Accessed June 30, 2015.
be warranted. Further discussion regarding additional 4. Maryland Institute for Emergency Medical Services Systems.
equipment selection is beyond the focus of this article. 2015 Maryland Medical Protocols for Emergency Medical Ser-
vices Providers. Available at http://meiss.org/home/EMSProvider
Conclusion Protocol/ tabid/106/default.aspx. Accessed June 17, 2015.
Prehospital EMS systems represent an essential compo- 5. U.S. Fire Administration, FEMA. Fire/Emergency Medical
nent of a comprehensive trauma network. Preparedness Services Department Operational Considerations and Guide
for Active Shooter and Mass Casualty Incidents. September
and response to active shooter and intentional mass 2013. Available at: https://www.usfa.fema.gov/downloads/pdf
casualty events require an adaptation of current EMS /publications/active_shooter_guide.pdf. Accessed June 30, 2015.
system practices that must at all times be balanced with

The Hartford Consensus 159