It was a suicide mission in a school of 2,000 students and 150 staff. Explosions, gunfire, booby-trapped explosives, and fire alarms activated by smoke and fire all challenged first responders as they descended upon Columbine High School in Jefferson County, Colo., on April 20, 1999.
In the chaotic and intense hours that followed the initial acts of ultra-violence at Columbine, the numbers revealed the complexity of the incident:
- 13 people were killed;
- 24 were transported to local hospitals and trauma centers;
- 170 patients were triaged through four casualty collection points (CCPs) established near the school;
- 10 critically injured students were transported in the "golden hour" with significant gunshot wounds and penetrating trauma injuries; and
- 14 others were transported with explosive shrapnel wounds.
That day changed the lives of the victims and their families forever, and opened the eyes of the public safety community to the immense task they face in providing safety and security for our schoolchildren. Following are some of the lessons we learned, lessons which all EMS agencies should incorporate into their preplans for schools in their response areas.
1. Tactical decisions made by first-arriving responders in the early minutes of any large-scale incident must be flexible, and multiple incident action plans (IAPs) should quickly be developed and revised as more information becomes available.What began as a normal Colorado day changed dramatically around 11:17 a.m. when two explosive diversionary devices, intended to create confusion and take law enforcement and Littleton Fire Rescue (LFR) resources farther away from the school, exploded in a field a mile from the school property, causing a large grass fire.
Within minutes, numerous cell phone calls from inside the school began overwhelming the communication center with information that was unclear or conflicting about what was unfolding at Columbine High School.
Arriving police officers and firefighters were faced with many critical decisions based on reports of 6 8 shooters, rooftop sniper(s), bombs, hostages, escaping suspects, fleeing students, critically injured victims needing EMS, fire and smoke, alarms, mass evacuation, the odor of natural gas, arriving parents and media helicopters.
2. Apparatus and vehicles will restrict egress; your IAP should include ingress and egress strategies. Within 2 hours after the initial calls for help were received, 10 fire apparatus were on the scene, along with 48 EMS units, two air ambulances and 166 fire and EMS personnel. More than 900 law enforcement officers from local jurisdictions, state and federal agencies responded to the incident. Responders vehicles (many locked after they were parked) littered the surrounding roadways from curb to curb, creating access problems for ambulances transporting the injured. An alert LFR officer noticed the egress problem and ordered tow trucks to remove police cars from key streets near Columbine to open routes to the school.
3. Unified incident command should be set up immediately on arrival of any multi-agency response to control freelancing and coordinate rescue and mitigation efforts.Incident commanders should establish primary and secondary staging areas early into the incident to control the flow of resources into the scene.
Communications is the key to success or failure in most large-scale incidents. Communications and channel assignments can pose problems in a multiple-agency incident unless a regional communication plan has been developed and tested to ensure interagency compatibility. Some EMS personnel not familiar with LFR s mass-casualty incident (MCI) operations left their vehicles unattended in staging, rendering them unusable when needed to transport patients. In addition, lack of interoperability between responder s radio systems created roadblocks in the integrated response related to coordination, accountability and the systematic planning process. During the extended operation, the need to charge dead batteries while still on scene also caused communications problems.
4. Preplan CCPs -- thinking beyond the obvious. Four CCPs were established as the Columbine incident progressed. A secured primary triage/treatment area was set up in front of the school near EMS staging and the incident command post, because we anticipated injured students would evacuate out the front of the school but that s not what happened.
First, students who fled the school ran in multiple directions. Also, unknown to fire and EMS responders and school staff, police officers were removing injured students out the back of the school and driving them into a surrounding neighborhood to safety. As a result, a treatment area had to be quickly established in a neighborhood cul-de-sac where 11 students, including four critically injured, were placed on the front lawn of a home.
As law enforcement secured different sections of the building, two additional, closer treatment areas were established on each side of the school.
Training Is Key
MCIs can easily overwhelm responders who are untrained and unprepared, potentially costing lives. Preplanning, MCI tabletop exercises, use of color-coded command vests and practical drills can reduce confusion during a real incident. MCI training builds a foundation for how responders will perform at a real incident, and drills will reveal flaws in your agency s IAP or standard operating procedures.
Acts of random violence will continue to occur in schools, malls, churches and other public venues across the United States. Emergency responders may find themselves in the crosshairs of perpetrators or terrorists, as they did at Columbine. Four LFR firefighters, dressed only in standard uniforms, came under direct gunfire as they carried critically injured students to their ambulances during the siege. Had these firefighters not put their lives on the line, these students would not have survived. And the complexity of such incidents adds further threat; at Columbine, a fire officer dressed only in turnout gear was mistaken for a gunman wearing a trench coat and was almost shot by a police sniper.
Shortly after Columbine, LFR developed a Tactical Emergency Medical Support team. Fifteen tactically trained and outfitted LFR paramedics, trained by the Department of Defense, now deploy with local SWAT teams to provide medical support to each SWAT mission and humanitarian aid to victims of violent crime.
Our goal: to be better prepared next time, if there is a next time.
Wayne M. Zygowicz, BA, EMT-P, is the EMS chief for Littleton (Colo.) Fire Rescue. He has been involved in EMS and the fire service for 25 years. He also serves as a member of the JEMS Editorial Board. Contact him at email@example.com.
Zygowicz has reported no conflicts of interest related to the Oct. JEMS supplement "The War on Terror" sponsor North American Rescue.