On 24 August the Federal Emergency Management Agency (FEMA) National Exercise Division in collaboration with the Clark County Fire Department (CCFD) and the Las Vegas Metropolitan Police Department (LVMPD) released the highly anticipated After Action Report (AAR) of the deadliest mass shooting in American history.

On 1 October 2017, the unsuspecting patrons of the Route 91 Harvest Festival came under attack. The reason behind the attack is still shrouded in mystery as the question of “why” persists.  As Homo Sapiens, we are inquisitive creatures who instinctively fear the unknown, while the ultimate unknown remains the human mind.  What drove Stephen Paddock to methodically, and legally, accumulate 24 firearms accompanied by thousands of rounds of ammunition over a six-day period?  What led this man to hammer out portions of his suite’s windows, pick up a rifle, and begin to indiscriminately kill 58 fellow human beings, injuring more than 850, then turning his weapon on himself?  The AAR does not address these questions; Paddock’s motive remains unidentified.

The AAR does provide clarity regarding the preparedness and capabilities of the City’s first responder agencies.  Las Vegas was, and is, prepared at extraordinary levels to respond to and recover from large-scale incidents such as this.  Yes, mistakes were made and yes, there is abundant room for improvement concerning fine-tuning multi-agency preparedness, response, and recovery plans, policies, and procedures.  However, the AAR contains an impressive table that lists dozens of proactive preparedness initiatives that have been enacted from 2005-2018.  These initiatives place Las Vegas far above the standard as a well trained, capable, and resilient city that was as ready as any could be for a horrific incident such as this.

Las Vegas was only given 11 minutes from the time Paddock opened fire to the moment when he took his own life.  Eleven minutes to observe, orientate, decide, and act while bullets were raining from an unknown floor of a golden hotel across a large intersection while thousands ran for their lives.  Hundreds of innocent people were shot, trampled, and maimed during this short period of time.  Officers were able to respond to the 31st floor within an impressive six minutes of Paddock’s first shots, and then, five minutes later were on the 32nd floor, which was one minute after Paddock had taken his own life, ending the active shooter threat.  The response time was incredibly fast taking into account the absolute chaos and fog of war.  The AAR is a stark reminder that even the utmost prepared and best-trained response agencies can be ineffective in stopping a motivated killer before hundreds are injured and dozens are dead.

An emerging norm was highlighted throughout the AAR: fellow citizens and victims braving a hail of bullets, disregarding their safety, to save strangers’ lives.  In past mass casualty active shooter incidents, the strategy was to prioritize neutralizing the threat, then ensuring the scene was completely cleared of any potential threats, and designating the cleared area as a “cold zone” before Emergency Medical Service (EMS) providers could enter the area to begin the triage, treatment and transport process.

Las Vegas has adopted a tactic growing in popularity, also supported by the FBI, called the Rescue Task Force (RTF).  The RTF is comprised of Law Enforcement Officers (LEOs) and Emergency Medical Services (EMS) personnel that are usually equipped with a Kevlar vest and helmet.  LEOs are to neutralize or isolate the threat, the “hot zone,” establish and maintain a “warm zone,” and then provide armed escorts for EMS personnel to enter the “warm zone” and conduct triage, perform any necessary immediate life-saving interventions (i.e. control major hemorrhage and/or ensure there is a patent and maintainable airway), then extract the victims to a Casualty Collection Point (CCP) located in the “cold zone.” The RTF is designed to provide time-critical medical aid to victims as quickly and safely as possible for the EMS personnel.  The traditional approach of waiting for the scene to be deemed completely cleared of all threats could take hours before victims would receive initial care.  This would lead to many bleeding out or succumbing to hypoxia, while medical personnel standby and watch.

Even while the RTF concept was utilized and executed relatively well, the first RTF team did not enter the “warm zone” until 55 minutes after Paddock initially pulled the trigger. Fifty-five minutes is much faster than traditional methods, but tragically about 53-54 minutes too slow to save a critical bullet victim.  Private citizens, active and former military, as well as on/off duty first responder personnel took action saving lives when time was of the essence.  The vast majority of tourniquets that were applied were improvised tourniquets from fellow concert patrons.  The majority of vehicles that transported victims were private vehicles.  Private citizens taking action when the situation called for heroes is what saved lives.

Our cities must be prepared for horrific incidents.  We as citizens must also be prepared.  The highest trained, best equipped, and most capable of emergency response agencies take valuable time to respond within the scope of their perspective plans, policies, and procedures.  It is truly up to the individual to be ready.  In those moments when seconds count, help is minutes away.