On August 24 2018, a report compiled by the Clark County Fire Department and the Las Vegas Metropolitan Police Department in collaboration with the Federal Emergency Management (FEMA) Agency National Exercise Division was released to the public.  A copy of the report can be found here. 

The purpose of the report is twofold:  First, to analyze the emergency response to the Route 91 Harvest Festival Mass Shooting.  Second, to present observations and recommendations with the intent of distributing best practices and lessons learned to better prepare other communities for a mass casualty incident should one occur.

The report is organized into 11 broad focus areas pertaining to the response, which were then mapped to FEMA’s core capabilities; a group of 32 activities developed by the Department of Homeland Security as part of the National Preparedness Goal, a copy of which can be found here.  The report contains 72 observations and recommendations broken down by application to law enforcement; fire, including EMS; and regional/statewide agencies.

The report offers valuable insights to any organization that is in the process of event planning or that has oversight over a venue where a large number of people regularly congregate such as, stadiums, concerns, houses of worship, schools and museums.

A number of observations stand out with respect to treating to the injured.  For example:

Observation 4

Although the size of the medical tent may have been sufficient for the festival itself (roughly seven cots), it was not designed to handle an MCI. While there were many trained personnel at the medical tent, a lack of equipment hindered treatment efforts. To compensate, OT officers gave up their personal tourniquets and requested additional medical supplies to assist victims. Civilians also used their own belts and shirts as makeshift tourniquets.

Although the size of the medical tent may have been sufficient for the festival itself (roughly seven cots), it was not designed to handle an MCI. While there were many trained personnel at the medical tent, a lack of equipment hindered treatment efforts. To compensate, OT officers gave up their personal tourniquets and requested additional medical supplies to assist victims. Civilians also used their own belts and shirts as makeshift tourniquets.

Recommendations:

• Continue to provide supervisors and officers assigned to special events with robust MCI/medical kits, including sufficient numbers of tourniquets and pressure bandages to have on hand.
• Require special events promoters to provide a pre-determined amount of MCI equipment for all future special events.
• Require throw/first-aid kits to be pre-staged at all special events of a pre-determined size. Kits can be given to people on scene for treatment, creating a force multiplier of first responders.
• Consider providing Tactical Emergency Casualty Care (TECC) training for officers.

 

Observation 12 

Security in the medical tent became an issue due to crowd panic, exacerbated by intoxicated festival.

Recommendation:

• Incorporate medical tent security protocols in special event Incident Action Plans (IAPs).

 

Observation 14

Venue participants and local civilians volunteered their assistance to firefighters, police officers, and ambulance personnel. While these volunteers caused some confusion, they also assisted greatly in transporting victims out of the area and provided some basic first aid to victims. 

Recommendations:

• Ensure that response agencies have mechanisms in place to coordinate with civilian volunteers and organize donations, efficiently incorporating these resources into operations.
• Support community “Stop the Bleed” first-aid training and education programs.

In addition, a number of recommendations focused on command and control and communications.  Both are essential to ensure the timely and efficient deployment of available resources.

Bottom line:  Hopefully events such as the Route 91 Harvest Festival Mass Shooting continue to be the exception and not the rule.  With any mass casualty event, whether it be the result of human actors or nature, proper planning, deployment and training will save lives.