From Buckets to Bullets: The Modern Era of Aggressive Interior Attack

The Roman emperor Augustus is credited with inaugurating a corps of fire-fighting vigils in 24 BC. Known as the ‘Watchmen’ this was quite possibly the first ever organized unit of firefighters in the world. Their responsibilities? Fire prevention through regulations established by the Roman Empire.

By the pre-industrial era most cities in the west had watchmen who sounded an alarm at the sign of fire, much like the Romans who preceded them.

The primary function of the world’s first fire service, extending long into the pre-industrial era was fire prevention. The one principal piece of fire-fighting equipment was the bucket, passed from hand to hand to deliver water to the fire.

After a major incident in Boston in 1631, the first fire regulation in America was established. In 1648 the New Amsterdam (now New York) fire wardens were appointed, thereby establishing the beginnings of the first public fire department in North America. Finally, in 1830 the world’s first standards for the operation of a fire department were established in Edinburgh, Scotland. These standards explained, for the first time, what was expected of an operational, organized fire service.

Today the National Fire Protection Association has implemented a comprehensive list of codes and standards for the operation of a fire department that has exceeded 300 different functions. What started as simple overwatch and community bucket brigades has grown to be one of the most dynamic and comprehensive professional fields in existence. Where once firefighters were only responsible for fire, today we have shouldered the responsibility of technical rescue, confined space, water rescue, motor vehicle accidents, basic life support, advanced life support and more.

Since the inception of the fire service we have seen a workforce that is unparalleled in its ability to adapt to the ever-changing needs of the public we are sworn to protect. While the title of firefighter is one that will be carried with pride for generations to come, we have truly grown beyond our roots, tasked today with comprehensive all-hazards emergency response and mitigation.

The fire service has seen such success in its evolution towards emergency mitigation exclusively as a result of its membership. Firefighters have always held true to the belief that it is not only our duty but our calling to do everything possible to serve our fellow man. The greatest minds in the fire service share the same mentality of every unnamed crew around the country today who will put their gear on the rig. What is that mentality? Aggressive intervention is, as will continue to be the key to saving and preserving life, regardless of the emergency.

However, at this moment in time it has become all too apparent that we as an industry are at an impasse, and for the first time in recent history, our courage to act is being challenged from within.

Up until this point, a large portion of the responsibility that we have grown into as firefighters has been the result of technological advances. Advances in medicine brought forth pre-hospital ALS, advances in technology brought forth MVA’s and extrication, and advances in construction efficiency have continued to evolve our tactics and strategy towards fighting fire.  However, the need to advance today is one that is unlike anything we have ever seen, and that is because it is not driven by population or technology, but rather by man’s inhumanity towards his fellow man.

This year, the National Fire Protection Association released NFPA3000 sparking a fiery debate concerning our responsibility as it pertains to active shooters and hostile environments. With the release of this document, it has become all too frequent that we hear our brothers and sisters sit back on the mentality that this is a police matter, or the risk is too high. We are suddenly placing our own safety above the that of our fellow man, and to quote my father, “the greatest disservice we ever did to the fire service was to teach that our safety came before the public’s.”

So why has this been such a devise topic. The answer is simple; onset and frequency. While most of the evolution of the fire service came on gradually over time, the threat and frequency of civilian public mass shootings (CPMS) and hostile environments has been rapid.

Since 2000 there have been at least 35 targeted mass shootings in the United States, and the frequency has risen to a projected 16.9 incidents per year. Six of the ten most deadly CPMS incidents have occurred in the last six years.   We are now face-to-face with the next phase in the evolution of the fire service, and for the first time, we are acutely aware of its onset.  The operations equivalent to jumping into a hot bath vs. gradually warming the water over time, we have been thrust into a vat of theoretical hot water, and our initial instinct is to jump.  E. Reed Smith, the medical director for the Arlington Fire Department has made an interesting observation about this instinct. He concluded that “Fire/EMS responders appear to only accept risk when responding to certain common operational scenarios…[they] reject risk in the name of safety for other non- conforming scenarios.”

This paradigm is accurate, we have accepted these incidents as un-common and consequently, have failed to consent to the risk.  Firefighters must accept active shooters as a common operational scenario.  Once we accept this we can move beyond the risk, accept the responsibility, and train accordingly to react in a manner that will save lives.

In the fire service, the decision to take on a new hazard as an operational standard begins with frequency and concludes with risk-benefit analysis. Ultimately, we ask ourselves

 

1. Does the frequency of the event warrant ongoing preparation?

 

      and…

 

2. Does the reward outweigh the risk?

 

It has already been well established that the frequency of hostile environment responses warrants operational preparedness, so the next question we must ask ourselves concerns the risk. How great a risk does a hostile environment response pose to firefighters?  Since 1978 there have been 3,000 LODD’s, but in that same period, only 4 cases of firefighter injury or death were reported while responding to active shooters. This includes 2 LODD”s in Webster, NY and the death of Captain David Rosa on June 25, 2018.  While unimaginably tragic, these line of duty fatalities only account for .001% of firefighter fatalities. Recent history would show a pattern of relative safety in regard to such incidents.

It could be argued that the low frequency of firefighter fatalities during active shooters is a result of our current cautions approach, so we must also explore the safety and stability of the incidents themselves.  I fall back here on the words of Station Pride editor and chief Jon Marr who said “our job is to calculate and measure risk. I think we can measure the risk and provide operational controls to make it safe enough for the risk to be worth it”.

According to research collected by C3 Pathways “firefighter safety in an active shooter after the 10-minute mark is safer than a structure fire.” They found that in 90% of active shooters the threat was neutralized or contained in under 10 minutes. In 37% of those incidents, the threat lasted no longer than 5 minutes. Regardless it took firefighters 3 hours to reach the first interior victims of the Pulse Nightclub shooting, 22 minutes at Sandy Hook Elementary, and Columbine took 4.5 hours before initial interior operations were initiated. This is critical when you consider the words of Chief Bill Godfrey who noted “the threat that is going to kill people is time…the time delay will kill them [victims] just as if someone were still shooting…this is where we screw up most often.” Therein lies the benefit of rapid pre-control interior operations during an active shooter.

Dr. E. Reed Smith and Jon B. Delany have delivered the most comprehensive and compelling research on this matter. In their research paper, Fatal Wounding Pattern and Causes of Potentially Preventable Death Following the Pulse Night Club Shooting Event they were able to conduct a clear and obvious profile of wound patterning and survivability. Essentially what they noted was that of the 49 fatalities recoded, 16 had potentially survivable wounds if prehospital intervention were available sooner. This accounts for a 35% survivability increase with more efficient and rapid patient care. At Columbine High School 4 of the 13 victims were potentially viable. In just these two shootings alone, 18 lives could have been saved by a more aggressive interior action on behalf of fire and ems.

Previous research by the same authors regarding Tactical Combat Casualty Care yielded a much lower survivability profile of 6%, but consider this… Since Charles Whitman took aim at a university campus in 1966 there have been 1,102 people killed during CPMS incidents. If more aggressive interior operations could account for a 6% survivability outcome, then the fire service could have saved approximately 67 additional lives. This number is staggering in a profession where every life counts.

The reaction to active shooter scenarios by firefighters has a clear and studied cause and effect, and the outcome is evident, the benefit outweighs the risk. Rapid and aggressive intervention WILL improve survivability, and the way to most effectively and efficiently mitigate these scenarios is to improve speed and efficiency.

The fire service is tasked as the last line of defense for those in need, and a rapid more aggressive approach to active shooters and hostile environments has an undeniable positive outcome on survivability. If there is even the chance to save one life, the risk is worth the reward, and evidence suggests the benefit is far greater than one. James Geering of Behind the Shied said it best, “it’s marginally dangerous, [but] so is making entry to a structure fire. You have to be intelligent, but there is a certain point where, if you’re going to put that badge on your chest, you have to be willing to take the risk.”

Life safety will always be the number one priority of the fire service, not our own lives, but the lives of those we have sworn to protect. This is the foundation upon which the entire fire service was built, and this is our moment in history to preserve this call to action for all generations that proceed us.

 

Bibliography:

 

Geering, James, and Bill Godfrey. “Behind The Shield: C3 Pathways.”

 

Sarani, Babak, et al. “Fatal Wounding Pattern and Causes of Potentially Preventable Death Following the Pulse Night Club Shooting Event.” Prehospital Emergency Care , 27 Mar. 2018.

 

Godfrey, Bill. C3 Pathways, http://www.c3pathways.com/.