According to this article by the Insurance Information Institute, the number of yearly natural catastrophes in the United States has doubled from 27 to 55 from 2009 to 2018. In 2018 alone, the FBI designated 27 shooting incidents in 16 states as active shooter incidents, resulting in 213 casualties and 85 deaths. These figures may be harrowing, but as this article indicates, they paint a clear picture: natural and man-made disasters are increasing in frequency and intensity.

People often look upon first responders as heroic. They rush towards danger when other people might run away. And the physical demands of being a first responder are undeniable. First responders are in charge of patient maneuvering debris, breaking down barriers, and patient transport. There's even a type of "carry" named after the fireman. 

Everyday Emergency Medical Services (EMS) responders provide an important service in treating and transporting patients with minor injuries up to serious, life-threatening conditions. While highly trained and skilled, neither the Emergency Medical Technician (EMT), nor the Paramedic was ever meant to be an expert in mass casualty incidents such as an active shooter event. Just as police units have regular patrol and also SWAT, medical responders also need specialized response teams. 

Rescue Task Forces (RTF) were created to respond to the immediate need of first responders for a more coordinated and streamlined response to mass casualty incidents, such as mass shootings. When multiple emergency response units are on a scene at the same time, coordination is key to ensuring both patient and provider health. RTFs provide this coordination along with preplanned protocols to promote optimal outcomes. While RTFs have greatly improved mass casualty response, they are not without some challenges.

Active shooters want to cause chaos. This chaos quickly spreads beyond victims and bystanders and can affect first responders too. When the key to saving lives is a fast response, there is no time to stop and wonder who is in charge. This need is why Rescue Task Forces were created, to streamline responses, coordinate multiple groups and facilitate faster care and treatment of victims.

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. 

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.

 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.