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UM medical teams teach new ways to respond to mass shootings

With police typically the first responders at a mass shooting, new tactics are being taught to give them the training they need to save lives in the immediate aftermath of horrific, and increasingly more common, events like Parkland and Pulse.

A key is sending emergency medical technicians, firefighters and other medically trained people in with police officers, who are usually still trying to assess and eliminate the threat.

“This new method allows fire rescue to be embedded with law enforcement so lifesaving care can get to the victims quicker versus waiting until the scene is 100 percent secured,” said Al Brotons, director of operations for the University of Miami’s Gordon Center for Research in Medical Education’s Section of Tactical Emergency Medicine.

On Tuesday, instructors from the Gordon Center went to the Florida Keys to train members of Monroe Fire Rescue, Islamorada Fire Rescue and the Key Largo Volunteer Fire Department to work with law enforcement during live drills inside the old Plantation Key School.

The firefighters and medics trained alongside Monroe County sheriff’s deputies, officers with the Florida Fish and Wildlife Conservation Commission, U.S. Border Patrol agents and members of the Coast Guard.

“We’re all going to have to play in the same sandbox,” said Islamorada Fire Rescue Chief Terry Abel. “We have to know every strength and every weakness so if the time does come, we can all play together.”

Florida Keys firefighters and a member of the U.S. Coast Guard take part in an active shooter drill inside Plantation Key School Wednesday, Jan. 16, 2019. David Goodhue/

The scenario Tuesday afternoon was a shooter inside a school who wounded and killed several people before shooting himself.

With police and firefighters, also taking part in the training were volunteers who portrayed the wounded. To make the scenes look and feel realistic, the Gordon Center instructors applied makeup to the volunteers, a process known as moulage, that simulated gunshot wounds to the limbs, torso and head.

Using real people “adds a certain emotional component, a human component, and a level of reality” for the law enforcement officers and first responders training to treat gunshot victims, said Dr. S. Barry Issenberg, director of the Gordon Center.

The drill consisted of two parts. The first was a walk-through where the trainees were accompanied by instructors correcting them through the process, and there were fewer victims.

A Monroe County Sheriff’s Office deputy, a U.S. Border Patrol agent and a U.S. Coast Guard member conduct an active shooter drill inside Plantation Key School on Wednesday, Jan. 16, 2019. The exercise was organized by the University of Miami Gordon Center for Research in Medical Education. David Goodhue/

The second part was more intense with more patients. Each lasted about 30 minutes, but because of the gravity of the scenario, “it feels more like four hours,” said Capt. Steven Carter, who serves with Sunrise Fire Rescue and is also assistant director of operations with the Tactical Emergency Medicine section.

Earlier in the day, the law enforcement officers and the firefighters trained together in Islamorada and “as teams in both the tactical aspects of how to approach an active shooter event for public safety as well as the medical response,” Issenberg said.

“For many of those in law enforcement, this will be the first time they’ve used a tourniquet or put on a pressure dressing,” Issenberg said. “Typically, we’ve only trained specialty law enforcement officers or those associated with SWAT. But, we’ve seen more and more in these recent events that it’s often law enforcement officers who are there providing the first care, who happen to have these medical supplies with them.”

Bernie Montoya, a core instructor with the University of Miami’s Gordon Center for Research in Medical Education, applies a makeup wound to Andy Rivers, of Islamorada, who volunteered to act as one of several wounded victims during an active shooter drill at Plantation Key School Wednesday, Jan. 16, 2019. David Goodhue/

The training program is paid for by a grant from the Florida Department of Education, which demonstrates a new reality where public money usually designated for learning is being spent to mitigate mass casualty events at schools.

“Unfortunately, active shooter events have become more prevalent in our communities, and the need to prepare and and train for such events is critical,” said state Rep. Holly Raschein, R-Key Largo, who observed the drill. “Our children’s safety while they are in school is of paramount importance, and previous incidents have shown us that improved coordination and communication between first responders is required to save lives.”

A Florida Fish and Wildlife Conservation Commission officer leads a group of firefighters and medics through the halls of Plantation Key School Wednesday, Jan. 16, 2019, during an active shooter drill conducted by the University of Miami’s Gordon Center for Research in Medical Education. David Goodhue/

As mass shootings become more frequent, police, firefighters and medics, as well as doctors and nurses, are realizing that the lessons of modern combat medicine learned in foreign theaters of war are increasingly becoming more useful in civilian life. Issenberg said the Gordon Center has developed a relationship with the U.S. Army’s Trauma Training Center.

The Army sends surgical teams who will be deployed to forward combat areas to the University of Miami and Jackson Memorial Hospital to train with doctors there before they are sent overseas, Issenberg said. And likewise, returning Army doctors, nurses and medics have come home with new knowledge that can be applied here.

“Some of the lessons that they brought back about how to respond to a hostile event both on the tactical and medical side, are now being applied in the civilian world,” Issenberg said.

David Goodhue covers the Florida Keys and South Florida for and the Miami Herald. Before joining the Herald, he covered Congress, the Environmental Protection Agency and the Department of Energy in Washington, D.C. He is a graduate of the University of Delaware.