Are paramedics ready for a mass shooting?
With an increasing number of mass shooting incidents across the U.S., including at least 12 between June 3-5, Columbus Division of Fire emergency medical personnel know it’s just a matter of time until it happens here.
“It’s not a matter of ‘What if?’” Capt. Aaron Renner said. “It’s a matter of when.”
While Columbus has not seen a major incident like those in Uvalde, Texas; Buffalo, New York, or at the Harvest Music Festival in Las Vegas, training for these types of events has been frequent over the last several years. It has helped prepare them for incidents like the machete attack on Ohio State University’s campus in 2016 and a shooting last summer at Bicentennial Park Downtown that killed 16year-old Olivia Kurtz and injured five other teens attending an unauthorized DJ concert organized via social media.
A major, multi-agency training is currently scheduled for July, involving multiple agencies.
Each incident and training provides Columbus Fire paramedics with an opportunity to learn, prepare and look at responses to incidents around the country to identify best practices for quickly treating a large number of patients in a singular event.
Part of that training is becoming familiar with the
specialized equipment carried on ambulances at each of the 33 fire stations across the city, designed for quick use during a mass casualty incident (MCI) or active violence incident (AVI).
This equipment includes ballistic helmets and vests, as well as more traditional emergency medical equipment.
“You can never 100% prepare for what’s going to happen. For these types of events, there’s always an unknown. With the high level of concentration and practice, you’re more ready. I really do hope it never happens in our area, but we fully want to be ready and expect it. We’re going to probably have these types of surges and be prepared for those as well.”
Dr. Urmil Pandya
Medical director of trauma at Ohiohealth Grant Medical Center
“We’ve had to rethink all of it,” Renner said.
Each Columbus medic unit carries a full complement of equipment and medications to treat a singular patient. However, they also have a specialized bleeding control kit on each medic that allows quick treatment of multiple patients.
These kits include tourniquets, gauze, chest seals and decompression needles that can be used to reflate collapsed lungs.
The kits also include specialized tourniquets that can be used for wounded children, who may be too small for a traditional tourniquet to fit properly.
“We’re not getting into deep treatment at an MCI,” said Battalion Chief Jeff Geitter, who is the fire division’s public information officer. “We’re not even staying with the patient that long. We’re triaging.”
Columbus Fire medics have been carrying specialized bleeding kits for the last several years, Geitter said.
There are also seven lieutenants, who Renner oversees, who are trained to coordinate responses with the Central Ohio Trauma System, the Franklin County Emergency Management Agency and other partners across the region to make sure all necessary resources are being used to the best capability.
The city Division of Fire also has a special mass casualty ambulance, called MC580, that is outfitted especially for a mass casualty incident. The ambulance has 12 plastic totes with supplies in them for various types of incidents, including treatment of burns and a significant number of doses of Narcan.
The ambulance, Renner said, also includes portable backboards that can be used by firefighters or civilians to move patients quickly, trauma dressings, tourniquets, and various other first-aid equipment.
“We used to have a trailer,” Renner said. “Now, we probably have more capability with (the ambulance) than we had with that.”
The ambulance also has multiple color-coded, pop-up tents that can be used at a centralized point to coordinate care for patients. Other equipment includes a generator and lighting, as well as stockpiles of equipment in each of the totes.
MC580 has been in operation for about a year and is available for use in Columbus and surrounding communities as needed, but fortunately has not yet had to be used at a mass casualty incident.
Renner said the equipment on MC580, as well as in the specialized bleeding kits, can be distributed to members of the public quickly, including packs of equipment that include gloves, scissors, gauze and tourniquets.
Being able to provide initial triage at a scene or while en route to an emergency room, such as using a chest seal or performing military-style treatment, is something that has been needed more frequently across the country in recent years as mass shootings have become all
too common.
While Columbus has two local hospitals that are Level I trauma centers – meaning they are equipped to handle severe injuries like gunshot wounds – the time between a paramedic’s arrival on scene and arrival at the hospital can be critical in improving the odds of someone surviving.
Both Ohiohealth Grant Medical Center and Ohio State University’s Wexner Medical Center are Level I trauma centers, as designated by the American College of Surgeons.
Nationwide Children’s Hospital is a Level I trauma center for pediatric patients, according to the American College of Surgeons. Ohiohealth Riverside Methodist Hospital and Mount Carmel East are Level 2 trauma centers.
Dr. Urmil Pandya, medical director of trauma at Ohiohealth Grant Medical Center, said that the hospital, which treats the majority of gunshot victims in Columbus, saw several “trauma surges” in 2021. These surges involved multiple patients coming to the hospital within a short amount of time, requiring multiple operating rooms, heavy use of blood supplies and additional resources.
“Prior to last summer, we never really saw anything like we saw,” Pandya said. “The most concerning are the gunshot wounds. They need the operating rooms more often, and more often need blood – that’s tougher to expand as a resource. We’re waiting to see what will happen this year, but we have some plans in place for how we’re going to address those moving forward.”
Those surges are a good, real-life test of the hospital’s capabilities to respond to a mass casualty incident, Pandya said. Grant Medical has plans in place, and has drills regularly, to prepare for a MCI, he said, but handling the surges is a good measuring stick.
Their drills involve having plans for increasing availability of operating rooms, maximizing the use of blood supplies and having plans for bringing additional surgeons, nurses and other medical staff to the hospital quickly.
“You can never 100% prepare for what’s going to happen,” Pandya said. “For these types of events, there’s always an unknown. With the high level of concentration and practice, you’re more ready.
“I really do hope it never happens in our area, but we fully want to be ready and expect it. We’re going to probably have these types of surges and be prepared for those as well.”
Pandya said there are steps that people who are caught in an active mass casualty incident can take to help paramedics. He said using basic first-aid measures, like working to apply pressure and stop bleeding, as well as performing CPR, can help paramedics.
“You may not want to move them because that can make things worse,” he said. “But the basics are do CPR if you think their heart is not working and if you see bleeding, it’s safe to apply pressure.”
Pandya said it’s also important to listen to law enforcement and paramedics on the scene, particularly if there is still an active and ongoing threat, to maintain personal safety.
bbruner@dispatch.com