May 5, 2018 | Categories: Others
Lieutenant Bruce Hydock, of Division 1, Station 7, was sitting at his station desk at 23rd Street and 10th Avenue, when he heard a big, long rumble at 8:15 p.m. on September 17th. “It sounded like a freight train went over the High Line,” Lieutenant Hydock said. “I looked at my partner and asked, ‘What the hell was that?’ Then we started to see multiple calls come in from the same area, which was an indication that something took place,” said Lieutenant Hydock.
Deputy Chief Alberto Meade of Unit 514 arrived within 20 minutes of the bomb going off and took command as the Medical Branch Director, “When I got to the scene, everything was still getting organized. The members were staging and doing triage for those patients. All of them were green-tag patients with injuries like a minor cut from flying glass or something like scraped knees, but they were able to walk to the ambulances so they weren’t serious,” said Chief Meade.
“My duties were to coordinate all the activities of the EMS Units and Lieutenants on the scene, and to get timely and accurate updates as far as patient count and severity. The rest was just managing the scene until one of my superiors arrived. Everyone was trying to determine if there was further danger to First Responders from a secondary or maybe even tertiary devices. We’re taught that the first explosion will bring First Responders in and subsequent explosions could take us out,” said Chief Meade. “The police had set up a perimeter keeping everyone safe while the NYPD Bomb Squad was sweeping the area. Any patients that were brought to us were treated and transported to local hospitals,” said Deputy Chief Meade.
It was after the terrorist attacks on Paris in November 13, 2015 that killed 130 and wounded many others that Chief of Department James E. Leonard and Commissioner of the New York City Fire Department Daniel A. Nigro met to discuss what the FDNY would do should something like this happen in New York City. “We discussed putting together these Task Forces of both Fire and EMS that we could develop. We had two important documents already in place that were revised. They were our Emergency Response Plan for Operations and Explosions, and Incendiary Incidents, but we had recently signed off on the Emergency Response Plan for active shooters in November 2015. That was a pretty in-depth response plan, but it didn’t form these Task Forces. The Department modeled these after how we tier our HazMat resources and have HazMat Task Forces and also the way our Incident Management Teams are staffed,” Chief Leonard said.
Under the leadership of Chief Leonard, the Department created Task Forces with 25-person units that include 3 Fire Officers, 3 EMS Officers, 12 Firefighters, 6 EMS members, and 1 Battalion Chief. There are five Borough Task Forces, each with roughly 75 members both Fire and EMS personnel, but only 25 people are activated for pre-planned events such as New Year’s Eve, for the Macy’s Thanksgiving Day Parade, for the 4th of July.
“We needed a mechanism for events that was pre-planned and ready for quick deployment, so we created Division Task Forces that include armed (law enforcement) First Responders as well,” said Chief Leonard. There are 10 teams of Division Task Forces based on the Fire divisions, with the 8th Division covering Staten Island and South Brooklyn. At the scene of the special event or assignment the Task Force is broken into “entry teams” known as the Rescue Task Force (TF). The Rescue TF is comprised of 1 Fire Officer, 1 EMS Officer, 4 Firefighters, 2 EMS members. Each of these teams has 4 NYPD SRG (Strategic Response Group) members for protection.
These Division Task Forces are undergoing a five-day training program. As of publication, they completed Day One of training so that they were up and running to be prepared for world events, and incidents like the Chelsea explosion. “I felt that the Department needed people with more training, more familiarity with moving with the Police Department,” said Chief Leonard. “We had over 600 volunteers from Fire Operations and over 500 volunteers from EMS Operations who wanted to be a part of these Division Task Forces.”
The FDNY’s Division Task Force members wear specialty ballistic gear for maximum protection while being able to provide patient care and movement. “We purchased over 600 ballistic vests, top-rated against both handguns and long guns. It’s the FBI’s top-rated vest along with a top-grade military ballistic full combat helmet. We went with tan-colored gear so all of our FDNY members would look different than the NYPD and that color isn’t associated with law enforcement on the East Coast. We trained extensively with NYPD. When the Task Force is activated, it’s the 25 members of FDNY and 14 members of NYPD,” said Chief Leonard.
“The mission statement of the Task Force is to enter into a warm zone under the force protection of law enforcement to rapidly assess, treat, and remove critically injured people from a warm zone to the cold zone,” said Chief Leonard.
“We first started talking about this kind of MCI (mass casualty incident) response during joint training for the chiefs a few years ago,” said Deputy Assistant Chief, Lillian Bonsignore, Chief of EMS Bureau of Training “We wanted to integrate the services and the resources on scene when it comes to the use of Fire and EMS personnel, in patient care situations where we have no fire and no smoke. We started talking about this at a management level…and discussed the policy with the Counter-Terrorism Task Force (CTTR). New York State had been training this through the Department of Homeland Security, so there was already some established material on it and people in the FDNY who participated in some of that training and were able to bring concepts and information back. We were preparing at a decent pace but after [the attack on Paris], Chief Leonard kicked this policy into high gear,” said Chief Bonsignore.
“It’s a big effort to try to train as many people as we train in new tactics and approaches, but…we pulled together and got it done,” said Chief Bonsignore. “One of the most impressive things that happened out of the creation of this Task Force was the relationship with NYPD. It was quite exciting to see.”
The FDNY’s tactics and training for this policy were taken in part from the Department of Homeland Security training at the State Preparedness Center. “The training procedures had already really been created so we adopted a lot of these tactics,” said Chief Bonsignore. The actual training guideline tactics were based off of TECC (Tactical Emergency Casualty Care) and how tactical para-medicine is handled in the military, she said. “That’s how we have to behave in these high-pressure situations where there is possibility of gunfire,” said Chief Bonsignore.
The patient care under force protection tactics considers thatif a person is wounded by an active shooter, they only have a finite amount of blood volume so if it takes First Responders an hour to get to you, you’re going to die from loss of blood, said Chief Bonsignore. “It’s a very simple concept. EMTs and Paramedics need to get to the patients sooner while the NYPD are addressing the shooter in another part of the building or situation. The EMT’s and Paramedics head into the warm zone under protection of law enforcement officers to determine who the most critical patients are. They’ll stop life threatening bleeding by use of tourniquets and quickly remove the most critical patients from the warm zone. The whole name of the game here is: stop the bleeding,” said Chief Bonsignore.
Through reading and research from other incidents around the world and military learnings, the Department’s EMS Academy concluded that a lot of bleeding and the inability to control bleeding during a MCI was a leading cause of preventable deaths amongst the civilian population and military personnel. “The Chiefs of the FDNY Training Academies and members of the FDNY like myself met with groups of subject matter experts on these types of incidents, and we were able to come out with our most key points and then formulate a training curriculum,” said Deputy Chief Paul Miano, Haz-Tac Battalion. They studied incidents as far back as the Columbine High School shooting in Colorado in 1999, the Sandy Hook Elementary School shooting in Connecticut in 2012, as well as the attacks in Paris in 2015 and Orlando this summer. “Our main goal with this policy is to get in, identify critical patients, and provide an intervention that will give the patient time so we can get them out to the cold zone where they can get more definitive care,” said Chief Miano. “If we just grab people and run with them, without stopping their bleeding,they could possibly bleed out,” he said. Before the FDNY Members go in, the NYPD Emergency Services Unit will have deemed that area clear. “It’s still potentially dangerous, but it’s clear, and that’s when our Task Force members will move in,” Chief Miano said.
The first thing an EMT or Paramedic does when they see somebody bleeding is to identify immediately the type of bleeding that it is. “If it’s a slow ‘ooze,’ then we know it’s like a venous type of a bleed, so we have a little bit more time to stop the bleeding. If we see a bright red squirting type, then we know it’s arterial, and someone can bleed out in less than six minutes from an arterial bleed,” Chief Miano said.
The task force is trained to stop the patient’s life threatening bleed under this protection in this warm zone so that they can get them to an ambulance as quickly and safely as possible. “Our first line of intervention with the bleeding is always going to be a direct pressure. We’re going to take our gloved hand, some 4×4 gauze, maybe even depending on where, like a knee or something, and put pressure on this wound to try and stop the bleeding. If that doesn’t work, we move to the tourniquet application. If the tourniquet doesn’t stop the bleeding, we then apply a second tourniquet. If those two tourniquets still aren’t stopping the bleeding, the rescue paramedic uses a hemostatic agent called QuikClot, a type of gauze that’s impregnated with kaolin, which helps blood to clot. Usually this gauze gets packed into the wound while still applying direct pressure with one of our fingers inside the wound until we get the bleeding controlled. Then the wound is wrapped
“In training, it was important to work on the relationship between us and the NYPD so we can actually have a cohesive unit to come together and operate. Having all of these things in place and the NYPD familiar with what we were going to do and how we were going to do it makes for a smoother operation,” said Chief Miano.
“It’s not a surprise that we’ve gone in this direction [of patient care under force protection] because FDNY is an all-emergency organization,” said Chief Bonsignore. “In the case of an active shooter incident, our members understand that a patient will only bleed for so long before they die. If danger is not absolutely evident to our members, I would never be shocked that our members go to a warm zone and get injured people out,” she said.
When word came in that a secondary device had been found the night of the bombing on 23rd Street, Lieutenant Hydock was redirected to a different post and became part of a Task Force. “We were put into play [to be prepared] if the device had gone off while the police officer was trying to recover it and get it away from everybody. We would be able to go in and render patient care and get any injured members quickly.”
Once the Task Force was enacted, Lieutenant Hydock and the FDNY members in the Rescue Task Force put on their tan ballistics gear, which included a Kevlar helmet with the face shield and a vest. “It’s all military-grade to stop bleeding so that we can save lives” said Lieutenant Hydock.
“People take this job for a reason, EMS, Fire, Police we’re all here to help the public and each other when something like this goes down. You check your own fear, resort to your training, and just go with it. I can’t imagine that I wouldn’t be afraid in a situation [like an active shooter]. The likelihood that an active shooter MCI does happen here is high, so to have this policy in place is good. Unfortunately, we can’t always control what people do, but if we control the loss of life…that would be great,” said Lieutenant Hydock.
“I think what we saw in the 23rd Street bombing was if the situation seems static and we have our eyes on the patients…our people are going to go and try to save those lives,” said Chief Bonsignore, who was a Sector Officer at the scene of the Chelsea explosion. She was set up at a Command Post a few blocks away in case there was secondary event.
“We learn from each event. More and more training comes out of each event. We analyze, ‘What did we do here? What could we do better?’ We have great Training Academies and facilities in place to constantly learn and grow from these events so that the next time, maybe we can do it even better. This particular incident in Chelsea, from my feeling, played out exactly how our training would want it to. There was no life loss, and there was minimal injury. The secondary device didn’t explode. Every time something like this happens, it allows us to grow and to practice our training,” said Lieutenant Hydock. “I just hope that every time someone does something catastrophic like this to any community, that the emergency response is as lucky and skillful as we were in Chelsea.”
“From a training perspective, I think our members did exactly what we wanted them to do at the Chelsea explosion. I think they followed the instruction that we’d given them to a T. I was very happy with the way things went. Of course, there’s always room for improvement. You never stop learning. You never say, ‘Okay we got it. We don’t have to train anymore.’ It’s a constant state of training. It’s a constant state of preparing. The training allows you to actually prepare for an event that you haven’t experienced before. The repetitive nature of our training will give you at least a full potential of having already experienced this so that you can plan for some of the things you might see,” said Chief Bonsignore.
“Every time we go to these incidents, we’re learning about the positions of command posts, how we want to deploy people, what should we be looking for, and the interaction with the NYPD,” said Chief Leonard. “It’s all about the safety of our members operating, but more importantly, what we like to say is that ‘NYPD is there to stop the killing, FDNY is there to stop the dying.’ One of the most important things is that we train in the ballistics gear on small tactical team movements with Police and Fire. Moving together is very, very important. We’re being very proactive in New York City. We intend to be a leader in this and we are well prepared,” said Chief Leonard.
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