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A Mass Shooting in a Small Texas Town Shows the Importance of a Coordinated, Team-Based Response

What Happened

Sutherland Spring, Texas

In November 2017, a man started shooting outside the First Baptist Church of Sutherland Springs, Texas, and then entered the building. Once inside, he continued his assault and killed 26 people and wounded 20. A neighbor saw what was happening and responded with shots of his own directed at the perpetrator. A 2017 New York Times article shared that the shooter fled in his vehicle to the neighboring county, where he crashed his car and was found dead on the scene.

Local Resources Were Quickly Overwhelmed

At the time, Wilson County had two paid ambulance services and two volunteer services. During this incident, the paid services were staffing one ambulance each, and the volunteers were not staffed. A call was put out to personnel, with enough responding to have 7 ambulances in service. Some ambulances made several round trips between the scene and the hospital. Also, in response to the call for personnel, at least 6 helicopters landed near that scene that were able to transport approximately 23 people.

During this mass casualty incident, Wilson County's emergency communications capacity was quickly overwhelmed. The dispatchers were overburdened by the sheer amount of traffic across their communications channels. Ambulances, planes, and the subsequent chase of the shooter all began using the emergency dispatch system to communicate. As the shooter fled, he crossed county lines and dispatch updates became a multi-county issue. Communication issues occurred as dispatchers were forced to relay calls via personal cell phones.

Lack of Response Planning

Prior to this incident, there was no coordination or drilling in place to respond to such a crisis. Most volunteers who were asked to assist were certified in cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use, while others likely did not have official emergency medical services (EMS) training and certification. There was a lack of equipment and resources, including trauma bags and tourniquets, immediately upon arriving at the scene. It was not until one police officer showed up who happened to have a box of tourniquets in his trunk that the response could move forward.

Wilson County now has 3 paid fire services that have dually certified fire and EMS personnel. These services are on duty 24/7 and collectively operate five engines. District 3 EMS took over a volunteer EMS service shortly after the incident and now has 4 EMS units staffed, and the 2 other paid services offer an additional 3 EMS units for the county. Additionally, in partnership with District 3 EMS — the EMS provider that covers the same response zone as District 1 Fire — more training and triage drills have been conducted, and the two have collectively put more units and trained staff in place.

Success Factors

Regional Partnerships Are Key to Successful Responses

Immediately after the initial dispatch, Fire Chief Chris Thompson contacted the Emergency Operations Center (EOC) manager and requested assistance from the Southern Texas Regional Advisory Committee (STRAC). STRAC serves as the Texas Department of Health Services designee to “develop, implement and maintain the regional trauma and emergency healthcare for 22 counties” within their response zone. Within 3-4 hours of the incident, STRAC was on scene. They set up command tents, a portable morgue, and an ambulance bus to transport the deceased from the scene. The Texas Department of Emergency Management (TDEM) arrived on scene a few hours after STRAC, and they assumed control. District 1 Fire and Rescue continued to serve as a local liaison after TDEM arrived. Eventually, the Federal Bureau of Investigation (FBI) and Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) brought in dozens of personnel; the Texas Rangers had somewhere between 15-20 rangers present; TDEM and STRAC both brought in large support staffs and maintained a large-scale logistical response for about 7 days. With all the activity, media providers overwhelmed cellular communications. These partners brought in a cell on wheels (COW) that provided temporary infrastructure to maintain cellular communication.

Community is the Lifeblood of a Response

Despite no prior coordination between the first responder services, they came together in the response and worked as a team. Typically, EMS units are compartmentalized, each responding within its own territory. And with the surprise of the incident itself, all of the volunteers stepped up and performed jobs they may never have done before. The community came together and united in their response.

Barriers

No Place for Ego

Command and control of the initial response were not clear. Additionally, a lack of prior collaboration and integrated training between the responder services hampered initial response efforts. Following the event and a county vote, District 3 EMS, a paid service, assumed service responsibility of Sutherland Springs and surrounding areas.

Public Officials Visiting after a Disaster

The arrival on scene of numerous officials and media put an additional strain on responders who had to implement more security measures in the midst of trying to address the myriad response requirements with limited resources.

Lesson Learned

Willingness to Accept Additional Resources and Support

It is important for communities to know where to go when more resources are needed and trust that additional resources and support will be needed in a response. Fire Chief Thompson knew about STRAC but was still amazed by the capabilities and resources they provided, including tents for meeting, sleeping, and eating. Working with STRAC, Bexar County Office of Emergency Management, and TDEM eased the response burden on local responders and allowed for a more fluid and successful response.

Advice

Staff and Maintain a Community Response System

For months after the incident, calls continued pouring in from community members eager to help. Being a small, mostly volunteer department, District 1 had to turn away most community volunteers. They eventually ceased answering calls for support on their non-emergency line. Because the station is so small, they were not able to accept all of the help offered. It is important to work closely with other community organizations that can help coordinate community support and response after a disaster occurs.

Person(s) Interviewed

Chris Thompson, Fire Chief
District 1 Fire and Rescue

Opinions expressed are those of the interviewee(s) and do not necessarily reflect the views of the Rural Health Information Hub.