Rapid Response: Paramedic preparation, response to police shot at mass gatherings

What happened: Snipers shot and killed five Dallas police officers. Seven police officers and two bystanders were also shot and injured during a protest of officer-involved shootings in Minnesota and Louisiana earlier this week.

Why it's significant: This is the most deadly law enforcement incident since Sept. 11, 2001. Police officers are public safety brothers and sisters to EMTs and paramedics. They respond with us, call us for help and more than ever they begin medical care — AED use, naloxone administration and tourniquet application — before we arrive.

Top takeaways: This loss of life is heartbreaking and tragic. As we mourn their deaths, worry about the injured officers and try to understand the cowardice of the shooters, we also need to consider our own preparation for responding to incidents at protests, as well as our day-to-day responses to civilians in need of medical care.

1. Mourn and honor the dead
Take a moment, privately or with your colleagues, to pray or think about the loss of life in Dallas. Internalization or the impact of the stress from an event like this is unique to each of us. How you mourn, pay tribute and manage stress from the event is also unique. Manage stress in a way that helps you move forward as a paramedic, partner, parent or spouse.

2. Be conspicuous at all times
In too many response areas, paramedics in blue or black uniforms are indistinguishable from police officers. Be conspicuous in your uniform selection, donning of high-visibility outerwear and parking the ambulance.

As you enter a scene, especially a building, call out regularly, "paramedics coming in" or "paramedics, here to help." Or use some phrase that announces your presence as a caregiver. Repeat throughout the incident, especially if a crowd is gathering, that you are a paramedic and are there to help.

When posting in the ambulance, at protests or as part of normal operations, consider locations that offer cover or concealment. Or pick high-visibility locations.

Regardless of the location, at least one member of the crew has to have their head up, not buried in a smartphone, and their eyes open, scanning their surroundings. Agencies with a predictable posting routine — schedule and locations — need to add variability and randomness to the posting pattern.

3. Be cautious and calm
More and more agencies are making the decision to equip paramedics with body armor. This is a reasonable precaution for every response and especially important when responding to or staging at mass gatherings that are or may become violent.

If your agency is considering an EMS body armor purchase, be thoughtful to the color and lettering. Red, green or light blue with bold 'EMS' or 'PARAMEDIC' distinguishes personnel as caregivers and not combatants.

If you are staging at a protest, be aware that as the crowd moves, grows or disperses the ingress and egress routes for ambulances change. Be situationally aware of the options to drive right, left, forward or backwards.

Don't match the emotional intensity of the crowd or the police officers. Yelling, "Calm the f…' down," never works and your surging adrenaline narrows your field of vision and perception of risks in a volatile environment.

4. Constantly remind the public that medics are the helpers
Every day is an opportunity to remind the public through face-to-face interactions, social network postings and media appearances that paramedics are the helpers. When anyone, civilian or police officer, is sick or injured we will respond, assess and treat with all of the skills and resources we have.

Learn more about mass gatherings and EMS safety. And share your top takeaways in the comments for EMS response to violence at protests and mass gatherings.

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