Anthony is the clinical manager for the Texas / California Division of PHI Air Medical where he helps manage the care provided to over 5000 critically ill and injured patients transported each year by 150 medical staff members stationed at 17 HEMS bases. Additionally, Anthony is an Acute Care Nurse Practitioner, providing emergency / critical care and resuscitation services in the busy urban emergency department of a major trauma, stroke, and chest pain hospital. When not practicing clinically, Anthony serves his community as a law enforcement officer in the patrol division of a North Texas Municipal Police Department. Anthony has a passion for learning and teaching about the provision of clinical medicine in crisis.

Tactical Medicine in Response to the Active Shooter

Real violence: Prehospital medical management of the millimeters and milliseconds that determine active shooter outcomes.
Cops and robbers, cowboy and Indians, and military movies have filled the minds of generations of healthcare providers with a vision of what gun fights and combat look like. Unfortunately, real violence looks nothing like any of these. As emergency and critical care providers, we forge additional perspectives as we care for the victims of violence. Yet, views of violence aftermath only scratch the surface of first-hand experience during the brutal, scary, gritty, and dirty realities of real world in-progress violence. It is horrible, and It is quick… really quick. In this focused discussion, we will talk about prehospital critical care team response to the mass shooting. We will explore how emotional and physiological barriers run amok making the simplest logistical and clinical decisions extremely difficult. We will discuss the importance of staying” left of bang”, incident recognition, initial confusion, and the critical nature of incident acceptance. Next we will review staff and patient safety priorities and basic concepts of tactical combat casualty care (TCCC). Finally, we will conclude with thoughts about your role as care provider when on duty as part of a pre-formed team, and what to do if off duty facing an active shooter. Today is the day to ponder actions you must take the moment an active shooter begins taking lives at an astonishing rate; THAT moment when the choices you make next will be the most important of your career. The choices you make today will affect the milliseconds and millimeters that determine survival… patient survival, your survival, and the survival of those waiting at home for you to walk back through the door.

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