Palm Beach County Fire Rescue Standard Operating Guideline

Transcription

1 Palm Beach County Fire Rescue Standard Operating Guideline Operational Procedure for the Protective Element Medical Team Effective Date /DRAFT Revised Date DRAFT SCOPE: PURPOSE: AUTHORITY: This guideline applies to all personnel and volunteers of Palm Beach County Fire Rescue. This SOG should be considered sensitive material and not to be shared with the public or News Media. If shared it could be used against us in an actual event. The purpose of this Standard Operating Guideline is to reduce the risk and increase the safety to PBCFR personnel while providing expedient care for victims of an Active Shooter/ Mass Violence Incident. The PEM teams are a unified response team consisting of Deputies and Fire Rescue personnel whose objective is to provide victims life sustaining and or stabilizing medical care with rapid evacuation to a Casualty Collection Point, Forward Triage Center or Cold Zone Triage Center for Triage, Treatment and Transport to a hospital. Fire Rescue Administrator Palm Beach County Sheriff NFPA 1561 IAFF Position Statement Overview: Palm Beach County Fire Rescue and Palm Beach County Sheriff s Office will utilize NIMS guidance to establish a single Command Post and establish Unified Command in deployment of Protective Element Medical teams (PEM). The PEM is comprised of three PBCFR personnel and four PBSO deputies. The PBSO deputies provide a 360 degree cone of protection while the Fire Rescue personnel treat, stabilize, and package the injured in a rapid manner while operating in the established Warm Zone and wearing Department issued Ballistic Protective Equipment (BPE). The BPE shall be worn as any other level of PPE by PBCFR Policy. PBCFR will provide T-ECC medical care and manage the injured by having a Law Enforcement Trailers assist with rapidly transporting patients to a CCP, Forward Triage Center or Cold Zone Triage Area. The primary responsibility for overall incident safety, security, and stabilization during an active shooter/violent person rests with the Law Enforcement agency having authority. FR plays a support role in these types of events and must either integrate into an existing Incident Management System or establish command.

2 Definitions: ACTIVE SHOOTER EVENT: Suspect that is causing as many casualties as possible. BPE Ballistic Protective Equipment: NIJ IIIa Ballistic Vest, Ballistic Helmet, CAT: Combat Application Tourniquet used to stop the flow of blood from a life threatening injury. CCP: Casualty Collection Point: Area to consulate the viable patients to provide more definitive triage and treatment. CONTACT Team: A rapidly assembled team of Law Enforcement members responsible for locating and stopping an Active Shooter. COVER is a Law Enforcement term that represents an object or location that provide protection from direct gunfire. CONSEALMENT: is a Law Enforcement term that represents an object that only provides protection from observation. COLD ZONE: Established by Unified Command as an area not controlled by the suspect and safe to operate without a Law Enforcement Security Element. FUP: Forming Up Position is the location that is designated by the Unified Command to team up the Law Enforcement Protection with Fire Rescue Personnel to form the PEM Team. FAP: Final Approach Position: The area outside the building that the PEM Team PAR s in with Command as they enter the structure. HOT ZONE: Established by Unified Command as an area controlled by the suspect and their weapons, Law Enforcement shall enter to contain and neutralize the suspect. HEMOSTATIC Gauze: Bandage used to stop the bleeding by packing into the wound cavity. VENTED CHEST SEAL: a seal with a valve used to treat a sucking chest wound. IMPROVISED EXPLOSIVE DEVICE (IED): Is an explosive device constructed and deployed in ways other than in conventional military action. It may be constructed of conventional military explosives, or from commonly found chemical ingredients. PEM Protective Element Medical: 3 unarmed PBCFR personnel protected by 4 PBSO Deputies who s only job is to provide a 360 degree protection envelope around them.

3 PRESSURE BANDAGE: Bandage used to stop bleeding. T-ECC Tactical Emergency Casualty Care : Rapid life saving procedures applied at the point of wounding to increase survivability. THREAT : An acronym that stands for; Threat Suppression, Hemorrhage Control, and Rapid Extrication to Safety, Assessment by Medical Providers, and Transport to Definitive Care. TRIAGE SYSTEM It incorporates aspects from all of the existing triage systems to create a single overarching guide for unifying the mass casualty triage process across the United States. TRAILER TEAM: A designated group of Law Enforcement Officers that are not involved with the contact team, they will begin to assist with victim removal and coordinate with Fire Rescue personnel for removal of critical patients and can be used to provide additional security as needed. SKED: Polycarbonate plastic litter used to slide a patient on the ground to evacuate a patient to a treatment area. TECC Tactical Emergency Casualty Care: Expedient medical care to stop the bleeding, and provide life saving care and rapid evacuation to a Casualty Collection Point. WARM ZONE: Established by Unified Command as an area not controlled by the suspect and containing casualties. PBCFR may operate with a Law Enforcement Security Element. PROCEDURE: 1) PBSO will respond to an active shooter incident with every available deputy. A supervisor will set up tactical command to obtain information on the location of the suspect to focus their resources on neutralizing the threat. 2) First arriving units will stage and establish command at a staging area. The District Chief will be notified by dispatch on the location of PBSO s command post and assume command and request a Level 2 MCI response. 3) The IC should establish a Staging Area and determine the minimum resources to be maintained in staging. All responding units will report to the Staging Area Manager in staging unless otherwise directed by command. No Self Dispatch to Scene. 4) Depending on the size and complexity of the incident, the IC may assign a Medical Branch Director or Medical Group Supervisor to ensure the triage, treatment and transport needs of the incident are completed.

4 5) Unified Command shall be established. The complexity of this event may require forming an Incident Management Team. Transportation routes should be established early with Law Enforcement while the outer perimeter is being set up. The roads must be kept clear in and out of the area. 6) The IC will establish and identify the HOT, WARM and COLD zones with the available information from communication within the active Hot Zone. Law Enforcement Contact Teams will be flooding the area to contain and neutralize the threat and establish areas of control. 7) In anticipation of multiple casualties. The Staging Area Manager will be established with a law enforcement security element to provide security for the staging fire rescue units 8) Upon an identified need by unified command that PEM teams should be deployed, Formation of PEM Team will be assigned by unified command. 9) Fire Rescue personnel that will be operating as the PEM team will be issued the PEM Kit from the District Chief/ District Captains vehicle at the Command Post or Unified (FUP) Forming Up Position in the Cold Zone. 10) PEM Kit contains: (3) Ballistic Vests, (3) Ballistic Helmets (3) (3) PEM trauma bags, 11) A dedicated TAC channel and a Simplex Fire ground channel will be assigned to the PEM team. Management of the PEM team will be coordinated within the Unified Command structure. This position will be physically next to the PBSO Tactical Commander to relay vital information to the PEM team. 12) All PBCFR personnel deploying with the PEM will be wearing BPE, PEM trauma bag. 13) Tactical movement is controlled by the PBSO. Medical decisions are made by PBCFR. Information is given to the PEM team via unified command on either the Tac Channel/ Simplex Fire Ground Channel. 14) PEM team will utilize the Triage procedures. All triaging of patients is dependent on the severity and amount of wounded. Utilizing TECC the patients are categorized into two categories, Immediate and Delayed, which prioritizes the treatment and evacuation to the CCP. 15) Information from the PEM team will assist the Medical Branch Director to prepare the Triage, Treatment and Transport area.

5 16) Command staff should take a proactive role in planning and clearing a clear route into the Triage, Treatment and Transport area and an expedient route out to area hospitals for PBCFR s transport units. 17) PEM Team will PAR in and out utilizing their unit identification at the (FAP) Final Approach Position in the Warm Zone as they enter and exit the building. The PEM team will be demobilized and reassigned when the operational zones transition from Warm Zone to Cold Zone and existing MCI procedures are implemented.