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Operating in Warm Zones: NCSP/SPTC Delivers A2S2 T&O Course at the State Preparedness Training Center

April 21, 2014

It is hour seventy-two in the fictitious city of Rosterfield, Any State. A small group of highly trained, well-coordinated terrorists have been executing a symphonic attack throughout the city utilizing small arms, improvised explosive devices, and fire, exhausting first-responder resources and producing multiple casualties. Emergency medical services (EMS) personnel and law enforcement officers are dispatched to the Rosterfield Bus Station where multiple terrorists are actively killing civilians. Upon arrival, law enforcement and bomb technicians must move quickly to create a safe area for EMS to provide life-saving medical interventions or civilians will continue to die.

The scenario described above is one of many that students face during the 2.5 day Advanced Active Shooters Scenario (A2S2): Tactics and Operations (T&O) course. A2S2 T&O exemplifies the National Center for Security & Preparedness (NCSP) and the State Preparedness Training Center's (SPTC) continuing efforts to provide cutting-edge scenario-based training that emphasizes the need for early and rapid life-saving medical intervention during events involving aggressive deadly behavior. Law enforcement must decide how best to treat casualties - with the option of utilizing warm zones in indirect threat situations to facilitate care.

During the most recent iteration of A2S2 T&O, EMS and law enforcement first responders trained together to establish and operate in a warm zone, or the geographical area that is in-between the "hot zone" where aggressive deadly behavior is actively occurring, and the "cold zone," where it is relatively safe and secure for first responders to operate. This area is also an indirect threat area according to Tactical Emergency Casualty Care (TECC) guidelines, meaning that emergency response involving patients is in an area of relative safety, although in an environment that is not conducive to routine pre-hospital care.

The warm zone can be hardened by law enforcement; meaning they hold an inner perimeter that allows EMS to operate freely within the area (secured warm zone). Law enforcement could also decide, in a dynamic situation, that EMS should be escorted into and out of the area by law enforcement (unsecured warm zone). Finally, law enforcement may determine that it is not safe for EMS to enter the area and may provide life-saving medical interventions as appropriate and move casualties into the cold zone, where EMS typically operates.

"It's really cool to see their side. I mean I've done EMS on my own voluntarily on the side but to incorporate it, especially for a mass incident like this and provide security and communicate together, it's really cool to see their side of the job, the see our side of the job and then kind of work in sync and make it one."

- Law Enforcement Student

Subject Matter Experts and Instructors utilized discussion, demonstration, skill development, and scenario-based training activities to facilitate student establishment and management of warm zones. This delivery of A2S2 T&O also incorporated a new and thorough instructor-led warm zone and casualty collection point demonstration. This component was designed to complement the integrated movement skill development by demonstrating the primary methods of integrating EMS personnel into an indirect threat situation.

During the demonstration, all students observed both EMS and law enforcement instructors as they operated in secured and unsecured warm zones. Instructors walked through warm zone operations step-by-step including proper escort formations, techniques to secure a corridor, as well as proper casualty movement techniques including emergency lifts, drags, and carries. After the demonstration was complete, EMS and law enforcement students formed groups and practiced these tactics and techniques.

The effectiveness of these additions was exhibited through student actions in the scenario-based activities. Law enforcement and EMS students operated together in consequence-driven, dynamic, and realistic training environments. Over the course of eight scenarios, students established warm zones and casualty collection points, aggressively treated life-threatening injuries, and stabilized and moved casualties to evacuation zones, in both indirect and direct threat situations.

The NCSP/SPTC will continue to adapt the training program to meet the evolving national training needs, with the next delivery of A2S2 T&O taking place in June 2014. Interested individuals should contact the SPTC at sptc@dhses.ny.gov or (315)-768-5689 for more information.