Emergency response often falls into distinct categories that naturally designate a situational lead based on the circumstances. For example, the fire department will typically take the lead when responding to a house fire, the police force generally is placed in command during an assault, and overdoses or mental health emergency responses are often led by the paramedics. 

Police are under significant pressure with the rise of mass casualty and active shooter incidents. Combatting an increase in both violence and public visibility, these first responders are expected to quickly secure a scene with minimal harm to bystanders. This response is expected to happen on an extremely quick timetable. In situations such as active shooters, police must move beyond neighborhood peace-keeping to act as tactical responders and disaster experts. 

Mass casualty incidents perpetrated by active shooters are showing a disturbing upward trend. Statistics from 2009 to 2018 illustrate an increase in the number and severity of active shooter incidents.

Emergency responders don't get to pick the location of an accident. One call may be in a first-floor ranch home with level sidewalks, while the next is on the side of a 5-lane highway. Another call may involve an active shooter, a fire response, or a fall off a bridge. EMS workers need to be ready for any event, where quick-thinking and adaptation are key to survival.

Active shooter events are on the rise. This is not a minor increase, but a drastic escalation. FBI data shows 35 incidents over a 5 year period from 2000 to 2005, yet 2017 alone accounts for 30 active shooter incidents in a single year. And the number of casualties has skyrocketed even higher. 2005 experienced 51 active shooter casualties, 2016 experienced 214, and 2017 saw a staggering 729 casualties from this violence. 

First responders such as EMS personnel, firefighters and law enforcement officers often deal with disturbing scenes when attending to accident victims, fires and violent crime. Although trained to deal with trauma, these tragedies inevitably affect you, especially in the aftermath when you start to process your feelings. Many people experience feelings of anger, helplessness, anxiety and guilt from what they have seen and their perceived inability to adequately help. Additionally, a significant percentage develop Post Traumatic Stress Disorder (PTSD), a condition that's debilitating and difficult to treat. To compound the issue, few EMS services cover treatment costs, time off and workman's compensation for PTSD. Fortunately, this antiquated view is changing and numerous states have, or are enacting, legalization providing workman's compensation for PTSD.

Resuscitation is required whenever a patient is unable to breath or their heart stops beating. This may be due to a medical condition such as a heart attack or a result of trauma caused by an accident. While cardiopulmonary resuscitation (CPR) is essential, hypothermia may occur, especially in instances of trauma, and exacerbate the patient's condition, leading to long term complications and even death. EMS personnel need to be cognizant of this risk, and if there's any indication of hypothermia, take immediate steps to warm the patient.

Many EMS services report difficulties attracting and retaining EMTs and paramedics. The rate of attrition varies across services, but there are several common factors including emotional and physical wellbeing. These factors contribute towards high voluntary EMS turnover.

 Winter brings a thrilling, brisk feeling with a chill in the air and fresh coatings of snow and ice. Skiers rejoice as untouched white powder begins to coat the slopes and children dream of new snow creations, while daily commuters start to break out the shovel. Winter can mean different things to different people, but to emergency service personnel it will always mean a new round of winter accidents and new challenges in winter emergency care.

The annual flu season is just around the corner and as an EMT or paramedic you are more than likely to come in contact with someone who has the flu. This is especially true considering information released by the CDC shows a gradual increase that indicates the 2018-2019 season is almost upon us. It's time to get your flu shot if you haven't already done so, since you are the first line of infection prevention.