Active Shooter In NS. April 19 2020

[mariomike]

The RCMP are not a transparent organization and they resist attempts to turn into one.

Not all emergency services are.

"Never, ever, admit the department has done anything wrong."

Not to suggest there is any liability in this incident.

 

[Jarnhamar]

Just to touch back on the 'Fitbit' discussion, I was talking to a former colleague who's spouse dropped dead in their house. She started CPR until relieved by fire/rescue and paramedics who also deployed a defibrillator. His Fitbit recorded recorded something as a pulse - yet somehow missed these external and electrical interventions - right up until it was removed from his wrist at the morgue.

Good example of the FitBit not being reliable to monitor a pulse. I believe it.

The Const. Ian Fahie on the scene also suggested that

O’Brien had a pulse but was left to die because she was mortally wounded and had no chance of surviving.

Perhaps she wasn't left to die for 8 hours as the family argues but the RCMP officer told the commission she had a pulse and was left to die.

 

[Jarnhamar]

Not all emergency services are.

"Never, ever, admit the department has done anything wrong."

Not to suggest there is any liability in this incident.

You're saying paramedics bury their mistakes. I see.

 

[Booter]

You're saying paramedics bury their mistakes. I see.

It is common. Right in manuals for things like collisions it says directly- admit no fault.

I have always done so where it’s been my fault. Because I don’t GAF. I do what’s right- but it is in the manuals.

 

[mariomike]

I don’t GAF.

I didn't know many who did. Wasn't coming out of their pocket.

A little remedial training, and back in service.

Not to suggest there is any liability in this incident.

 

[Eye In The Sky]

Perhaps she wasn't left to die for 8 hours as the family argues but the RCMP officer told the commission she had a pulse and was left to die.

Question for the LEO/EMS folks:

Is that a possible COA; to determine a casualty is so badly wounded they cannot be saved? Who can make that call on site legally?

I’ve heard of it happening before in NS; CAF mbr severely wounded in a motorcycle crash - EMS arrived and didn’t try to transport member as death was imminent. Casualty expired on the crash site very very shortly after.

 

[mariomike]

Question for the LEO/EMS folks:

Is that a possible COA; to determine a casualty is so badly wounded they cannot be saved? Who can make that call on site legally?

I’ve heard of it happening before in NS; CAF mbr severely wounded in a motorcycle crash - EMS arrived and didn’t try to transport member as death was imminent. Casualty expired on the crash site very very shortly after.

Don't know about Nova Scotia. But, unless they were transected, decapitated or decomposed, my partner and I took them all.

"Just going for check-up."

Drew a chalk outline if it was a public place. Even if Obviously Dead, leaving a body in a public place used to be a big no no. Now they do.

The question was, "What are we going to say at the coroner's inquest if we are wrong?". We didn't go to medical school.

Response times were never great. "When seconds count, we're 15 minutes away.", as the old saying went.

I heard that a third of our GSW and stabbing victims arrived at the hospital in private cars, rather than wait. No first-aid.

Don't know how true that is, but I can believe it.

Hope that helps.

 

[brihard]

Question for the LEO/EMS folks:

Is that a possible COA; to determine a casualty is so badly wounded they cannot be saved? Who can make that call on site legally?

I’ve heard of it happening before in NS; CAF mbr severely wounded in a motorcycle crash - EMS arrived and didn’t try to transport member as death was imminent. Casualty expired on the crash site very very shortly after.

I cannot conceive of a situation where we don’t call for paramedics or whatever is available. Doesn’t mean help necessarily arrives.

Tactical situation may preclude paramedics from entering the scene. Remoteness may mean there simply aren’t any.

 

[Eye In The Sky]

So legally there is no “must treat and transport/only Dr can pronounce deceased”?

 

[Booter]

Question for the LEO/EMS folks:

Is that a possible COA; to determine a casualty is so badly wounded they cannot be saved? Who can make that call on site legally?

I’ve heard of it happening before in NS; CAF mbr severely wounded in a motorcycle crash - EMS arrived and didn’t try to transport member as death was imminent. Casualty expired on the crash site very very shortly after.

There wouldn’t be something in place like that per say. The actual medical finding isn’t made by them. But their training would tell them that while that place and shooter aren’t secure that they can’t really do anything beyond assisting that casualty in self aid while securing the area-
If they are beyond self aid and ems wont retrieve them they aren’t really in a position to assist.

A few years ago they used to refer to this as “triage black” and you can’t be helping them with cpr and ventilation.

That’s beyond the ones that are “obviously deceased”.

It changes province to province- but in some places an EMS crew under the direction of a physician can do it. Or places I ve been where I was the only person on the tundra with a doc on sat phone.

The big thing there is they assessed and had nothing to offer, the scene was active and they couldn’t just spend the time on aid- so they made a call. A call that would have been discussed in their active shooter training- the need to step over and beyond casualties that need medical in order to accomplish the first priority.

What rural EMS protocol in the county looks like who knows. They may not even be a service with REAL trauma certifications. I run into those quite often in rural.

 

[Eye In The Sky]

Tks. Helps me understand the situation the officers and EMS faced. Those calls must be hard to make on the spot and harder afterwards “at 3am on replays”.

 

[mariomike]

So legally there is no “must treat and transport/only Dr can pronounce deceased”?

In our jurisdiction, ALS paramedics are permitted to contact the base hospital emergency physician for instructions regarding patient management or pronouncement of death. Ontario legislation permits ALS and BLS crews to pronounce death only in the presence of rigor mortis, lividity, decomposition, or decapitation.

 

[Eye In The Sky]

Tks for the info!

 

[Booter]

In our jurisdiction, ALS paramedics are permitted to contact the base hospital emergency physician for instructions regarding patient management or pronouncement of death. Ontario legislation permits ALS and BLS crews to pronounce death only in the presence of rigor mortis, lividity, decomposition, or decapitation.

Pure complete speculation- but it may well be that EMS staging spoke with RCMP on scene and they made some determinations on care together remotely. Which wouldn’t be crazy.

 

[Booter]

Pure complete speculation- but it may well be that EMS staging spoke with RCMP on scene and they made some determinations on care together remotely. Which wouldn’t be crazy.

I REALLY feel for those members. That’s the last conversation I would want on my mind. Questions need answering but my goodness that would torture a person.

 

[Fishbone Jones]

I always understood that you did CPR, if possible, until rescue showed. It not about saving the life, it's about keeping the blood circulating so they can harvest the organs. Which to me, just makes so much sense.

 

[Eye In The Sky]

I REALLY feel for those members. That’s the last conversation I would want on my mind. Questions need answering but my goodness that would torture a person.

They might be made disconnected of emotion at the raw time, but they must be a absolutely haunting later on.

 

[Bruce Monkhouse]

I always understood that you did CPR, if possible, until rescue showed. It not about saving the life, it's about keeping the blood circulating so they can harvest the organs. Which to me, just makes so much sense.

We had a sudden death, weight bench claw through an inmates head, and even though the family wanted to donate his organs they could not because of required inquests/ autopsies.

 

[Booter]

I always understood that you did CPR, if possible, until rescue showed. It not about saving the life, it's about keeping the blood circulating so they can harvest the organs. Which to me, just makes so much sense.

That’s normal first aid protocol- call for help. Do cpr. Get help- cpr continues. Others take over until whatever local protocol for declaring people exists.

But In these events- there is no real medical care until things are secure. What “secure” means and how “active” an event is- is REALLY where the conversation should be.

And that would have to be answered by the NCOs and incident commanders, not the guy with the rifle.

Which is so far not anything I’m hearing about.

Consider:

My officers are called to a murder. There’s the deceased and another person dying, they sweep the house and secure it before rendering aid to the seriously hurt person while ems attends,

My bad guys had squirt out a window and steal a car, the car is causing damage and mayhem,

I have so many officers- some are involved in the pursuit, some are managing the event, some are rendering aid.

at a certain point, in isolated places I have to start breaking them into teams.

In my sheets managing the incident, the moment I am changing phases of the operation I am recording times and how I made the decision- in this scenario my event is “hot” while I’m pursuing my suspects- but the initial scene is secure, I couldn’t justify not Rendering aid because somewhere the guy is still on the loose, so I can have a hot event and scenes that are no longer REALLY in danger.

So the real meat of the decision making is not on the front line- it’s on those people managing events across those multiple kms. What were they setting as priorities- what was communicated to the officers. What contingencies were being built during this time?

Not cst smith standing on the ashes- what was being communicated higher than them. In a real sense the guys in these stories- while their recollections are interesting, they aren’t really valuable- in the sense of making changes and identifying shortcomings.

And it may well be those coordinating things did a good job. Who knows- I don’t. Because the inquiry, so far, has a really “low” perspective in my opinion.

Maybe it’s going to move up.

When I lecture on some of these concepts I always speak about “hasty response”.

When an initial disaster happens there is the initial hasty response, it’s that finger in the dam response that buys you some clarity while you plan an organized action.

The hasty response phase lasts longer the larger and more complicated the event, the less familiar people are with the subject matter, and the speed that the decision makers orient themselves to the event.

Somethings this large and without precedent would have had this really long hasty phase where processes that didn’t exist had to be created to cope with the event.

The end of that hasty phase is what I’m watching for. But in my incredibly shallow
Understanding of the event- I can’t identify where new conflicting events stopped emerging and the commanders could have had some
Clarity emerge to move into the phase where all the processes of your response are communicating and engaging in an organized fashion.

Im sure it’s there. Just hasn’t jumped out at me yet.

I think that is why I am empathetic to the officers trying to explain themselves. Because their individual actions are not where i suspect the failings are,

 

[lenaitch]

In our jurisdiction, ALS paramedics are permitted to contact the base hospital emergency physician for instructions regarding patient management or pronouncement of death. Ontario legislation permits ALS and BLS crews to pronounce death only in the presence of rigor mortis, lividity, decomposition, or decapitation.

No doubt things are more structured now, and everybody is more liability conscious, but 'back in the day', 50 miles down the highway from a small town hospital, we used common sense and experience to tell us that a guy embedded in the grill of a Kenworth, or a bush worker who fell on his chainsaw probably warranted the coroner attending.