Article updated on September 6, 2017.
While working the streets in your patrol sector today, are you prepared to respond to a mass-casualty incident? The Oklahoma City bombing, which caused 168 deaths and left more than 680 injured, had its 20th anniversary in 2015, which has many of us in law enforcement thinking about our mass casualty training.
What type of training have you received to deal with such a significant event? What type of trauma gear do you carry while on patrol? Are you honestly prepared to triage wounded men, women and children in such an event?
In the mid-90s, terrorism was just becoming a familiar topic with law enforcement training as a whole. Although larger agencies such as NYPD and LAPD had already been dealing with terrorism response for some time, the Oklahoma City bombing was the catalyst for law enforcement trainers to set their sights on terrorism response for law enforcement officers across the country.
A lot of focus was spent on educating officers on the effects of bombs, incident command, and mutual aid. However, a very important topic seemed to be overlooked by some – dealing with mass casualties within the first five minutes of the trauma.
Continuing to Evolve Response
The Oklahoma City Bombing rescue effort was a textbook response.
An EMS command post was set up immediately after the bombing and 210 injured persons were transported from the triage center to area hospitals with in the first couple of hours of the incident.
Within 23 minutes of the bombing, the State Emergency Operations Center was established and operating. Law enforcement and EMS conducted a significant rescue operation that would become a training resource for years to come.
Looking back 20 years, we have other mass-casualty and terrorist events – such as Columbine, 9/11 and the Boston Marathon bombing – to further build upon what we’ve learned. During this 20-year period, the military has developed the Tactical Combat Casualty Care (TCCC) for our troops in combat. By now, many of you have heard of TCCC as law enforcement is slowly embracing the concept.
It’s actually a very simple method and is taught to all combat soldiers to deal with preventable deaths on the battlefield – TCCC has proven to significantly increase the survival rate of our soldiers. The military’s development of TCCC has also proven to be useful to law enforcement.
Skills for the First Five Minutes
The skillset doesn’t require an EMT license to triage a victim and the necessary equipment can be carried by any uniformed officer. TCCC is not your police academy first aid class. It’s success is largely contingent upon it being applied within the first five minutes of a victim receiving the injury – if so, we greatly increase the chance of survival.
The five-minute triage time was a significant change over the Vietnam era “Golden Hour,” which was thought to be the measure of time a victim needs triage to survive a battle field injury.
TCCC skills should be required of all academy classes. These skills – which can be learned by any officer – include airway management, treatment of tension pneumothorax, and mass hemorrhage control. Students of TCCC learn how to use a nasopharyngeal airway tube, tourniquets, blood clotting agents and much more, all in a days’ time.
Battlefield first aid skills taught in TCCC training have already proven their worth to individual officers that have had their own lives saved due to the training that they or their partners received.
Be Your Agency’s TCCC Evangelist
If you were dispatched to an Oklahoma Bombing, 9/11, or Boston Bombing type event, what training and equipment do you have to utilize if you are the first officer on the scene? Can you triage a wounded child that has a massive hemorrhage on a leg, which if left untreated, could bleed to death in less than five minutes? If you don’t have the capability, the solution is simple: get it!
Encourage your agency to develop TCCC training so that you will have the ability to save an innocent victim when the need arises. The training can be concluded within eight hours – most of the time – and the additional equipment can be carried by individual officers with very little difference in their uniform or appearance. Larger response bags can also be purchased capable of triaging many victims. These larger triage bags can be purchased in a back pack configuration and will be important as EMS becomes overwhelmed in the first minutes of the incident.
