08/19/2026
You are a member of a local Tactical EMS unit supporting a Special Response Team during a high-risk warrant. An ALS ambulance is staged nearby in support of the operation.
During the operation, the deck your team is standing on suddenly collapses, sending multiple team members more than 10 feet to the ground.
Your initial assessment identifies three team members with severe extremity injuries and one team member with an impalement injury.
As the TEMS paramedic, you have BLS and ALS equipment immediately available to you, along with the staged ALS ambulance.
This scenario raises several important tactical and medical questions:
What is your initial assessment of the situation, both tactically and medically?
How would you triage the injured team members? Who receives treatment first, and what life threats are you looking for?
How would you move injured personnel from the X while balancing rapid evacuation with the need to provide appropriate hemorrhage control, airway management, and other lifesaving interventions?
What additional resources would you immediately request? Consider additional ambulances, fire, additional TEMS personnel, command resources, and receiving hospitals.
How would your plan change if an active threat remained present?
Would you continue treatment where the injuries occurred, or would you prioritize moving casualties to a safer location before providing more definitive care?
A structural collapse introduces multiple simultaneous threats: ongoing tactical danger, secondary collapse, significant hemorrhage, traumatic arrest, airway compromise, spinal and orthopedic injuries, impalement, and potentially limited access for evacuation. The TEMS provider must constantly balance medical priorities, tactical priorities, and the safety of the rescue team.
What would your plan be?
This post is solely educational. The outcome of the officers involved is unknown, and we wish all of the officers involved a speedy and full recovery.
