coordinates with other first responder stakeholders on a wide range of
training and public outreach initiatives for active shooter response in collaboration with interagency partners, first responders, and community
and private-sector organizations.
Recent IED and active shooter incidents have shown us that some traditional practices of first responders need to be realigned and enhanced to
improve the survivability of victims and the safety of the first responders
caring for them. Thus, at the request of first responders and first receivers who encounter casualties from IEDs and active shooter incidents, the
White House asked the OHA to lead a multidisciplinary interagency team
to develop recommendations for state and local first responders focused
on improving the response to IEDs or active shooter incidents or both.
Subject matter experts from the DHS; the Departments of Defense,
Health and Human Services, Justice, and Transportation; and the White
House came together to study civilian IED and/or active shooter response
best practices and lessons learned. The results of this effort translated
evidence-based strategies from the U.S. military’s vast experience in
responding to and managing casualties from IED and/or active shooter
incidents, as well as the military’s significant investment in combat casualty care research, into the civilian first responder environment.
Key themes in responding to and managing casualties
from active shooter and intentional mass casualty events
Three key themes emerged during this collaborative evaluation: early,
aggressive hemorrhage control; use of protective equipment (which
includes ballistic vests, helmets, and eyewear); and greater first responder
interoperability and incident management. The recommendations in
these areas will help to save lives by mitigating first responder risk and
improving the emergent and immediate medical management of casualties encountered during IED and/or active shooter incidents.
First, the first responders should incorporate tourniquets and hemostatic agents as part of the treatment of severe bleeding (if allowed by
protocol). Tourniquets and hemostatic agents have been demonstrated
to be quick and effective methods for preventing exsanguination from
extremity wounds (tourniquets) and for other severe external bleeding
First responders…must make high-consequence decisions
quickly and in coordination with responders from different
agencies, jurisdictions, companies, and professional disciplines.
There should be greater
EMS, fire services, and
law enforcement to work
more effectively during
IED or active shooter
incidents or both.