EPD trains for mass casualty incident

MARCH.

For Evanston police officers, remembering the word MARCH could help save a life … maybe even their own.

Between today and tomorrow, all 130 or so members of the Evanston Police Department are training at Evanston Township High School, using the facility to practice responding to an active shooter, something ETHS has never seen … but police have to be ready.

Of course, part of the training deals with how to enter the building, locate the suspect, and bring the incident to an end.

“Officers first have to stop the killing,” said Cmdr. Ryan Glew.

“Then they have to stop the dying.”

That’s because in an actual situation, responders would find people who have been shot and seriously wounded, perhaps even a fellow officer.

That’s where fast but effective intervention for the victim is critical.

“My job is not to fix all of his problems,” said Officer Greg Romero, a trainer, as he explained techniques on applying tourniquets and chest seal bandages, and how to move a wounded victim.

“My job is to keep him alive long enough to get him to the E-R.”

Thats where MARCH comes in, a mental checklist to help quickly assess the victim, and then decide what to do.

M stands for “massive bleeding,” which may not be as obvious as you might think. The officer might have to gently reach underneath the victim, to see if blood is pooling.

A is for “airway.” Is it blocked?

R stands for “respiration,” related to but not the same as airway. In this case, as the other trainer Officer Nathan Basner explained, respiration means “is the victim’s breathing adequate to sustain life?”

C is “circulation. Does the victim have enough blood, and how can you tell if that’s the case (“pale and clammy skin, raccoon eyes”).

H has two meanings, “head injury” and “hypothermia.”

As odd as it seems, head injuries might not be easy to spot, as those injuries could be internal.

Brusing around the eyes, and visible yellow spinal fluid are clues.

There’s not too much a police officer can do for head injuries … just tell the medics “he needs to get out of here ASAP.”

For the other H, “hypothermia.” The officer’s responder pack contains a silver rescue blanket, to place on the victim.

“That blanket reflects the victim’s body heat back into him,” Basler explained.

Each patrol car contains a Go Kit, with rescue supplies such as the chest bandage, gloves and PPE such as masks hemostatic gauze, and a “mega-mover” (basically a canvas stretcher).

Proper placement on the mega-mover was reviewed and practiced.

“It doesn’t have to be pretty,” said Romero.

“We just have to get him out of here.”

One other critical piece of equipment in the Go Bag is, of course, the tourniquet, used to stop bleeding.

Besides applying it to a civilian victim, or another officer, responding police might have to apply a tourniquet to themselves, if they are hit by a bullet … and do it using just one arm … quickly.

“You can lose consciousness in 40 seconds in a massive arterial bleed,” explained Romero, who, besides being a police officer, is also a trained emergency medical technician.

So speed and almost mechanical muscle memory are vital.

“When my adrenaline is at 10, my motor skills are at zero,” Romero said.

That’s why it’s critical to store the tourniquet so it can be unfolded quickly. Too much time could kill you.

The tourniquet also has a tab where, if possible, the responding officer should write down the time when the band was applied.

E-R doctors want to know that, because if the arm or leg has been constricted by a tourniquet for a long time, clots could build up, potentially causing a heart attack when the wrap is taken off.

If they know when the tourniquet was applied, doctors might need to give the victim specific medication first, to make removal safer.

And while writing down the time on the tourniquet itself may be challenging to say the least (perhaps the tab is covered with blood), Romero said the responding officer could write the time on the back of his/her hand, or on the forehead.

Every little bit of information helps.

While firefighters are the specific medical responders for every type of emergency, in some cases the police will get there first. And if there’s a shooter, the paramedics will have to wait until the scene is safe.

The police can’t wait.

“You may be the first one in the door,” said Basner.

This type of training is not new. It’s just getting emphasized more, to become “engrained in our organizational structure,” said Glew.

And despite all the media attention given to mass casualty shootings, the same type of medical response training can be applied to all sorts of incidents, from storm-related building collapses, to fires and to hazmat chemical releases.

And it can also be critical for police responses on the street.

Seven years ago, Evanston Officer William Arzuaga applied a tourniquet to the leg of a 17-year-old, who had been shot on Jackson Avenue.

“The E-R commented,” said Glew, that “if it had not been for the tourniquet, the individual would have bled out.”