PER-260 Terrorists attacked morning commuters at a subway stop, first spraying them with an unknown chemical and then shooting them as they fled, causing mass panic in the crowded station. Moments later, the police receive a report that a suicide bomber has detonated, causing more injuries.

The hospital was quickly overwhelmed with chemically contaminated patients suffering from gunshot and shrapnel wounds. An already horrendous situation got worse. Gun shots rang out inside the hospital. Active shooters were on the hospital’s the second floor, indiscriminately shooting staff and patients. The staff rushed to evacuate the hospital as police officers rushed in, searching for the active shooters.

It’s a nightmare situation that could happen in any community. The question is, is your community prepared to respond? The Center for Domestic Preparedness partnered with the Federal Law Enforcement Training Center to train state, local, tribal and territorial (SLTT) responders and receivers on skills that will specifically help them in such a situation and many others they may encounter during a natural or manmade disaster.

During the week of July 27, the CDP taught the Healthcare Leadership for Mass Casualty Incidents (HCL), Hospital Emergency Response Training for Mass Casualty Incidents (HERT) and Law Enforcement Response Actions (LERA) courses. During the same timeframe, one of the National Disaster Medical System’s (NDMS) Disaster Medical Assistance Teams (DMAT) was conducting their own training at the CDP. But, for the first time, the Federal Law Enforcement Training Center (FLETC) joined. FLETC brought their instructors from Glynco, Ga. And Cheltenham, Md. to teach two of their signature SLTT courses: The Active Shooter Threat Training Program and the Basic Tactical Medical Training Program.

The Law Enforcement Response Actions, Active Shooter Threat Training Program, and Basic Tactical Medical Training Program courses are all law enforcement centric with different specialties to protect public safety to include locating and eliminating an active threat, providing tactical medical care in austere conditions and performing law enforcement duties in a hazardous material contaminated environment, explained Chuck Medley, the CDP’s Assistant Director for Training Delivery. HCL provides students the knowledge and skills to effectively manage hospital operations during a mass casualty incident, to include patient surge, staffing, facility utilization and public information. HERT prepares students to don and doff Personal Protective Equipment and perform triage, decontamination, surveying and monitoring and tracking and treatment of patients. The HERT operates directly outside the hospital, preventing possible hospital contamination; however, has the capability to move to other locations to assist in decontamination operations. NDMS delivers the personnel, resources and equipment to establish and operate an alternate care site, providing medical support and care to survivors as appropriate. Additionally, the NDMS can support hospital decompression missions along with sheltering and care of special needs populations, Medley explained.

But, the training didn’t stop there. After spending several days in their respective classes throughout the week, the students all came together to test what they had learned, Friday, during the Integrated Capstone Event (ICE). The ICE is a culminating, hands-on exercise that promotes an interdisciplinary response to a mass casualty incident. The CDP uses realistic training venues, such as a four-car subway setting and a city street scene in its Advanced Responder Training Complex and a former U.S. Army hospital, the Noble Training Facility, the only hospital facility in the United States dedicated solely to training hospital and healthcare professionals in disaster preparedness and response. More than 50 role players added even more realism to the exercise, taking on the parts of the active shooters, incident survivors, elected officials and family members looking for loved ones.

For this ICE, the students were responding to the aforementioned domestic terror attack in the subway and a suicide bomber topped off with an active shooter that forced the evacuation of the hospital.

“The training partnership between CDP and FLETC provided unique opportunities to jointly train at a hospital - the Noble Training Facility,” said Dominick Braccio, FLETC’s Assistant Director of the Regional and International Training Directorate. “Because of their 24-hour operations, hospitals are not normally readily available as immersive training environments. By integrating complex scenarios, such as adding chemical agents and by making the hospital the scene of an active shooter, police officers become prepared to deal with different types of hot zones and learn how to operate successfully when called to action as a tragedy unfolds.”

While Noble provides the unique setting, the ICE provides the culminating event, both in terms of the actions and the responders’ roles, Medley said.

“What we try to do at every ICE is put the pieces together,” Medley explained. “Most disciplines are used to training on their own. At the ICE, we bring those disciplines together, the same way they respond to an incident together. It adds realism to what they are doing and gives them a better perspective of how other disciplines – Fire, EMTs, Law Enforcement, whoever, are all part of that response.”

“Adding in FLETC’s training and NDMS’s medical personnel takes that training to the next level,” Medley explained. “It makes it much more complex, but it also makes it all that much more realistic. That’s what we want, responders to be trained for what they will see and have to deal with during a real active shooter incident, earthquake or whatever the disaster is.”

Medley said the CDP and FLETC trainers started planning the ICE more than eight months ago. The training staffs put in more than a thousand man hours to plan and coordinate the classes and the ICE. Based on the students’ reactions, the hours of preparation paid off.

“This was a great learning experience for all the [response] disciplines involved,” said Deputy Sheriff Donald Smith of the Orange County Sheriff’s Office. Smith took the Active Shooter Threat Training Program. “I learned a lot from the hospital side and the HAZMAT side.”

Smith has attended CDP training before. While working as a bomb technician, he took several of the CDP’s hazardous material technician courses. He is now assigned to the Emergency and Special Response Teams. As such, he trains the new deputies on “movement-to-contact,” the department’s active shooter program.

“I actually have some great take-aways from the instruction I received in the Active Shooter course to take back to my department as lessons learned,” he said. “I also learned some concepts and ideas to better that training in the future.”

Jose Rivera and Brian Newland both took the Basic Tactical Medical Training Program, the other FLETC course offered that week.

“This course put me on my ‘A’ game! It has taken me to a totally new level of law enforcement,” said Jose Rivera, a Senior Police Officer III Class with the Boise (Idaho) Police Department.

Rivera retired from the Los Angeles Police Department where he served as a SWAT team member for 25 years. He is currently assigned to the Boise Airport where he works side-by-side with TSA agents. Rivera took two of the CDP’s Field Force courses earlier this year.

For this course, Rivera trained as the tactical medic, who went in right behind the police officers clearing the scene at an active shooter incident to treat the survivors and any wounded officers.

“This course should be a permanent part of the curriculum. This is what law enforcement needs,” Rivera said. “And you meet new people. Who would have thought Florida and Idaho would work together?” Rivera said referring to his classmate, Newland.

Newland, a firefighter assigned to the Cape Coral (Florida) Fire Department, currently works as a SWAT medic for the Cape Coral Police Department. He also trains the SWAT team and assists in training the police department in first aid.

“This course was outstanding. I couldn’t see more of a need for it right now,” he said. “You can’t turn on the TV without seeing an [active-shooter] incident going on and the first guys standing there are police officers.”

Any time you have an active-shooter situation, until the scene is secured, [medical support] is not coming in,” Newland explained. “These are our frontline guys and they need help right now. By bringing the other officers in and training them, it’s going to save lives.”

Newland spoke of how the police officers were learning to use basic lifesaving tools like compression bandages and tourniquets.

“So, now police officers are going in with the tools they can use to save somebody’s life. In some cases, a person could die from an injury in 90-seconds. But with some basic treatment, you could save that person’s life.

“What we had today, we know is coming,” Newland said, speaking of the ICE scenario. “The last thing you want is to come in and not be prepared.”

Rivera added, “Tactical [medical care] is the wave of the future. This is where law enforcement and firefighters are headed. FEMA and FLETC are so far ahead of the game compared to other agencies.”

The CDP and FLETC have spent the weeks following the training event reviewing the students’ feedback. The Centers are already preparing the next joint training event, which is scheduled for April.

“This was a tremendous training experience,” Medley said. “A lot of people at both the CDP and FLETC worked really hard to bring this training event together. Our goal is to provide realistic training. If this training saves just one life – of a law enforcement officer, an innocent bystander, anyone – then it was all worth it.”

FLETC is the primary provider of basic and advanced law enforcement training to federal law enforcement agencies, as well as a significant contributor to advanced training for state, local, and international law enforcement officers and agents, FLETC trains more than 70,000 law enforcement officers each year. For more information on FLETC training, go to https://www.fletc.gov/.

The CDP operates the Nation’s only toxic chemical agent training facility using nerge agents and biological materials to train civilian responders, as well as the only hospital dedicated solely to training hospital and healthcare professionals in disaster preparedness and response. CDP training for state, local, tribal and territorial responders is fully funded by the Department of Homeland Security to include travel, lodging and meals. For more information or to sign up online, go to http://cdp.dhs.gov.