On Friday morning, EMS, fire and police personnel from the Binghamton NY region responded to a multiple shooting MCI at the American Civic Association (ACA), an organization that helps immigrants coming to the United States assimilate into America. Early reports stated that 13 people were feared dead, and 26 to 30 were wounded.
The agencies that serve the quiet community of 45,000 residents on the New York/Pennsylvania border were thrust into MCI mode at 10:30 a.m. when a lone gunman pulled his vehicle up to the rear doors of the ACA Center and blocked the doorway to prohibit occupants from exiting out that doorway.
He then walked around the front of the structure and began shooting people almost immediately upon entering the facility.
Inside were dozens of immigrants waiting to take their United States citizen test. The three-and-a-half hour shooting rampage and hostage incident ended around 2 p.m. when the gunman reportedly shot and killed himself inside.
Emergency crews evacuated the injured to local hospitals and University Hospital, a Level 1 Trauma Center in nearby Syracuse, N.Y. Responding personnel used large trees, vehicles and structures along Front Street, adjacent to the Susquehanna River, to take cover and await an "all clear" to recover and care for shooting victims.
Some key points to remember when dealing with an incident of this nature:
- Stage EMS units out of harm's way and develop a safe pathway to transfer patients along as they are retrieved;
- Coordinate action plans with law enforcement incident commanders;
- Establish patient collection and treatment areas in safe locations, with police positioned to protect EMS personnel in the event a gunman infiltrates the area or is among the wounded recovered from the scene;
- Use scoop, Reeves or basket stretchers whenever possible (unless spinal immobilization is required), because these devices offer better hand-holds and place the patient in a more curved structure, better suited for rapid transfers out of high-hazard areas than flat backboards (Note: Few gunshot victims require spinal immobilization);
- Obtain language translators to assist in communicating with the different dialects on scene (Note: This is a resource that should be pre-planned before an incident occurs and one that can be mobilized by dispatch center personnel on request from the scene);
- Assign medical teams to law enforcement zones to care for wounded officers as soon as possible after their injuries; and
- Establish rehab early because personnel in high tension situations burn off more energy than is apparent on scene and will "crash" rapidly from exhaustion when the scene is secured.