Page 57 - Journal of Special Operations Medicine - Fall 2016

this approach. There are concerns of potential liability Acknowledgment
to an agency if it provides protective equipment that is We thank Sgt. W. Matthews and the Winston Salem,
no longer within the manufacturer’s warranty period. North Carolina, Police Department command staff and
This is specifically addressed and countered in the NIJ firearms range staff for their assistance, support, and
publication noted above, and such concerns should be dedication.
interpreted in light of our first point, that body armor
is not required in the circumstances envisioned. Addi- Disclosures
tional concerns have been expressed that some medical The authors have nothing to disclose.
personnel could develop an unwarranted sense of pro-
tection from such equipment, leading them to proceed
into areas that are unsafe. High-fidelity training specific References
to the response required by the medical teams should 1. Schweit KW. Addressing the problem of the active shooter. FBI
address these concerns. Law Enforcement Bulletin, May 2013. https://leb.fbi.gov/2013
/may/addressing-the-problem-of-the-active-shooter. Accessed 22
April 2014.
Conclusion 2. Shoot first: Columbine tragedy transformed police tactics. USA
In keeping with current recommendations, body ar- Today. 19 April 2009. http://usatoday30.usatoday.com/news
/nation/2009-04-19-columbine-police-tactics_N.htm. Accessed
mor is not mandatory for medical responders paired 22 April 2014.
with armed LE teams providing care at active shooter 3. Smith ER Jr, Delaney JB. A new EMS response: supporting par-
incidents. Body armor in good condition can continue adigm change in EMS operational medical response to active
to retain its protective capabilities for many years past shooter events. JEMS. 2013;38:48–50, 52, 54–55.

the end of the manufacturer’s warranty. Although com- 4. Callaway DW, Smith ER, Cain J, et al. Tactical Emergency Ca-
sualty Care (TECC): guidelines for the provision of prehospital
monly retired from law enforcement use because of age trauma care in high threat environments. J Spec Oper Med.
alone, this equipment can provide a significant degree 2011;11:104–122
of ballistic protection and is far better than nothing in 5. Smith ER, Iselin B, McKay WS. Toward the sound of shooting:
an environment where threats can arise suddenly. Con- Arlington county, VA., rescue task force represents a new medi-
firmation and visual demonstration of this principle is cal response model to active shooter incidents. JEMS. 2009;34:
48–55.
provided in this report (Table 2). 6. Jacobs LM, McSwain NE Jr, Rotondo MF, et al. Improving
survival from active shooter events: the Hartford Consensus. J
Table 2 Highlights Trauma Acute Care Surg. 2013;74:1399–400.
7. Jacobs LM, Rotondo M, McSwain N, et al. Active shooter and
• Ballistic protective equipment is not provided to many intentional mass-casualty events: the Hartford Consensus II.
medical responders Bull Am Coll Surg. 2013;98:18–22.
• Body armor is not mandatory for medical responders 8. Office of Law Enforcement Standards, National Institute of
in a rapid-response role, as outlined in the Hartford Standards and Technology. Ballistic resistance of personal body
Consensus at an active shooter event armor, NIJ Standard-0101.06. National Institute of Justice.
July 2008. http://www.ncjrs.gov/pdffiles1/nij/223054.pdf. Ac-
• Retired body armor that has not reached the end of cessed 22 April 2014.
its service life may be an effective and low-cost safety 9. National Institute of Justice. Selection and Application Guide to
solution for medical providers at these events Personal Body Armor NIJ Guide 100–01. Washington, DC: Na-
• Three “retired” ballistic vests (aged 6 to 27 years) tional Institute of Justice; 2001:60–62. https://www.ncjrs.gov
defeated handgun and shotgun rounds as a /pdffiles1/nij/189633.pdf. Accessed 22 April 2014.
demonstration of this concept

This approach may facilitate development and imple-
mentation of rapid-response programs, which, in turn, Dr Stopyra is with the Department of Emergency Medicine,
can allow prompt medical care and save lives. If used, Wake Forest School of Medicine, 1 Medical Center Blvd.,
ballistic protective equipment should be fielded in a way Winston Salem, North Carolina, 27157-1089.
E-mail: jstopyra@wakehealth.edu.
to make it available to responding personnel in the very
early stages of such an event. The possibility of addi- Dr Bozeman is with the Department of Emergency Medi-
tional threats (additional shooters, explosive devices, cine, Wake Forest School of Medicine, Winston Salem, North
and so forth) and other factors affecting rescuer safety Carolina.
should be considered by scene commanders before de-
ploying rapid-response teams, with or without body ar- Dr Callaway is with the Department of Emergency Medicine,
Carolinas Medical Center, Charlotte, North Carolina.
mor. Ultimately, there is no one-size-fits-all approach.
The best solution should involve layers of protection Dr Winslow is with the Department of Emergency Medi-
and be determined at the local level by individual juris- cine, Wake Forest School of Medicine, Winston Salem, North
dictions and agencies. Carolina.

Ballistic Protection at Active Shooter Events 39