Saturday, July 21, 2012

First Responders Die A Little, One Tragedy At A Time.

In almost all cases of tragedy and horrific carnage such as in Aurora Colorado the first 60 minutes are the same.  A lone call is received by emergency dispatcher's followed by a flood of calls.  Police are notified via radio of the location of the incident and a quick general description of the event; what they might expect to see upon arrival.  The officer or officers dispatched to that location have maybe 60 seconds to decide what might actually be happening and which resources they will need to handle it.

In the case of the Colorado theater shooting the first few officers on scene know they will be actively hunting for a shooter or shooters among a mass of innocent people in total confusion.  Officers communicate with each other while driving at speeds of 60 plus miles per hour and unlock automatic rifles from secure locations within the squad.   Meanwhile paramedics and fireman listen to the radio call in their station and begin to make preparations.  If time permits, a call is made by dispatch to the local hospital ER to warn them of the pending medical need.  They in turn warn other ER's.

First officers on the scene pull up, survey what they see and run into harms way with guns drawn.  In the chaos many patrons are holding cell phones that look all too much like weapons but no mistakes are made.  In another minute more officers will arrive to triage the wounded, coral witnesses and call for paramedics.  Apparently in the Colorado incident Police are fortunate to apprehend one suspect within 60 seconds of arrival but still have no firm knowledge of any other possible threats.  Because there still could be an active shooter, paramedics and other non-police personnel cannot enter the scene.  There is a limited number of resources (paramedics and ambulances) and no chances can be taken that they will be harmed.  Until an all clear is given by police, fire dept commanders will hold their life saving teams well outside the incident area.

Perhaps 10 minutes have now passed.  Dispatchers are still receiving calls from the scared and wounded wanting the personal attention they need and first responders begin to die a little.  In this case the dispatchers who want desperately to help and to get help to others are faced with being the voice who has no ability to act but wants very much to do so.  Police on scene are in charge and dispatchers must wait for orders.  They document where the wounded are and prepare to get them help when word comes that it is safe to do so.  Paramedics have now staged just on the perimeter and listen to police radio traffic.  They too begin to die from the pressure of wanting to get in to help but needing to wait until orders are received.  By this time, maybe 12 to 15 minutes, police officers have identified who they believe are the most critical and want their commanders to let the paramedics in.  Some officers continue the hunt but they can never be totally sure the site is safe, most are now drawn to the most badly wounded and attempt to offer what meager help they can given the resources in their hands are guns and not first aid equipment.  Some officers begin to request they be allowed to transport the wounded in their own squads; time is now of the essence and life or death is just minutes away.  The Police commander reluctantly opens the scene for paramedics praying they have not made the wrong call.

Paramedics pull up with the voices of dispatchers directing them to locations of wounded.  All the victims on scene want attention but only the most serious cases get it;  resources are again limited.  Additional calls go out for more ambulances and paramedics.  The police who initially hunted the shooter try and comfort those that are now dying; a little of each officer is dying too.  They know it is too late and that they will be the last person in that wounded individuals life to talk with them and comfort them before they pass away.

By this time the unseen but extreme pressure on the first police who arrived on scene begins to shift it's focus to paramedics who are equally over-whelmed and the hospital emergency rooms who have just gotten their first cases.  One or two, even 10 or 15 are manageable but 50 plus far exceeds anyone's resources.  More police arrive as do firefighters and the same with Dr's and nurses.  The problem is resources in terms of ambulances, medical equipment and even treatment and operating rooms.  Ambulances are driving as fast as they can back and forth.  Within 25 minutes of the first call for help the first ambulances are now making their second run to get back to pick up the wounded.  Every first responder at this point knows they are seriously outmatched by the needs of the people they are trying to help.  The off air conversations between police, paramedics and hospital personnel are reduced to swearing for the most part; not at anyone but about everything.  Perhaps anger against the pressure will turn the tide in the helpers favor but that is not likely and they all keep doing anything and everything they can, to be of help.

The first responders are all dying now, a little at a time, as the pressure far exceeds their individual and collective ability to help at the level they want and the level that is necessary.  There are many heroic actions but each responders focus is on what they need and want to do and the fact they can't or at least not as fast as they want.  And this battle with the pressure continues for as long as it takes.  Officers and paramedics pick their battles one at a time and each small victory is cherished.  Eventually everyone knows they will prevail.  The question is how much will they think about what they could have done better.  It is in this discussion with themselves that their death occurs a little at a time.  

When their shift ends, many will gather with each other for a small meal and a cold drink to decompress and talk.  Outsiders are not welcome as they couldn't possibly understand what the first responders saw today.  Pulling up to total chaos and carnage imprints images in one's mind that won't ever totally go away.  There are comments but no questions.  There is some attempt at humor but each knows nothing but their own humanness in the heat of battle was funny.  What they're really talking about is the back up each felt from the others as they attempted to fix the unfix-able.

Police and Firefighters are often paid on the basis of what they may need to do, not on the basis of what they normally do.  In Colorado, in this instance as in far too many others, they were underpaid and over performed.

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