Emergency services changed greatly in the wake of the 9/11 attacks.  Did we sustain the change?  If you are from a metropolitan area, you probably did to some extent.  If you are from rural America, I would bet that you have not. Sure, there was an increase in ICS (Incident Command System) classes.  Have you taken the entry-level course? Are you in a leadership role? Have you taken the course appropriate to your rank?

Yes, we had an influx of Homeland Security grants.  We saw too the rise of MCI (Multiple Casualty Incident) trailers and improvements in communications and equipment.   How many of those disposables that expired long ago, however,  have been replaced?  How many new radios and other pieces of equipment were purchased only to sit on a shelf - never to be trained on, used or actually deployed?

Do You Live in a Small Community? Do You Think You Are Immune to an MCI Event?

Think again.  It may be an act of terrorism but no community is immune to a MCI threat.  The mindset should not be if it happens.  Rather, it should be when it happens.

What will it be? Here in Kansas the weather is more likely to attack that an active shooter, but we have learned that anything is possible.  As I teach a myriad of MCI related topics, I cover events that have caused MCI’s in Kansas in recent years.  They include the obvious, motor vehicle collisions, tornados and other weather related events.  I also include training on car bombs, Federal Building attacks and active shooters.

At this year’s Kansas EMS Association state conference I was lucky enough to hear Chief Mark Willis of Newton Fire-EMS speak about the response to an active shooter MCI last February.  The initial response was 2 Hesston EMS units and 3 Newton ambulances along with Chief Willis who assumed command and declared the event a Level 1 incident. 

That declaration brought in 2 air ambulances and the activation of the Major Emergency Response Group (MERGe). The use of MERGe brought in ambulances from the surrounding counties as mutual aid both to provide response to the shooting and to back fill coverage for Newton.   The event was successfully managed by multiple EMS agencies because of their repetitive practice and integration MERGe program. 

MERGe was born in response to a devastating tornado that struck the town of Andover, Kansas in 1991.  Initially MERGe was an EMS team that would deploy upon request and help mitigate a situation.  Over time the program has grown to include equipment and communication tools and has become formalized. 

Over the last decade MERGe has moved from a regional project to a statewide program.  It has been deployed numerous times to a variety of MCI’s including tornados in Greensburg, Kansas and Joplin, Missouri.  

The real key to the success of MERGe is the passion of the individuals involved.  They do not wait for something to happen.  They routinely practice their response, fine-tune plans and revisit protocols.   The MERGe team participates across the state in exercise simulations, tabletop exercises and live events.  They coordinate the EMS coverage of the annual Symphony in the Flint Hills concert. 

Not Sure Where to Start with Training?

Look around and see what might be a weakness or a potential cause of a multiple patient event.  How prepared are you for a school bus crash injuring multiple children?  Are you ready should an active shooter attack city hall?  We identified a lot of challenges in our response by what happened at a city hall shooting in another state.

Watch the news.  No matter where “it” happens, ask yourself and your crews, “What would we do if “it” happened here?”

Whatever you do to prepare for a MCI event, keep it fresh.  It is not a policy put in a book and forgotten about until needed.  “Practice as you play and you’ll play as you practice. “