Fla. EMS Train to Work in the Warm Zone

Feb. 06—E. Reed Smith stood at a table with a black foam roller Monday afternoon, inviting emergency medical technicians and fire rescue responders to stuff inch-deep holes in the roller with gauze.

Some gauze was simple, while some had liquid-absorbing chips and others had chemicals to help clots.

The holes in the foam represented wounds in a leg, and the trainees worked to stuff every crevice with gauze and to keep pressure on the fake wounds.

The lessons Monday were part of a FEMA-sponsored First Care Provider training, hosted by Alachua County Fire Rescue. Tactical Emergency Casualty Care teaches citizens, law enforcement, emergency medical technicians, fire rescue responders and hospital workers how to save as many lives as possible during traumatic violent events, like active shootings.

"An active shooter takes a moment's notice," said Lt. David Torsell of Alachua County Fire Rescue. "You have to have the personnel that you have at the ready."

Typically, he said, paramedics and rescue responders wait for law enforcement's all-clear after a shooter is stopped before tending to victims. This training teaches responders how to use any available time, including before a shooter is stopped, to save lives.

Smith, operational medical director for the Arlington County Fire Department in Virginia, said paramedics are taught how to stabilize patients in safe environments after a catastrophe.

"We're training them to do it in an unsafe environment," Smith said.

EMTs and fire rescue workers learned about different types of wounds, gauzes and tourniquets and how to make the best of limited resources.

In an active shooter situation, they learned about following law enforcement's lead to work in "warm" zones, where a situation is dangerous but secured. A shooter would be elsewhere, in a "hot" zone, Torsell said.

"It's still new to a lot of people," Torsell said of the training.

Monday, about 30 EMTs and fire rescue members met at Santa Fe College's Institute of Public Safety for a daylong training. Wednesday, they'll join the law enforcement officers to train together. Hospital workers will be trained Thursday. Citizens had training Monday night.

First Care Provider training focuses on all members of a community. It treats citizens at a shooting as immediate responders who can help injured victims before law enforcement officers arrive. Law enforcement officers then build on what citizens have done at a scene while fire rescue and EMTs arrive, who then build upon that care while taking victims to hospitals, where victims receive more complete care.

"It's always been siloed," Smith said. "This is breaking down the silos."

Mark Havelock, a Gilchrist County Sheriff's deputy and Alachua County Fire Rescue member, has responded to shootings, but he hasn't worked at an active shooting. Modern threats, like terrorism and mass shootings, take the need for diverse training to a new level, he said.

"I do see the need where public safety has no other option than to train with each other," he said.

Torsell said learning to use any time and resources available in a traumatic situation can be the difference between someone bleeding to death or surviving.

"It's a necessity in order to facilitate saving people's lives," Torsell said.