Three Keys to Managing Civil Unrest

“Medic 4, respond to assist PD, large disturbance in progress. Stage for PD.” 

After turning out of the station, you immediately note smoke coming from the city hall area. As you get close there are 100-plus people in the street. Some are fighting, some chanting, some running. Police have started to disperse the crowd with tear gas and engage looters. It’s smoky and chaotic. A beer bottle hits the ambulance, and a man runs up bleeding. You have never seen anything like this before. 

Introduction

Hopefully you never have to respond to this situation, but civil unrest has grown more likely for your EMS service to see. These emergencies can be challenging and far different from your day-to-day responses. Some can turn into MCIs, some can turn into active shooters, and any and all emergencies can happen at one time in the same small area or spread out across your jurisdiction. Mitigation of these incidents depends almost completely on three things: training, preparation, and communication. 

Training

Never let your people be unprepared. Your staff should know how to react when these types of incidents kick off. That is solely up to what kind of training your department holds and how you deliver your policies to the staff. It is important both legally and financially to be sure your staff understands what actions can be taken when violence is directed at them and how to carry that out without worsening situations and causing legal ramifications.

As these incidents can easily escalate to cause mass casualties, training for civil unrest can be combined with other topics and trainings such as those for MCIs and active shooters. A solid understanding of and training on the unified command structure and triage processes will make the response to civil unrest more efficient. Knowledge of procedures for working within hot, warm, and cold zones and how to properly utilize casualty collection points is critical. Other facets that should be explored include self-defense and proper use of and training on ballistic vests and helmets. These items are often overlooked. The first time a member dons ballistic equipment should not be during a riot. In the fire service firefighters are constantly in and out and performing in their bunker gear. The reason? The first time you put all that gear on shouldn’t be at your first fire. Self-defense training for EMS providers exists and should be considered essential.

How do we do this training? In the same format we have done all training since our first EMT class. Start with a presentation. Explain the need and desired outcome along with policies and expectations. Policies will clearly define the roles you expect your employees to take during such events. Also be sure to cover any protocol changes that might go into effect if such an incident should arise.

Next proceed to small scenarios and/or tabletop exercises. This will put the knowledge in action and clear up any questions. It will also possibly expose some weak spots in your plan. Most important it begins to build muscle memory. Annual training drills, whether incorporated with other types of training or not, should be done on this topic. Interagency participation is important, as is working within the unified command system. Multijurisdictional drills can be difficult to coordinate, but the payoff will be worth your while. 

Preparation 

Beyond training, there are other aspects to preparedness, such as policies, procedures, equipment, staffing, and intelligence. 

It is unlikely your department has a specific policy for managing civil unrest, but if you do, you are ahead of the game. Writing a policy or revamping your current one will ensure your response will be as smooth as it can be and potentially reduce legal and financial ramifications. High-stress and potentially violent situations lend themselves to loss of control by emergency services. Having clearly defined expectations will minimize the liability of the department and leave little to question by responding personnel. 

Addressing procedures for your department will identify roles and responsibilities for your members. When they are called on to respond to a disturbance, they will act decisively and in a manner that will clear up an incident in the quickest, most effective way. Interactions between agencies should be defined as well and include what the expectations are for EMS from law enforcement and vice versa.

A variety of equipment can help. MCI equipment and command communication vehicles may be necessary. Familiarize all members with this equipment. Ballistic gear, such as body armor and helmets, may already be provided, but if not, it must be ordered at once to ensure a safe response to situations that will have fluid hot and warm zones. There are many types of ballistic gear—things to keep in mind include the level of protection you are looking for; whether you’ll require members to wear them on every emergency or just in violent situations; if you want storage and if you want that to be customizable; and labeling. It is recommended that your members be clearly distinguishable from law enforcement. 

Tear gas protection may eliminate loss of personnel to decon and treatment. Consider rapid-extraction equipment such as soft litters to rapidly move patients to a CCP or triage area. Services fortunate enough to have an MCI vehicle or trailer can easily add civil unrest response kits and rapidly deploy these vehicles before or during an incident. 

Note the growing trend where violent protesters are using makeshift protective equipment or even the same formal gear as responders (e.g., ballistic vests, helmets, etc.). Some of this can render nonlethal weapons less effective. Remain aware and note changing conditions, as violence can break out with little warning.

A contingency plan for staffing should take into account how many extra ambulances or fire trucks could be staffed if the need arises. Review mutual aid agreements to ensure adequate coverage for your service area. 

Riots can be sudden and random, but in recent years we have seen fewer spontaneous events and more predictable situations that can cause riots, like protests and sporting events. Intelligence is an important part of preparedness. Local law enforcement will have information unable to be obtained through media sources. Meet regularly with public safety agencies so this information can be shared and EMS and fire staffing models can be shared with law enforcement. These are usually “same page, same book” situations. As an event approaches meetings can escalate to daily. 

Communication

In terms of safety, having proper communications can be the difference between everyone going home safely at the end of the shift or not. Just like anything else we do, communications require training. 

It can be challenging for different public safety entities to communicate in a large-scale emergency that requires the specialties of all involved. Different codes or jargon among agencies can complicate the process. Utilize channels to which all agencies have access and keep the speech plain and simple. Proper communication can assist in accountability, which can be complicated when a lot of assets are spread out and coming and going.

A dedicated command and communication vehicle can be used to keep all in charge together, on the same frequency, and also allows the command post itself to be mobile if the need arises. At some level there is likely a vehicle like this near you that can be requested. Know who has it, how to request it, and what equipment it has. 

Conclusion

One thing history shows us is that civil unrest can occur in any jurisdiction at any time. Multiple causes can trigger it, such as concerts, protests, sporting events, or even a fight that starts at a bar. Many strategies we have in place for other emergencies can be applied during civil unrest. That said, training, preparing, and equipping our departments and personnel with the needed policies, procedures, protocols, and knowledge is paramount to a safe and successful response. Communications and planned and practiced command structures can be established seamlessly when intelligence suggests an event is imminent and also be put in place if an unexpected event occurs. 

Kyle J. McCoy is a field training officer and paramedic with MU Health Care EMS in Columbia, Mo. Reach him at kjmccoy221@gmail.com.