“We need to prepare for the inevitable. The Center for Domestic Preparedness (CDP) and its staff gave us the best tools to bring materials and best-practices back to Loma Linda, [California],” said Emergency Management Specialist Georgann Smith last June after training at the CDP. At that time, Smith could not have known that she would be putting her training to the test less than six months later.
Located in Anniston, Alabama, the CDP is a Federal Emergency Management Agency training center that provides state, local, tribal and territorial emergency responders specialized, all-hazards preparedness training focused on disasters and mass-casualty response.
As employees gathered for a holiday party December 2, 2015, two shooters opened fire at the Inland Regional Center in San Bernardino, California, leaving 14 dead and 21 others wounded. On that day, CDP training proved to be invaluable for Smith and one of her colleagues, and for a San Bernardino police officer, all of whom were involved in the response to the active-shooter event.
San Bernardino Police Officer Rob Snyder was among the first to respond to the shootings. Snyder had attended several CDP courses, including Initial Law Enforcement Response to Suicide Bomb Attacks and Law Enforcement Response Actions for CBRNE Incidents, during which he received training on providing support to mass-casualty triage operations and prioritizing victims for treatment and evacuation. He had also participated in an Integrated Capstone Event (ICE), a culminating exercise that promotes an interdisciplinary response to an all-hazards, mass-casualty incident. Snyder said those CDP training experiences quickly proved vital to his ability to operate in the challenging environment of the real-world shooting.
“Even though our incident was overwhelming, I felt confident with performing my duties due to my experience at the [CDP],” Snyder said.
Snyder said he arrived at the Inland Regional Center just minutes after the shootings and described the scene as chaotic, with people running from the building while others screamed for help.
Snyder said the glass doors had been shattered by gunfire, the fire alarm was blaring and the sprinkler system was spraying water, having likely been struck by the recent hail of bullets. Snyder proceeded into the building, not knowing if the shooters were still on the premises or if they had fled.
“I walked past several wounded or deceased victims,” he said. “There were hundreds of expended rifle casings on the floor.”
Snyder said the strong odor of gunpowder and smoke filled the conference area as he crossed through to clear other rooms.
“We worked diligently as a team, clearing each of the rooms,” Snyder explained. “When we encountered subjects behind closed doors, we quickly identified them as victims… and gave them directions to exit the building,” he said. Once they had cleared the building, the officers knew the shooters had fled the scene. Snyder later learned that the shooters had left explosive devices in some of the rooms that he had searched.
Though this was the first active-shooter incident to which Snyder had responded, he said he was well-prepared because of the frequent training he received from the San Bernardino Police Department, as well as the training he received at the CDP.
“I noticed a shocking resemblance [in] the training environment provided at the CDP [and] the real-life experience from the Inland Regional Center,” Snyder said, referring to the noise, sight limitations, and physical obstacles he had to negotiate at the scene.
“I felt having to deal with these distractions in [the CDP’s] training environment helped me prepare for the reality of such an event,” Snyder said. “We were unable to duplicate these distractions in our in-house training.”
Once Snyder and the other officers finished clearing the building, Snyder returned to the first-floor conference room where the shootings had taken place. There, additional police officers and fire department personnel were attending to the wounded and deceased victims. Snyder volunteered to report to Loma Linda University Medical Center, one of several trauma centers that received victims from the shootings, where he served as the liaison between the medical center and the officers on the scene, a role for which students train and practice while at the CDP.
“I was able to relay information of the incident to hospital administrators and assist with their decisions on maintaining staffing and readiness for events that were occurring,” Snyder said.
Meanwhile, Smith and fellow CDP graduate, James Parnell, both being Loma Linda University Medical Center staff members, were on duty at the trauma center when notification came in about the shooting just three miles away.
Smith had taken several CDP courses, including Hospital Emergency Response Training for CBRNE Incidents (HERT). Last June, she and more than 100 other healthcare professionals from Southern California took the Healthcare Leadership for Mass Casualty Incidents (HCL) course. In the four-day HCL course, Smith learned how different entities work with each other during a mass-casualty response. The course teaches students how to make informed decisions on topics such as planning, staff and resource management, response, and decontamination in a mass-casualty situation.
Smith said the December 2 active-shooter response was the first time she had ever been involved in an event of this type, but explained that her CDP training helped her and her colleagues better understand their roles during an incident. She said the ICE helped build confidence and trust in her skills.
“The [ICE] helped us perform better and prompted us to examine our own processes when we returned home,” Smith said.
The trauma center’s first notification and response started at 11:10 a.m. Smith said she, Parnell and their colleagues activated the Hospital Incident Command System, set up the emergency department, and established a perimeter and triage area all within 18 minutes, just as the first patient arrived. Within 10 minutes, three more gunshot victims arrived from the Inland Regional Center.
Though, in total, the trauma center received five gunshot victims from the incident, Parnell, the trauma center’s patient care director, said they were expecting to receive 20.
“Our plan was to care for the most critically injured inside in the surgical suites and care for the walking wounded outside in the triage area,” Parnell said.
Loma Linda being a Level 1 trauma center, defined as a medical facility capable of providing total care for every aspect of injury, Parnell said he has responded to several mass-casualty incidents.
“We are used to treating high volumes of high-acuity patients,” he said. “Because we [conduct disasters drills] so often, there was an air of quiet confidence among our staff.”
Parnell had attended the HERT course and the ICE in June 2015. He said his CDP training was particularly beneficial during the December 2 response. The sequence of determining a set-up location, role assignment, triage and communication amongst the staff—skills he practiced during the ICE—all came in handy, he said.
“Because of CDP training, I knew right away what had to be done, how it had to be done and in what order,” Parnell said. “Everything just clicked and went like clockwork. We were fully set-up and ready to receive patients in less than 20 minutes. That would not have been the case if I had not received that training.”
For Snyder, Smith and Parnell, responding to the active-shooter incident and receiving patients from the scene reinforced the value of CDP training, and they all said they want more.
Snyder said he hopes to take the Basic Tactical Medical Training Program during which law enforcement officers learn to treat life-threatening injuries in an austere environment. He said he regularly encourages other officers and his wife, a registered nurse, to take CDP training.
Smith said she plans to train again at the CDP, too.
“As an emergency management specialist, I need to continue to train and develop my skills for communicating and executing a successful program,” Smith said. “[The CDP] is the best place to practice for real-world events. It’s very realistic.”
Parnell said he plans to take the Healthcare Leadership for Mass Casualty Incidents and Framework for Healthcare Emergency Management courses, during which healthcare personnel learn disaster preparedness planning and emergency management for healthcare, among other topics.
When Snyder, Smith and Parnell attended CDP training, they could not have known they would one day respond to the worst active-shooter incident since the 2012 Sandy Hook Elementary School shootings; however, they all said they knew they could depend on their CDP mass-casualty training should they ever need it.
The CDP offers nearly 50 courses for responders from 17 emergency response disciplines. CDP training is fully funded by the Department of Homeland Security, including students’ travel, lodging, and meals. For more information on CDP training, or to register online, go to http://cdp.dhs.gov.