San Antonio Fire Department Combined Active Threat & Med-Cat Incident SOG #2003 PDF

SAN ANTONIO FIRE DEPARTMENT Effective Date 10-26-23 COMBINED ACTIVE THREAT & MED-CAT INCIDENT SOG Policy# 2003...

SAN ANTONIO FIRE DEPARTMENT Effective Date 10-26-23 COMBINED ACTIVE THREAT & MED-CAT INCIDENT SOG Policy# 2003 Review Date Approved by: Assistant Chief Ramon Casanova 10-26-26 Reviewed / Revised by: Assistant Chief Michael Stringfellow.01 PURPOSE This guideline outlines roles and responsibilities for (1) an Active Threat Incident, (2) a Hostile Incident involving fire and/or weapons and (3) Med Cat Operations..02 GOAL The goal is to ensure successful coordination and communication between agencies resulting in effective scene control, maximum patient treatment and survival, and evidence preservation. Active Threat Incidents differ greatly from routine incidents due to an increase in safety requirements and the necessity of a Unified Incident Command (UIC) structure for mitigation of the emergency and coordination of our resources..03 ASSUMPTIONS A. During Active Threat Incidents, first arriving law enforcement (LE) personnel are trained to neutralize the threat upon their arrival. When available LE Supervisor or Officer should establish the Forward Command Post (FCP) to coordinate command and operations. LE is the lead agency in any Active Threat Incident. B. All Active Threat scenes are to be considered HOT (i.e., not a safe or secure area) until LE determines otherwise. Zones (Hot, Warm and Cold) will be established for identification and concise communications. These zones are dynamic and can change as the incident develops and expands..04 DEFINITIONS A. Active Threat Incident- Incident involving an individual actively engaged in killing or attempting to kill people in a confined and populated area; in most cases, active shooters use firearms and there is no pattern or method to their selection of victims. B. Hostile Incident- Incident involving fire and/or weapons that is not an Active Threat Incident but poses increased risk to citizens and Fire personnel. Examples include a barricaded subject who starts a fire, a threat to a school with no reported injuries, or a shooting incident with multiple victims. C. Hot Zone- The unsecured area where there is a known hazard or threat to life that is potentially direct and immediate. This includes any uncontrolled area where an active shooter could engage people. This area is defined by the Law Enforcement and is within the line of sight/ line of fire from any doorway or window of the incident occupancy. The only SAFD personnel allowed to operate in the Hot Zone are MSOU personnel and the Med Cat when operating directly with Law Enforcement. Law Enforcement Officers providing cover/ over watch do not negate the Hot Zone and we cannot perform suppression in the line of fire. D. Warm Zone- An area adjacent to the Hot Zone which has been secured by law enforcement but still has a moderate threat. Personnel in this area shall wear ballistic gear. Fire suppression personnel can position in the Warm Zone if Law Enforcement personnel are on site to provide immediate protection. E. Cold Zone- A low threat area that is secure from the immediate threat and safe to operate without ballistic gear. Staging and the UICP will be located in the Cold Zone. SAN ANTONIO FIRE DEPARTMENT Page 2 of 9 Combined Active Threat & Med-Cat Incident SOG #2003 F. Forward Command Post (FCP)- Used in Active Threat Incidents, this is the location of the first available LE Supervisor and Fire Command Officer. Normally 200’ outside the structure, this is where the initial Command (and subsequent Unified Operations) will begin. G. Rescue Task Force (RTF)- A combined team of LE and Fire personnel who will operate in the Warm Zone. SAFD personnel may only participate on an RTF if they have undergone RTF training and have ballistic equipment. H. Unified Incident Command Post (UICP)- Located in the Cold Zone where the Command Bus will site. I. Ambulance Exchange Point (AEP)- Location close to the Evacuation Corridor where critical patients are rapidly loaded for hospital transport. J. Anchor Team- The first RTF inside is considered the Anchor Team. The Anchor Team should identify itself geographically (ex: Anchor Team Library). K. Casualty Collection Point (CCP)- Located inside the structure, this is where civilians are collected and triaged prior to evacuation. LE should establish CCPs prior to RTF entry and identify them geographically (ex: Auditorium CCP). The LE Officer in Charge is called the Room Boss. Patient movement must be coordinated with LE. L. EMS Transport Corridor- the EMS route from Staging to the Ambulance Exchange Point (AEP) and then to area hospitals. M. Evacuation Corridor- main path of egress/ingress. Identified by LE, this is the path the RTFs will take. There may be multiple Evacuation Corridors. N. Barricaded Subject- An armed individual resisting Law Enforcement contact. By threat or by actions this individual generates a Hot Zone. O. Exposures- Non-involved adjacent buildings. When fire is a threat, it is critical for LE personnel to clear exposures. P. Scene Secure/ Scene Unsecured- Law Enforcement designates “Scene Secure” when the subject is either in custody, no longer a threat or the area has been cleared by LE. At this time, there is no longer an active Hot Zone and SAFD personnel can take actions deemed appropriate by the IC. “Scene Unsecure” indicates the presence of an armed subject who poses a threat to first responders. The Law Enforcement IC will designate the Hot Zone. Q. Tenable/ Untenable Building- Consideration for incidents involving fire. “Tenable” indicates that it is possible for someone to be alive inside the structure after fire knockdown and thereby pose a threat to fire personnel making entry. “Untenable” would indicate that the fire reached a fully developed state and it is unreasonable to believe that anyone inside could be alive. The SAFD IC will make a determination of the building’s tenable/ untenable status. If the building is deemed tenable, it will be necessary to have LE Special Operations clear the building before SAFD personnel approach or enter. If untenable, the inside threat has perished, and normal fire suppression actions can proceed. R. Med Cat- A specialized vehicle that has ballistic protection which enables it to operate inside the Hot Zone. It will be staffed by a minimum of 2 Firefighters (FFs) who have been trained as Med Cat Driver/ Operators. More personnel can be added to the crew depending on the intended mission (fire suppression or patient rescue). This apparatus will be operating in the Unified Command setting with Law Enforcement, EMS and Fire. S. Medical Special Operations Unit (MSOU)- Designated Paramedics that have received tactical training with Law Enforcement Special Operations personnel. These medics (typically assigned to M01 and M45) are authorized to work inside the Hot Zone. In the event a Law Enforcement Officer is injured MSOU will serve as RIT for Law Enforcement SAN ANTONIO FIRE DEPARTMENT Page 3 of 9 Combined Active Threat & Med-Cat Incident SOG #2003.05 ACTIVE THREAT INCIDENTS- RESPONSE ALLOCATION: A. The initial dispatch for an Active Threat incident will include the following: 3 Engines 2 Battalion Chiefs 1 Medic Officer 2 Ladders 2 MSOU 1 MSOU Medic Officer 3 Medic Units 1 Technical Rescue Team 1 Fire Safety Officer 2 Arson Investigators FSC and MSC PIO Command Bus Ambulance Bus Med Cat Note: If the event will extend for a long period of time, the Southwest Texas Fusion Center (SWTFC) will dispatch a liaison that will report to the ICP. B. Medic Units assigned to an Active Threat incident are expected to return to the scene Code 3 after hospital transfer unless told otherwise by Medical Branch. In a large incident we anticipate needing every available EMS asset. C. Any double company dispatched to an Active Threat incident should bring their Squad if possible. Squads will be used to transport personnel and equipment from Staging. You do not need to notify Dispatch in this situation..06 ACTIVE THREAT INCIDENTS- COMMUNICATIONS A. SAFD Communications will: 1. Coordinate with the SAPD Dispatcher who is managing the Active Threat incident to share information. Relay critical information on the Fire Operations channel (ex: “Reports of 3 shooting victims at the food court” or “We have a report that the shooter is down”) 2. Dispatch the incident on Mutual Aid channels and allocate five (5) Mutual Aid radio channels for the following functions: a) Fire Operations – MA20- channel controlled by the initial IC (who becomes Ops). Initial SAFD radio traffic and then FCP communications. b) Law Enforcement – MA 21- the LE channel will be patched onto a Mutual Aid channel. SAFD personnel will monitor this channel for situational awareness. Communication on this channel is prohibited unless called by law enforcement. c) *Staging- MA22- Activated when directed by the IC. All unassigned or responding SAFD units will move to the Staging Channel. The Staging Manager will control this channel and will monitor the Fire Operations channel (assigning resources as directed by the IC). Units leaving Staging will be report to Fire Operations, Medical Branch, or Occupant Services. d) *Medical Branch- MA23- Activated when directed by the IC. The Medic Officer will control this channel at the FCP. e) *Occupant Services- MA24- Activated when directed by the IC. The UIC (2nd BC) will control this channel. Functions on this channel will include Family Reunification Group, Treatment Group(s), and any calls for Occupant Services. SAN ANTONIO FIRE DEPARTMENT Page 4 of 9 Combined Active Threat & Med-Cat Incident SOG #2003 f) Emergency Common- EMER-COM- Area radio channel available to any responders at an emergency response. 3. Identity a Staging location for the incident and make a recommendation to the responding BCs. 4. If there are calls for rescue at the incident (including people hiding) Dispatch must transmit the information on the Occupant Services channel for relay to LE. Critical information about the active threat should be relayed to the Fire Operations channel. B. During the initial stages of an Active Threat incident, the SWTFC’s Tactical Information Operations Center (TIOC), when requested, can provide responding units with the necessary information to coordinate with on scene LE agencies. This can be accomplished by calling (210) 207-7680. C. SAFD Dispatch must be prepared to coordinate with LE Dispatch to provide responding companies with the location of the FCP and other vital information..07 ACTIVE THREAT INCIDENTS - COMMAND CONSIDERATIONS AND INITIAL ACTIONS A. Monitor the LE channel and relay critical information on Fire Operations channel. Prior to arrival, the responding BCs should coordinate with Dispatch and identify a Staging Area in the Cold Zone. Announce the location on the Fire Operations channel. 1. The first arriving Officer should assume Staging Manager. If your company is RTF equipped seek relief by a following non-RTF company. a) Apparatus lights at Staging will be turned off except for the Staging Manager. b) To reduce radio traffic, arriving resources will report face-to-face to the Staging Manager. c) Identify RTF-capable units (MSOU, TRT, and other RTF companies) and be prepared to send them to the FCP. d) Non-RTF Fire personnel should be added to Medic Units to assist with patient care during transport, assist with the walking wounded in a Treatment Group, setting up a Landing Zone, etc. e) When directed by the IC, a Staging channel may be activated. Any resources in Staging or responding to the scene will then switch to the Staging channel. The Staging Manager must continue to monitor the Fire Ops channel to support Operations. f) Identify minimum Staging resources from Operations. g) Utilize Squads where possible to move equipment and personnel forward. h) The Staging Manager should ensure that force protection is in place. Request LE to direct walking wounded away from Staging. i) Staging Manager should set up a cache of ballistic gear from any personnel who have gear but have not been trained. This can be redistributed as needed. j) No one should move towards the FCP unless he/she has ballistic gear and training. B. The 1st BC (or 1st arriving, MOF, or Company Officer with tactical gear) will report to the LE Supervisor at the Forward Command Post (FCP) to: 1. Assume Incident Command (later, you will become Operations) and get a briefing from the LE Supervisor. SAN ANTONIO FIRE DEPARTMENT Page 5 of 9 Combined Active Threat & Med-Cat Incident SOG #2003 2. Announce the location of the FCP. Gather information and provide a Conditions Actions and Needs (CAN) report to SAFD units. 3. *If there is no FCP upon arrival, contact the Dispatch on Fire Operations and request a location and an LE Supervisor. 4. For a confirmed Active Threat incident request additional resource as needed. 5. Request RTF personnel from the Staging Manager. 6. Establish a. Rescue Task Force (RTF) Group made up of multiple RTF Teams. a) SAFD RTF members must have both the appropriate ballistic equipment and RTF training. b) As needed, assign an RTF member as the RTF Team Leader. c) Coordinate with LE and form multiple RTF Teams utilizing an On-Deck model. When possible, a one-to-one ratio of LE and Fire personnel should be used. However, at minimum, armed force protection at the front and back of the RTF can be used for entry. d) Track RTF team accountability throughout the incident. e) The first RTF Team will proceed towards (or establish) the Casualty Collection Point. The first RTF is considered the Anchor Team and may remain inside to manage patient care. f) If an MSOU team is available, they should be among the first RTF to enter the structure. The MSOU team should not assume Anchor Team responsibilities, but they can assist with triage and patient care. g) Once immediate RTF needs are met, establish an RTF Rapid Intervention Team (RIT). If a second MSOU is available, use them as the RTF RIT. This team would be used for any LE or Fire patients. h) Ensure the RTFs have forcible entry capabilities. i) Each RTF will have a designation (RTF1, RTF2, etc.) and RTF Team Leader. This RTF Lead will: i. Monitor the Fire Operations channel. ii. Provide CAN reports to IC/ Operations (who will communicate face-to-face with Medical Branch). 7. Establish a Medical Branch and assign the 1st arriving Medic Officer to the FCP. a) Coordinate with LE to identify the Ambulance Exchange Point (AEP) and the EMS Transport Corridor. b) When directed by IC/ Operations, activate the Medical Channel and coordinate Medic Units on this channel. Communicate face-to-face with IC/ Operations. c) Evaluate patients and EMS resources. Anticipate non-trauma medical emergencies at the incident. d) Coordinate with Dispatch and Medical Command on hospital availability. 8. Create an Operations Site Plan for the incident and share this with the UICP. a) Include locations for the FCP, Evacuation Corridor, AEP, and Staging. C. When the 2nd BC arrives on scene, he/she will receive a CAN report and then assume Incident Command. The 1st BC will remain at the FCP and will become the Operations Section Chief (“Ops”). 2. Evaluate resources and support Operations. Tracking assignments will be critical. 3. Identify a location for the Unified Incident Command Post (UICP) and site the Command Bus. Announce on the Fire Operations channel. 4. As needed, assign a Planning Chief. a) Collect floor plans and relay to FCP if possible. SAN ANTONIO FIRE DEPARTMENT Page 6 of 9 Combined Active Threat & Med-Cat Incident SOG #2003 b) Coordinate with LE and identify the Incident Action Plan. (What are ongoing actions? What is known?) c) Ensure a clear Communications Plan is established and each channel is being monitored at the UICP. d) Identify the Operations Site Plan. 5. Periodically brief other agency partners. 6. Identify the EMS Transport Corridor and coordinate with LE Traffic. 7. Evaluate overall scene safety and ensure force protection is in place. Consider the incident perimeter, crowd control, and evacuees. 8. Identify a safe location for Media and coordinate with the PIO. 9. Organize Occupant Services. Order resources from Staging. Use the Occupant Services channel. a) Establish a Family Reunification Group. Identify a location for evacuated personnel to locate. Coordinate with Emergency Management Coordinator at the EOC as appropriate. A dedicated shelter and bussing may be needed. b) As needed, assign a Treatment Group to address any walking wounded. c) If Dispatch receives calls from people inside the structure these will be relayed on Occupant Services channel. This information must be relayed to LE. D. Roles and Responsibilities inside the Casualty Collection Point (CCP) 1. First arriving Fire Officer shall assume Anchor Team Lead. b) Meet with LE Room Boss/Hall Boss to gather information. c) Assign your personnel to begin triage and treatment. d) Provide CAN report to FCP. e) Maintain a strong command presence and assign incoming companies: 1. Assist with triage and treatment. 2. Prepare patients for movement to the AEP. f) Coordinate with the FCP on the AEP location and ambulance needs. g) Prepare patients for transport to the AEP. h) Coordinate with the FCP on ambulance and patient arrival at the AEP 2. Follow up on RTF Teams at the CCP. a) Meet with Anchor Team Lead to receive assignment. b) Assist with triage and treatment as needed. c) Prepare patients for transport to AEP and continue to monitor status. d) Promptly move patients to AEP when directed. e) After patient drop off make FCP aware of status and await next assignment. 08. HOSTILE INCIDENTS- INITIAL ACTIONS: A. While responding to an incident monitor the active Law Enforcement radio channel for situational awareness. B. Upon arrival, the Initial IC must establish contact with Law Enforcement personnel and get a briefing on the situation to include: 1. Where is the location of the threat? Is the threat mobile? 2. Hot Zone location. Incident Orientation if designated (Alpha side, etc.) 3. Number and location of any patients. It is extremely challenging to accurately track patients. Dispatch can assist with tracking patient transports. SAN ANTONIO FIRE DEPARTMENT Page 7 of 9 Combined Active Threat & Med-Cat Incident SOG #2003 4. Location of the Forward Command Post (FCP). (Be advised, the initial LE Supervisor will likely be mobile in the early stages. It is vital to assign someone with ballistic protection to this Officer as soon as possible.) 5. Identify the best staging location for SAFD resources. Multiple sites may be necessary depending on the incident size. C. Evaluate SAFD resources and their location(s). 1. Is this more of a (1) medical emergency or (2) fire suppression emergency? 2. Assign a Chief Officer or senior Company Officer (with ballistic gear) to the FCP/ LE IC. 3. Assign a Medical Branch and assign resources. 4. Consider exposures and develop a protection plan. These scenes can have a large geographic footprint and will often require divisions. Clearly identify divisions, assign division supervisors and allocate division resources. 5. Brief SAFD personnel and update as needed. 6. Develop a Fire Suppression Plan as needed. 7. Develop a Medical Plan as needed. 8. Evaluate the need for Rehab for long incidents. D. Fire Suppression Plan. 1. We will not fight fire inside a Hot Zone. The Med Cat is the only exception. 2. Verify that Law Enforcement personnel are positioned to protect SAFD personnel in the Warm and Cold zones. 3. If we will use the Med Cat, assign an experienced Company Officer to the vehicle to direct fire suppression operations if deployed to the Hot Zone. Assign a supplied engine to support the Med Cat. A second engine may be needed for a hose lay exceeding 400 feet. 4. Hold a briefing for LE, Medical Group, Med Cat crew and their supporting Engine on Med Cat objectives. Brief all personnel on the Med Cat approach, Med Cat assignment, and the emergency exit plan. 5. Assign fire personnel as needed to protect fire exposures. Consider deploying aerial master stream(s) out of the direct line of fire on other streets. 6. Prepare to rapidly implement the fire suppression plan once Law Enforcement declares the Scene Secure. 7. Due to the geographic footprint, multiple divisions may be required, and each division may need its own Division/Group Supervisor (DGS), Medical and Fire Suppression resources and Rehab capability. 8. Consider using an SAFD drone or requesting SAPD Eagle to spot. E. Medical Plan. 1. Develop a plan with the Medical Branch, Division supervisors, Law Enforcement, MOF and MSOU. 2. Medical Branch will coordinate with Dispatch on needed hospital capacity. 3. If the Med Cat will be used for Hot Zone entry hold a briefing with LE, Medical Group and the Med Cat on objectives. 4. Establish an Ambulance Exchange Point as needed. 5. Evaluate the need for Helicopter transport and LZ location(s). SAN ANTONIO FIRE DEPARTMENT Page 8 of 9 Combined Active Threat & Med-Cat Incident SOG #2003 09. MED CAT GUIDELINE: A. The Med Cat Operations in the Hot Zone: 1. Fire Suppression. The Med Cat nozzle is capable of flowing over 350 gpm and the nozzle can be safely operated from within the unit. a) If fire suppression is needed, the Incident Commander must designate an experienced Fire Officer to join the crew of the Med Cat to direct the fire stream deployment. The nozzle can rotate 90 degrees to either side of the front. b) The crew will add 1-2 Law Enforcement Officers for force protection resulting in a four- person crew. c) There is no water tank or pump on the Med Cat so the vehicle will require a dedicated, supplied fire engine to support hydraulic operations. The supplied engine will provide 3- inch hose that the Med Cat will forward lay into the Hot Zone. If more than 400 ft may be needed a second engine should be positioned near the first engine to utilize its bed. d) Once spotted in the Hot Zone, the Med Cat will inform the supply engine and request the fire engine to pump the dry line. The initial pressure should be 180 psi for 400 ft. The engine will flow water and shut down when requested by the Med Cat. 2. Patient rescue. When there are patients that require rescue from inside the Hot Zone, the Med Cat is an ideal apparatus. a) Two MSOU personnel will join the crew. b) One law enforcement officer will join for force protection- ideally a Tactical Medic or SWAT Officer. This results in a five-person crew. c) MSOU personnel will direct the Driver to position for best advantage. Once positioned, only the MSOU personnel will exit the Med Cat to rescue the patient. The law enforcement officer and Driver/ Operators will remain in the vehicle. d) The Med Cat will then proceed to the Ambulance Exchange Point to transfer the patient(s) to another ambulance. B. Med Cat activation should come in one of two ways: Upcoming (planned) incident – The on duty FSC or MSC receiving the request will coordinate for the event and make the necessary notifications to Fire and EMS Operations as well as the Domestic Preparedness Chief. These incidents can be a high-risk public event, a VIP visit, a law enforcement event with higher risk, etc. Active incident unfolding- (such as an Active Threat incident in an open area) the Med Cat can be requested by the on-scene IC, FSC, or Dispatch based on the incident information. In this situation, trained Driver/ Operators closest to FS01 will take the vehicle directly to the incident for operations. If personnel from FS01 are out, Dispatch will tone out the nearest Med Cat Driver/ Operators. C. FSC Responsibilities: 1. Maintain the Med Cat Driver/ Operator deployment roster at the FSC Office. Qualified personnel are also identified in TeleStaff under the “Med CAT On Duty” roster. 2. FSC will call the appropriate FFs and notify them of the activation. If the FSC is unable to perform this notification the Communications Supervisor can assist. 3. For upcoming events the FSC will then send an email to the following personnel: SAN ANTONIO FIRE DEPARTMENT Page 9 of 9 Combined Active Threat & Med-Cat Incident SOG #2003 a. Fire Med Cat email address. b. The two assigned FFs; c. The two affected BCs (ex: BC1-B, BC4-B); d. The two affected fire stations (ex: FS04-B and FS47-B); e. The affected FSC. *In the email the FSC should provide a brief description of the deployment such as, “Med Cat will be activated on the B Shift July 30th from 1200-1800. The Med Cat will report to (location) and report to (position). FF ____ from E04 and FF ___ from E47 have been confirmed.” D. Med Cat Driver/ Operator Responsibilities No one may drive the Med Cat unless he/ she has successfully completed the SAFD training program. Personnel qualified will be indicated in their TeleStaff profile with “MedCAT” and on duty personnel can be found with a “MedCAT On Duty” roster view. To Drive/ Operate the Med Cat there must be a minimum of two people inside the vehicle at all times. This includes maintenance personnel who may need to drive the vehicle. Once inside the Med Cat, personnel must secure all doors. There are two checklists FFs will use (one for activation and one for demobilization). The Med Cat is located at the SAFD Warehouse at Cherry Street, and the keys are in a medical vault at FS01. When FFs are activated, they should report to FS01, pick up the Med Cat at the Warehouse, proceed to the incident location and report to IC. We will remain with three personnel at the FF’s home company for the duration of the Med Cat incident just as we do when using MACs and BTs. Higher Class (HC) will be assigned for the duration of the incident and the two FFs will evenly divide the HC. Each FF will notify his/her respective BCs when they return to their home station and the BCs will enter the appropriate HC (in the notes indicate “Med Cat deployment”). E. Fire Dispatch Responsibilities 1. If the Med Cat is requested for an ongoing incident by an IC or the FSC, Dispatch will alert FS01 and add the Med Cat to an incident. 2. If the personnel at FS01 are on another response or there are not two Operators available, Dispatch will locate other Driver/Operators using the “MedCAT On Duty” roster view on TeleStaff. The closest available personnel to Cherry Street warehouse will be alerted and their assigned apparatus will take them Code 3 to the warehouse. When two Operators are available, they will take the Med Cat to the scene. 3. When the IC requests to relieve Driver/Operators at an extended scene, Dispatch will identify two new Driver/Operators using the “MedCAT On Duty” roster. Dispatch will notify the station(s) and the Driver/Operators will then await transport to the scene. A Squad will be dispatched to pick personnel up, take them to the scene and then return off-going Operators. 10. REVISIONS AND CONFLICTS: A. This Standard Operating Guideline (SOG) replaces both the Active Shooter Guideline, as well as combines additional subjects consisting of Active Threat, and Med Cat Operations, into a single SOG. This will be subject to revisions as needed to ensure consistent and professional operations. Where prior correspondence conflicts, this guide shall supersede.