Podcast appearances and mentions of travis cox

Automation World Gets Your Questions Answered

Play Episode Listen Later Sep 25, 2023 33:57

NEW! Watch this show on YouTube at https://youtube.com/live/iXHgu7zomfoBill Godfrey:Welcome to the Active Shooter Incident Management Podcast. My name is Bill Godfrey, your podcast host. I am joined today by three of our wonderful C3 Pathways instructors. On my right here is Tom Billington, one of our Fire/EMS instructors. Welcome, Tom.Tom Billington:Good to be back.Bill Godfrey:It is good to have you back. Been a minute, that's for sure. We're also joined across the table from us. Russ Woody, one of our law enforcement instructors. Russ, welcome from North Carolina.Russ Woody:Yeah, glad to be down, Bill.Bill Godfrey:Good to have you here. And then we've got Travis Cox, also one of our law enforcement instructors and our training director. Travis, it's good to have you here in the studio.Travis Cox:Hey, it's good to be here. Good to see you guys again.Bill Godfrey:It's exciting. It has been a minute. It feels good to be back doing podcasts again. And of course, we've upped the game a little bit. I looked, it was September of last year that we did our last podcast, so we're just shy of a year being off the air. Can you believe that?Travis Cox:Yeah. It didn't seem that long, but time flies as they say.Russ Woody:It really does.Bill Godfrey:It sure does. It sure does. And everybody's due an explanation about why that is. And the truth of the matter is, there has been a lot of changes, all good stuff, but a lot of changes over the last year and it just became difficult to keep up with. You may or may not notice if you have heard the podcast before, we are also videotaping our podcasts now, as well. They're going to be up on our YouTube channel and we're here in our brand new studio.Travis Cox:And it's amazing.Russ Woody:Yeah, it looks great. Really does.Bill Godfrey:It is so exciting to be here. But we've also moved, we are no longer in the building we were in before. We've moved to a new location. We've got new offices set up, new space. We've got a dedicated studio set up and we're getting ready to open a dedicated training center. Granted it fell a little bit behind schedule, some construction delays. It just seems like you can't keep construction on schedule no matter what you do. But that's going to get cleared up and we're going to have this beautiful training center opened up here I think pretty soon.Russ Woody:As you know, Bill, when I got here, I started taking pictures. I've been sending pictures to all my friends about how this facility looks, how professional it is, and a lot of people were saying, wow, that's quite an improvement. So it's come a long way.Travis Cox:Definitely. Definitely. When I first saw it, it wasn't what I expected, but when I saw it I said, "Oh man, this is the first class all the way." So excited to be here and looking forward to what we're going to be doing in the future.Russ Woody:Very much same. It really didn't surprise me. It seems like everything that Bill does, really puts forward every effort and it is a great facility.Bill Godfrey:Well, those are gracious words, Russ, but this is a team effort and there's a lot of people involved in doing this from picking out all the stuff. Our producer, Karla, who's behind the scenes, she and a couple of the other people picked out a lot of the carpet and the finishings and the colors and it's just really nice to have a place that we can call our own and do some dedicated training in. And with any luck, we'll get the construction back on schedule and we'll get caught up here pretty soon. So anyways, it's exciting to be back. Let's get into the meat of it. We decided to talk today about rescue task forces and some of the common challenges that we see with RTFs, being a little bit confused about what the expectations are, what they're supposed to be doing, that kind of stuff. So Tom, this was one that you kind of threw out as a suggestion and we were all like, yes, that's a great topic. So why don't you talk a little bit about what was on your mind and what you're thinking.Tom Billington:Well, Bill, when we teach a class, we usually don't have enough time to go into all the exact details, but the RTF is such an important part. The Rescue Task Force, and first of all, just talking about what it is the Rescue Task Force is, it's usually a group of four people. So usually two Fire/EMS and two law enforcement working together as a team to go into the casualty collection point and start doing the treatment and get things sorted out. But we've never really talked about how do you do that? Why do you need more than one RTF? What is your goal when you get there? How do you organize things? And I think that's just a good place I wanted to start. But definitely, I think the important part is how are we formed and why are we formed this way, I think is the important part. I may be in a situation where I'm working with law enforcement officers I may have never met if I'm in a large organization. So I want to make sure that I know what's expected of me as the medical person and what I expect of the law enforcement person as far as the medical roles go. So I think that's just some of the things I wanted to cover.Bill Godfrey:Yeah, I think that's exciting.Travis Cox:It is really important for law enforcement to know what their mission is and what the responsibilities are on RTF because sometimes that can get confusing and sometimes law enforcement thinks they're there for other purposes besides what the RTF purpose is.Tom Billington:That's right.Russ Woody:Yeah. Seen it so many times where the law enforcement personnel that are attached to that RTF don't understand that they have made a promise to those individuals that, I'm with you. They are there with them throughout the event.Travis Cox:Yeah, exactly. Exactly. When I teach that section, I like to use my Top Gun rule. Never leave your wingman.Russ Woody:That's right.Travis Cox:Never leave your wingman. And the fire counterparts are your wingmen on that mission.Bill Godfrey:And before we dive into the meat of where Tom's going with this, which I think is really important and we have not talked about before on the podcast series, even though we've talked about RTFs, we haven't talked about where Tom's want to go with this, but I do want to just remind everybody who's listening, when Tom talked about the typical two and two, that's just a typical. There's no magic to those numbers, but here's what's important. There are people on the team that are responsible for security and they're up on their weapons platform. There's people on the team that are responsible for medical and they are carrying whatever medical gear that you're going to take in and you work together. And I think, Tom, where you were going that starts in staging before you deploy is the conversation to introduce yourselves and talk about what the expectations are and the rules. Because at the end of the day, so if Tom and I are the medical element of the RTF, our job is to take medical care of the patients, but you guys are responsible for moving us safely to where those patients are.Tom Billington:It's a hundred percent team effort. It's a hundred percent team effort. And law enforcement has to know the safest route to get to where you need to get to. And then once we get there, it's up to the medical side to start doing their triage and treatment.Bill Godfrey:Yeah, absolutely. And at the end of the day, your situation, your staffing, your community, your resources, the threat that you're facing is going to dictate the size of that team and who's on that team. And there may be some communities where the rescue task force is made up of all law enforcement personnel and that's fine, but you still have to divvy up the duties. Some of them have to be on security and some of them have to be on medical. And I just wanted to set that foundation before we go into talking about the CCP.Tom Billington:Absolutely. I've seen it where you just mentioned all law enforcement personnel. Sometimes some agencies have what we call TAC medics. So you have EMS-trained folks that are capable of filling that medical function when they go down range as the RTF.Bill Godfrey:Yeah, very good. So Tom, we're the first RTF. Let's just assume for this conversation that the four of us are RTF-1. We're the first ones down range, other than the contact team who's hopefully organized the casualty collection point or at least established the location, has got some security, has got that done. But we're the first ones that are going to punch through, so let's just kind of talk from that context. You guys are going to move us up, get us where we need to be. Tom, when we punch through the door, what's the first things on your mind?Tom Billington:Literal, earlier I took my app out of my phone, the Active Shooter Incident Management checklist, the app, C3 app. It tells you right here, once I'm stood up and I know who the team is and we're going down, one of the things I need to do is make sure tactical knows that I am deploying. I work for tactical, we are on a medical mission, so I need to make sure tactical knows where we're going and they agree with where we're going. And then once we get in there and we find the safe route, we have to know what are we going to do when we're in the room. Remember, if our makeup is two medical and two law enforcement, if that's our case, and we have seven or eight critical patients, are two medical personnel going to be able to handle this? No.So the first thing I want to do when I enter that room as an RTF is I'm going to take the lead, maybe might call it the capture collection point lead, CCP lead. I'm going to take the medical lead right off the bat and say, "Hey, I need more RTFs. I need them now. Let's not mess around." I'm going to call a triage and ask for what I need specifically. I'm not going to say, send me some more. I'm going to say, "Hey, I have three yellows, four reds, I need five more RTFs at this CCP." I get a response from triage. Yes, we copy that, we'll send it. Now my next job is I'm going to start my triage. That's where the law enforcement has already done a great job, hopefully. You want to talk about law enforcement triage a little bit.Russ Woody:On the law enforcement side, when we get there-Bill Godfrey:Russ, I'm going to bump into you there for just a second because I want to clarify what Tom was saying. He was saying earlier we need to notify tactical and I want to clarify those comments. So Tom and I, as the medical element, are on the radio with triage and the RTF team actually works for triage. What Tom was talking about with the tactical is, our security is on the radio with tactical.Tom Billington:Exactly.Bill Godfrey:And you need to let them know where you're moving when we get there, that's what Tom was addressing.Russ Woody:Absolutely.Tom Billington:Yeah. We kind of refer to the tactical position that air traffic controller, that person working tactical is going to give us the direction, the route where we need to get there. And then once we get there, we're going to get our medical personnel in that room and that CCP and then let them go to work.Bill Godfrey:And when we hit into the CCP and the numbers that Tom was talking about giving, we're going to give those numbers to-Tom Billington:Triage.Bill Godfrey:To the triage group supervisor. So just wanted to make that clarification. Russ, with that, talk a little bit about what we're hoping for law enforcement who've set up that CCP to done some triage ahead of time.Russ Woody:So hopefully the contact teams that we'll talk about in another podcast, I'm sure, have met some of the goals that are going to help us. And that is setting up that casualty collection point. And in doing that, they should have provided security for that casualty collection point. So they should be there providing that and we should be able to come in with our RTF and arrive safely. We have been guiding through and once we're there have that ability to then function as the lead in that room needs us to possibly for some time. But law enforcement, hopefully, has done some triage. We're only going to go red or green given that casualty count of those particular injuries and then started possibly some of the treatments that would be appropriate for law enforcement.Bill Godfrey:And of course, you mentioned the key there is we're not expecting law enforcement to go through and do full assessments. It's a click, red or green. If they're hurt and they follow your commands to get up and move to a particular location, that's a green. And if they didn't, that's a red. Done.Russ Woody:That simple.Bill Godfrey:Yeah, it really is that simple. So when we get in there, you mentioned, Tom, the importance of taking lead. And I want to visit on that for a minute. So you and I came up in a time, and I don't know, thank God we don't touch patients anymore really.Tom Billington:Yeah, I agree.Bill Godfrey:But we came up in a time where it was common for us to be the only medic that was covering an area that was covered for four or five ambulances. And so we ran into incidents on a regular basis where you were the only medic and you had essentially four, five, six patients you had to take care of. Maybe not a mass casualty in today's sense of mass casualties, but you had to provide multi-patient care. And over the last, I don't know, 20, maybe 30 years, 20 years, certainly, we have seen the number of paramedics in the field that are deployed really, really go up, which is a great thing. But the result of that is the frequency with which they need to manage multiple patients has really plummeted. And I think it's been a little bit of a lost skill, Tom.Tom Billington:The triage part has been a lost skill. Again, like Bill said, I've done triage in the field where I had to decide somebody's not going to survive. Now when you start getting a lot of paramedics in the room, they start looking at each other. So somebody has to take the lead and that should be that first RTF, a medical officer take the lead right off the bat. And a few things when you're taking the lead is, when I come in to the casualty collection point, I'm looking around. How did I come in here? What route did I take? What would be a good area, thinking ahead, where I might be able to set up an ambulance exchange point? Is there a closer door to my right that I didn't come in? Could that be a good ambulance exchange point? I'm thinking about that also. So now I'm thinking about my triage, thinking about a possible ambulance exchange point. I'm calling for more resources. Now, I'm going to start triaging the folks and start doing some treatment.Bill Godfrey:So-Tom Billington:Go ahead. Go ahead, Bill.Bill Godfrey:I was just going to say, tell me a little bit about why you want to think about the ambulance exchange point when you're coming through the door.Tom Billington:The ambulance exchange point is one of the areas that we know in our research, a lot of time is wasted. The clock is ticking and that is one area where we can save precious minutes. And since I am the first RTF in, I'm getting situational awareness of where I'm located in the facility. I have a good idea from walking in here, oh, I know that this might be a faster route. So that way I can work with law enforcement to get security set up for AEP, ambulance exchange point, rapidly, so we're not going to be waiting on that. We don't want to wait, we're fighting that clock continually. So always thinking ahead a couple of steps.Russ Woody:And we, as law enforcement, hopefully, will realize and talk with you on that and then pass that information on to tactical or the contact teams that are there on the ground with us and they will go and push out and establish that security at that AEP and hopefully maybe a corridor in between.Travis Cox:Yeah, I was going to say that's where that teamwork starts to come in as that RTF gets in that room and the medical treatment starts to happening. That's something that law enforcement can start working on is as you come up with a suggestion for where the AEP should or could go, we can provide that intel. Is that the safest route? Is it possible that we can secure that area? All those other factors that come in from a law enforcement perspective to make sure that we're working together to get the best possible location for the AEP.Bill Godfrey:Yeah. So let's talk about that for a second, Travis. On the law enforcement side, talk a little bit, the two of you, about what's involved in actually securing an AEP. Okay, so Tom and I go, "Hey, there's an exit door right there, it backs up to a parking lot. We'd like to use that as our AEP." What's involved in you guys actually making that ready so that we can get an ambulance moved up?Travis Cox:Well, I think one of the first things we have to consider from the law enforce side is what's the status of the suspect or the shooter? Is the suspect contained? Is the suspect down or is the suspect at large? Obviously, if the suspect's still at large and we don't know exactly where he or she may be, that's going to provide a lot more security elements or security questions that we have to take into consideration when we look at a AEP site bringing those patients outside. So I know, Russ, you've done a lot of that before. And once we take those patients outside, there's a lot of risk factors we have to take into consideration.Russ Woody:Absolutely. And it does. It's a resource drain if it's an area, and terrain will dictate if you have to push out quite a ways or if you can get on the edges of buildings and provide the security that's needed there. But certainly, it has to be done early because it won't take that Rescue Task Force long to get in and that first patient that they contact that is in real dire need and us fighting against that clock to now decide to move them out. And that's going to take some time to get that ambulance into the space and make sure we have it secured for them.Bill Godfrey:And I think that I wanted to highlight that, Tom, because I think it is one of the most consistent things that we see is that we forget about getting the ambulance loading area, what we call the AEP, the ambulance exchange point, and we call it the AEP instead of the transport loading zone because it requires security. It takes time to get that secured, that area, I don't want to use the word cleared, but to check that area and feel like that you guys have it under cover. And if we've waited until we're ready to transport and now we're doing that, we just pissed away 10 minutes.Tom Billington:Absolutely.Travis Cox:So if the shooter does go active, again, law enforcement already has a pre-planned situation or pre-planned idea of what they want to do, who's providing cover, who's going to address the threat, and then we can move forward from there. So those are things that we have to take into consideration on the law enforcement side, and communication is key that we're communicating what the plan is to our medical counterparts. So as we're moving those patients, they know what to expect if we get a shooter going active again.Russ Woody:And for the law enforcement on that AEP or on that scene, that immediate action plan could be as simple as, if there is a threat that starts again, the two of you are going to stay here and continue to secure this because we've made a promise that this is secure and we've got to keep to that to that Fire and EMS side and the patients we have there on scene. And then, okay, the other two or four that are in that scene, you'll be the ones that will go and go after that active threat.Bill Godfrey:I like it. Okay, so we're RTF-1, we've punched through the door, we've done an initial triage call quickly. We've identified an area that we think is good for an ambulance exchange point. We have handed that off to you guys as our security element. You're talking to tactical and working on getting that secured. It's time for you and I to go to, we called for the additional help, now it's time for you and I to go to work, pick it up from there.Tom Billington:And that's where our old fashioned triage from way back kicks right in. We have to decide, there's two of us right now using the triage method that we're using in whatever system we're in at that time, who's going to get treated first? What actions can we take immediately to help somebody sustain better? What other quick things can we do? But then we get down to the meat and bones and say, "All right, this person needs intervention now." And that's when we start doing some more advanced procedures. We don't want to go to town on the advanced procedures, folks. We want to get them in an ambulance, get them to a trauma center, but we can do some things that can keep that clock at bay. Some airway management, maybe portal decompressions or things like that.Bill Godfrey:Basic bleeding control, tension-pneumos, that kind of stuff that we need to deal with. The other thing that I want to mention, granted, it's a little bit of a pet peeve of mine, the most common triage system used by Fire and EMS across the country is the START triage system. And I hear people tell us on a regular basis, "What's your-" "Oh, we use START." Okay. And then you ask them a few questions and you realize, they've just told you that they use START and they have no idea what the flow chart is or what the criteria is for how to classify people as red, yellow, or green. And it leaves me going, "Okay, you say that you use START, but you don't, because you don't know what the criteria are. So what methodology are you using?" And before I move on from that, I do want to remind everybody that's listening, START has no scientific basis to it whatsoever. It was originally developed out on the west coast in response to training civilians who were going to be expected to do interventions in mass earthquakes. And somewhere along the line, we adopted it in the EMS system. And yet even though we say across the country, more than 50% of the people use START, I think I've had less than 2% of the EMTs and paramedics that I've asked that have been able to tell me what the criteria are. And so it's a huge gap. The other reality is, especially in a shooting, great, I use START, I used it correctly and now I have four reds, which one's the priority?Russ Woody:The judgment of what you feel has to happen and hopefully by then these other RTFs are showing up. And so that's when you can start saying, all right, this is my judgment. I can do the best for this person for their longevity to survive. And so that's how we do it. The other RTFs come in, and again, you're not off the hook when the other RTFs come in. You start assigning them immediately to the next patients that need to be treated. But also, remember, you got to talk to triage. Triage is your boss. Triage wants to know what's going on. Triage is saying to the RTFs, "Hey, how many reds do you have? How many greens do you have? How many yellows do you have? What's going on in there? What time is it?" All those things. So again, if you're the lead RTF, you have to think about that. You need to get the color codes of what you have to triage because they need to tell transportation for the ambulance counts. So we have to get that job done also. However, do not get hung up on colors. The triage colors will change. Some will go down, some will go up. We just want to get the best count out there as possible and get these folks out of there and get them into an ambulance as soon as possible.Bill Godfrey:Travis, you and Russ have both been coaches at the tactical position countless times where you're coaching tactical triage to transport. How many times have you seen triage and tactical get wrapped around the axle over the colors not matching what they were 10 minutes ago?Travis Cox:Oh, all the time. All the time. And you got to be cognizant of the fact that they are going to change and you just have to deal with it as it changes. So again, it's about beating the clock and reducing the clock as much as you can. Not so worried about the colors of the patients, but how quickly can you get the ambulance exchange points set up. How quickly can you get those patients on the move and get them to a trauma center.Russ Woody:Not only the color code, but also just the casualty count itself is going to vary as it goes along. Just because the contact teams gave you a count of 15, don't get hung up that we've only got 13 or 14 there. Where's the other? Or we must be missing-Travis Cox:Just get the resources there.Tom Billington:That's right.Travis Cox:Just get the resources.Russ Woody:Get the resources. And don't forget-Tom Billington:Because this comes up so much, I'm going to even stress it even further. I've had instances where the RTF is saying, "Hey, we're ready for an ambulance." And triage says, "Wait, how many yellows do you have?" No, we need to get these people to the hospital. So don't get wrapped up in that. And that's another discussion for triage and transport.Travis Cox:I think it comes down to trusting the people that you've sent down range. If whoever's in that room and is telling you what they need, if you're on the outside, you're triage or transported tactical, you got to trust the judgment of those responders inside the room because they have the best vantage point of what's going on and what's needed.Bill Godfrey:I need one more rig. So sometimes just in how we communicate, I think, can probably help that up. And I do want to highlight your point and make it loud and clear that first RTF through the door has got to provide the assignments for the other ones that are coming through, whether that's one more RTF, three more RTFs. If law enforcement sets up a cordon and we dump 15 medical people in there to do ... whoever's coming in, we need to tell them what we need done. "Hey, we've got three reds over there I haven't been able to get to. We're down to the reds. I need to know which one needs to go first." And to talk about that, I've got this kind of injury. I've got these kind of vitals, and have those conversations. So if it's maybe the second RTF coming through the door begins to help us finish up that assessment and that initial care, and then the third RTF coming through the door, they say, "Tom, what do you need? It's time to start moving people." Go ahead. Go ahead, Russ.Russ Woody:That's one of the things, too, you have to be careful of. I know you've seen it, Travis, I have. Be careful, that lead in that room is vitally important to not blurring lines between the casualty collection point and turning the AEP into a casualty collection point. We want to only move them out when it's time appropriate.Travis Cox:Good point.Russ Woody:So there's not going to be any delay getting them loaded for transport and moving them out. We don't want to take all of our 15 out and have them out there exposed to possible threats or elements. So that's one thing, again, that lead is vitally important.Travis Cox:Yeah, I was going to say another thing about that lead that's so critical, and we see it in training all the time. If someone does not take a lead role in that room, you see in training all the time, at least I've seen it in training all the time, that a patient may get reassessed two and three times over when they're ready to transport, but because no one's taking lead and there's no coordination within that room on the medical side, you're wasting time there just reassessing the same patient over and over when they're ready to be transported.Bill Godfrey:We didn't tag them. We didn't put a ribbon on them. We didn't mark them. We didn't. Yeah, that's a huge issue. And I also want to reinforce that because as medical guys, we're not typically trained in tactics. And you guys have heard me tell the story about how I learned what the X was. I had a patient that was down in the middle of a hallway that had exposure to about four rooms on each hallway. It was an X intersection. And I leaned over to start trying to take care of the patient and the guy I was with, it was my security goes, "No, no, no, no. We're going to move him." I go, "No, I need to take care of him." And I lost that argument and I got moved along with my patient into a room. And they're like, "You don't treat on the X." And I go, "What the hell's an X?" "Well, that was where that guy was standing when he got shot, and that's a bad place to be."And then afterwards, they took me out to the hallway and said, "Look at all these exposures." And I think what you're saying is critical. The AEP is a safe location. The CCP is a safe location, but if you take all of your patients out of the CCP and expose them to being laying on the sidewalk, you've taken them from a less secure place, which is an interior, believe it or not, everybody's always in a hurry to get out. You're safer on the inside with security posted than you are exposed to all those elements on the outside. And so on the medical side, we have to remember not to move them until we're ready. There's either an ambulance there or an ambulance that's immediately on the way. Move those out, which requires coordination for us among the RTFs to say, "This one's going next." We should be stacking them by the door. This red, this yellow, this green are going to go next. Whatever the numbers are going to be to try to balance our load. And so our natural tendency is to try to get everybody outside, but that goes against-Travis Cox:Yeah. We're more secure inside and we can secure the place better inside. So we want that rescue unit or that ambulance either en route or on station before we start to move. Obviously, depending on how far the room is from the AEP, that's going to dictate that. But we definitely don't want that ambulance just sitting there, nor do we want patients sitting outside waiting on the ambulance. So it's a timing thing.Russ Woody:Perfect world, the ambulance would stop rolling at the same time that the patient got to the back of the ambulance.Tom Billington:Classic touch and go.Russ Woody:Perfect.Bill Godfrey:I think, you know what, that's a really good way to kind of talk about and illustrate that. And I think as we are coming up on the end of our time here, I think as we wrap this up, the big thing to just kind of reinforce is underlying is that first RTF has a lot more responsibility than just medical care for the patients they encounter. They've got to take a leadership role. And if you happen to be a medic and a company officer, great. And if you're not, suck it up, buttercup. You're the first one through the door. And oh, by the way, it doesn't have to be a medic. EMTs, I've seen EMTs do magic.Russ Woody:Oh, yes.Tom Billington:And again, we have our handy dandy right here on my phone, Incident Management Checklist. It tells me, as the RTF, everything we just talked about. So if you start getting behind, pull that checklist out. What did I forget? What can I follow up on? It tells you all these points. Stick to them to get that clock from ticking too fast.Travis Cox:And then for my law enforcement friends, when we get in there, they're part of that contact team. There's a lot we can do before that RTF gets there. So as much as we can do, we've evolved as responders, we're carrying tourniquets. Some of us are carrying medical kits, so at least minimum we can triage the room from red to greens. And so we can give some information to the medics when they do get there, and that'll speed up the process to help speed up the clock.Russ Woody:Have that security in place, come up with your immediate action plan and start providing medical if you can.Travis Cox:Saving lives is everybody's job, not just medicals.Russ Woody:It is.Bill Godfrey:It is. And Russ, I think your point is well taken. Don't forget to post your security. If you've got a contact team of three or four, you can't all do medical. It's kind of like an RTF. You're splitting your function a little bit, but don't forget where you are. So well, let's talk about any closing thoughts. Anybody have, anything else they want to add?Tom Billington:Sometimes I just wish we could take a big stopwatch and put it around the neck of the person who's the first RTF, because you can save lives with time if you do things correctly. Follow that checklist, make sure the AEP is getting set up, make sure you're getting triage done and make sure you have resources coming in to help you. You can save lives just by that timing. So it's very important and it's an important issue to discuss.Russ Woody:Absolutely. To Tom's point, we can do certain medical treatments as law enforcement and the medical personnel on scene can do certain things too, but there's some things that can only be cured in an operating room. So moving them off that point and getting them there is key.Travis Cox:I'll say this because over half of my law enforcement career, I've been in a training role and you have to train this. You can't wait to disaster day to throw together RTF for the first time. So I would encourage all those agencies out there, whether it's on special events, on smaller incidents, but you got to put RTFs together, get law enforcement and Fire and EMS comfortable with working together, comfortable with trusting each other's judgment. And then when disaster day does hit, you'll be ready to go.Bill Godfrey:Yeah, Travis, I completely agree with you. We talk about how we work together all the time on calls and we do, but there's a difference between being on the same call and being integrated into each other's teams. And what we're talking about with a Rescue Task Force is the equivalent of you guys being with Tom and I when we roll up on a structure fire and we're like, "Okay, throw this pack on, grab the hose line and come right in behind us, it'll be fine. It'll be fine. Trust us." So if we don't practice that ahead of time and we don't work on that, it's going to lead to some challenges.Tom Billington:Yeah, training is key. Training is so vital to making that concept work, RTFs.Bill Godfrey:Gentlemen, thank you so much. It's exciting to be back at it again. I'm certainly glad that we're back doing podcasts again. Thank you for coming in and doing this. And to the audience, thank you for being patient with us as we've negotiated this last year of mass changing and we've tripled the number of deliveries we're doing across the country, which is super exciting. We're doing the Active Shooter Incident Management Advanced Class pretty much every week somewhere in this country, which is fantastic. But it brought with it's some growing pains, and so we fell off the wagon a little bit. But now that we've got our studios set up and we'll get some rotations done and get caught up on podcasts, I'm looking forward to being back on the regular.Travis Cox:Absolutely. We got big things on the horizon. We hope you guys are following us on social media and keeping your eye on us, and hopefully, we'll see you in a training class soon.Bill Godfrey:Ladies and gentlemen, thank you for joining us. And until next time, stay safe.

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What is High-Performance HMI?

Play Episode Listen Later Aug 17, 2023 19:00

Find out the difference between traditional and high-performance HMI screen styles, as well as which type manufacturers tend to use most and how difficult it is to switch from one version to another in this episode featuring Travis Cox of Inductive Automation.

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Ridgeline Riverhawks head football coach Travis Cox - Aug. 8, 2023

Play Episode Listen Later Aug 8, 2023 15:31

Eric Frandsen and Jason Walker talk to Ridgeline Riverhawks head football coach Travis Cox about his 2023 team.

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Previewing Ridgeline football; Kase Wynott commits to USU bball; Gavin Barthiel - Aug. 8, 2023

Play Episode Listen Later Aug 8, 2023 55:43

Eric Frandsen and Jason Walker visit with Ridgeline Riverhawks head football coach Travis Cox. USU basketball gets a commitment from Kase Wynott. Interview with USU linebacker Gavin Barthiel.

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Ep. 118 - [Travis Cox] Changing Integration Forever - From Integrator to Product and Beyond

Manufacturing Hub

Play Episode Listen Later Jun 29, 2023 74:10

Travis Cox | Chief Technology Evangelist @ Inductive AutomationMy passion is helping companies solve challenges using Ignition and modern technologies. I have been in the automation industry for 18 years. Through that time as a Co-Director of Sales Engineering for Inductive Automation, I have seen numerous successful launches of HMI/SCADA and IIoT projects across many diverse industries. I have worked with companies to help build robust and scalable architectures, apply best practices, integrate solutions, leverage edge and cloud computing, and learn how to fully utilize the Ignition platform.Inductive Automation started out as a group of Systems Integrators looking for a better product.Join us as we talk with Travis about the journey from integration to product and the last 20+ years of the journey. Along the way, IA has been able to work with a number of leading integration companies and OEMs. We'll ask Travis what will be in store for the next 20 years of integration.Are you a Home Automation fan? Stay tuned for some bonus conversations as to what we can do to put technology into the hands of people sooner. Connect with Us Travis Cox Vlad Romanov Dave Griffith Manufacturing Hub SolisPLC #manufacturing #automation #industry40 #digitaltransformation #ignition

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Sects On The Beach with Travis Cox

Mega

Play Episode Listen Later Jan 29, 2023 47:01

Trevor Fox (Travis Cox, Stormchaser improv) creates Christ centered cocktails. Travis Cox: @travislcox -- SHOW INFORMATION Mega HQ Get ad free + bonus content with MEGA PREMIUM Support Us on Patreon Instagram: @MegaThePodcast Twitter: @MegaThePodcast Follow Holly and Greg Holly Laurent: Twitter | Instagram Greg Hess: Twitter | Instagram Music by Julie B. Nichols Edited by Makenzie Mizell Learn more about your ad choices. Visit megaphone.fm/adchoices

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Travis Cox: Getting Out of $100K+ of Tax Debt

The Livian Podcast

Play Episode Listen Later Dec 16, 2022 35:24

On this episode, Eric Forney talks to Travis Cox about how he strategized his way out of $100K in tax debt. Travis shares how he got into real estate, and how he sold 32 homes and made $120K at 20 years old in his first year as an agent. A few years in a row, he couldn't pay his tax bill, and soon he had over $100K in tax debt. He realized he needed to learn about accounting and taxes, and in the process realized there wasn't a program that could keep all of his expenses, accounting and financial reports in one location. He shares how he got the idea for GreenStats because he needed an app that would help him track everything, and he wanted to be able to share that app with other agents who needed the information. He worked his way out of tax debt, worked with developers to create and GreenStats, and now he's running a Real Estate team and GreenStats while spending time with his wife and 3 children.Learn more about GreenStats here

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Ignition from Inductive Automation

The Automation Podcast

Play Episode Listen Later Oct 19, 2022 47:07

Travis Cox brings us up to speed on Ignition from of Inductive Automation in Episode 124 of The Automation Podcast. For more information, check out the "Show Notes" located below the video. Watch the Podcast: Listen via Apple, Google, Pandora, Spotify, iHeartRadio, TuneIn, YouTube, Amazon Music, Stitcher, RSS, or below: https://theautomationblog.com/wp-content/uploads/2022/10/TheAutomationPodcast-E124-Ignition.mp3 The Automation Podcast, Episode 124 Show Notes: Special thanks to Travis Cox of Inductive Automation for coming on the show! You can now support our work and join our community at Automation.Locals.com! Thanks in advance for your support! Vendors: Would you like your product featured on the Podcast, Show or Blog? If you would, please contact me at: https://theautomationblog.com/contact Sincerely, Shawn TierneyAutomation Instructor and Blogger Have a question? Join my community of automation professionals and take part in the discussion! You'll also find my PLC, HMI, and SCADA courses at TheAutomationSchool.com. Sponsor and Advertise: Get your product or service in front of our 75K followers while also supporting independent automation journalism by sponsoring or advertising with us! Learn more in our Media Guide here, or contact us using this form. (23 views)

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USU scrimmage preview; #11 in our Top 25 Aggies; Ridgeline football's Travis Cox - August 5, 2022

Play Episode Listen Later Aug 5, 2022 55:40

Eric Frandsen and Jason Walker speak with Travis Cox, head coach of the Ridgeline Riverhawks #11 in our Top 25 Aggies: Chandler Dolphin Preview Utah State football's first fall scrimmage Which Aggies/position groups need to perform well in camp? Utah Jazz trade rumors

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Ridgeline Riverhawks Head Football Coach Travis Cox - August 5, 2022

2s & 3s: A Utah Jazz Podcast

Play Episode Listen Later Aug 5, 2022 16:32

Eric Frandsen and Jason Walker speak with Ridgeline High School Football Coach Travis Cox

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3.27 Remembering the Rudy Gobert Era with Travis Cox

Play Episode Listen Later Aug 1, 2022 51:09

Friend of the pod, Travis Lincoln Cox (@TravLCox) -- the Leonardo DiCaprio/Denzel Washington/Jack Nicholson of Utah Jazz fandom and preeminent Rudy Gobert Stan -- joins Doug and Marc to remember and pay tribute to Rudy Gobert's legendary run with the Utah Jazz. --- Send in a voice message: https://anchor.fm/marcus-hintze/message Support this podcast: https://anchor.fm/marcus-hintze/support

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#TakeNote Thursday: 2022 Utah Jazz Postseason Preview

The Hive Sports

Play Episode Listen Later Apr 14, 2022 38:53

• Travis Cox (@travlcox on Twitter) joined as a special guest to talk about how positivity fuels his Jazz fandom • We then talked about the playoff matchups on the Jazz side of the bracket and which ones are the most ideal for this team • We ended the show with a few random bets for the series --- Support this podcast: https://anchor.fm/thehivesports/support

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Why Soy is SOy Good - Soy as super food, the truth on soy and breast cancer, and the scoop on soy as a phytoestrogen and your hormones - with Dr. Travis Cox

Plant-Based and Healthy

Play Episode Listen Later Apr 5, 2022 17:56

In Episode #12 I review the real scoop on soy. Anytime anyone brings up the “S” word (ie Soy) there is the notoriously bad reputation that comes along with it like, “soy has phytoestrogens that causes feminization in men and breast cancer in women”. But this could not be further from the truth! That's why I decided to dedicate an entirely separate episode in order to take a deeper dive into soy and reveal the real scoop on this superfood. In this episode I also discuss;- Soy as a superfood and its nutrient content. - Isoflavones of soy and what they really do. - Soy health benefits on cholesterol and cardiovascular health.- Soy and its role in muscle gains. - Soy, phytoestrogens and the research on feminization in men. - Best sources of soy in whole-food plant-based diet.- Tofu, tempeh, miso, natto, soy crumbles and more!Resources:https://pubmed.ncbi.nlm.nih.gov/18558591/ https://pubmed.ncbi.nlm.nih.gov/33383165/ https://pubmed.ncbi.nlm.nih.gov/30314925/ https://pubmed.ncbi.nlm.nih.gov/32979840/https://pubmed.ncbi.nlm.nih.gov/23725149/ https://pubmed.ncbi.nlm.nih.gov/34371819/ https://pubmed.ncbi.nlm.nih.gov/35249559/https://pubmed.ncbi.nlm.nih.gov/28338639/https://pubmed.ncbi.nlm.nih.gov/17413118/https://pubmed.ncbi.nlm.nih.gov/29666853/https://pubmed.ncbi.nlm.nih.gov/22296873/https://pubmed.ncbi.nlm.nih.gov/1333523/Want to support the show? Help us by subscribing and leaving a review on Apple podcasts or wherever you listen to your podcasts. It only takes a few minutes and helps more people find the episodes.About your host: Dr. Travis Cox - BA, DC, MSc is a Doctor of Chiropractic with a focus on Functional Medicine and plant-based nutrition. He is the creator of PBandHealthy.com and host of the Plant-Based and Healthy podcast. Connect with him on Instagram, Twitter and Facebook @yourvegandoc #pbandhealthy. And remember, individuals inspire and communities create change!Audio credit: Thank you @katetrajanmusic for your lovely voice on the intro/outro and @craigritchiemusic for the super catchy music track for the intro/outro... many thanks!

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The Plant Protein Problem: Setting the record straight with the Top 7 Myths of Protein in a Plant-Based Diet - with Dr. Travis Cox

Plant-Based and Healthy

Play Episode Listen Later Mar 27, 2022 26:16

In Episode #10 I review the top 7 myths (8 if I counted all of them properly!) of the plant protein problem, and discuss what to do about it. The number 1 question most vegans and vegetarians get is, “where do you get your protein from?”. The top plant protein myths that I discuss include:- You need meat. - Plants are a poor source of complete proteins and essential amino acids.- It's TOO difficult to get ENOUGH protein without eating meat. - You need to eat a lot of FAKE MEAT to get enough protein. - Going meatless will cause ANEMIA from iron deficiency.- It's hard to build muscle and retain it while on a plant based diet.- Plant protein is going to cause LOW ENERGY and negatively impact your endurance exercises.- Plant “anti-nutrients” and soy protein creates inflammation and interferes with the benefits of protein.Resources:Mariotti F, Gardner CD. Dietary Protein and Amino Acids in Vegetarian Diets-A Review. Nutrients. 2019;11(11):2661. Published 2019 Nov 4. doi:10.3390/nu11112661Fanelli NS, Bailey HM, Thompson TW, Delmore R, Nair MN, Stein HH. Digestible indispensable amino acid score (DIAAS) is greater in animal-based burgers than in plant-based burgers if determined in pigs. Eur J Nutr. 2022;61(1):461-475. doi:10.1007/s00394-021-02658-1Craddock JC, Genoni A, Strutt EF, Goldman DM. Limitations with the Digestible Indispensable Amino Acid Score (DIAAS) with Special Attention to Plant-Based Diets: a Review. Curr Nutr Rep. 2021;10(1):93-98. doi:10.1007/s13668-020-00348-8Zheng J, Zhu T, Yang G, et al. The Isocaloric Substitution of Plant-Based and Animal-Based Protein in Relation to Aging-Related Health Outcomes: A Systematic Review. Nutrients. 2022;14(2):272. Published 2022 Jan 9. doi:10.3390/nu14020272Gorissen SHM, Crombag JJR, Senden JMG, et al. Protein content and amino acid composition of commercially available plant-based protein isolates. Amino Acids. 2018;50(12):1685-1695. doi:10.1007/s00726-018-2640-5Nyakayiru J, Jonvik KL, Trommelen J, et al. Beetroot Juice Supplementation Improves High-Intensity Intermittent Type Exercise Performance in Trained Soccer Players. Nutrients. 2017;9(3):314. Published 2017 Mar 22. doi:10.3390/nu9030314Want to support the show? Help us by subscribing and leaving a review on Apple podcasts or wherever you listen to your podcasts. It only takes a few minutes and helps more people find the episodes.About your host: Dr. Travis Cox - BA, DC, MSc is a Doctor of Chiropractic with a focus on Functional Medicine and plant-based nutrition. He is the creator of PBandHealthy.com and host of the Plant-Based and Healthy podcast. Connect with him on Instagram, Twitter and Facebook @yourvegandoc #pbandhealthy. And remember, individuals inspire and communities create change!Audio credit: Thank you @katetrajanmusic for your lovely voice on the intro/outro and @craigritchiemusic for the super catchy music track for the intro/outro... many thanks!

37. An Evidence Based Look at the Gut-Thyroid Connection with Dr. Travis Cox

The Plant Powered Gut Show

Play Episode Listen Later Mar 17, 2022 40:36

When your doctor diagnosed you with a thyroid imbalance, did they explain the gut-thyroid connection to you?Most likely not.What most women aren't being told is that there is in fact a connection and if addressed properly, can transform the entire trajectory of your thyroid healing journey.In this episode of the PPG Show, I interview Dr. Travis Cox, who dives deep into the details of this connection in addition to: 1. What the thyroid gland is2. What are the signs and symptoms of a thyroid imbalance3. How prevalent is Hashimoto's disease (hint: it's a lot more common than you'd think)4. What the microbiome mash-up is5. What to look for when testing for a thyroid imbalance6. The difference between Hashimoto's and hypothyroidism7. And much more!Further Reading:Microbiome in Hashimoto's:https://pubmed.ncbi.nlm.nih.gov/28903182/Changes in gut microbiota with hypothyroidism: https://pubmed.ncbi.nlm.nih.gov/29320965/Thyroid hormone balance via the gut microbiota:https://pubmed.ncbi.nlm.nih.gov/25516464/Thyroid hormone metabolism & the gut microbiota:https://pubmed.ncbi.nlm.nih.gov/28167127/Hashimoto's and Gall bladder connection: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6129049/Find Dr. Travis Cox online:Podcast: https://podcasts.apple.com/ca/podcast/plant-based-and-healthy/id1603314209Instagram: https://www.instagram.com/yourvegandoc/__________________________Join the Healthy Gut Solution Facebook Group: www.facebook.com/groups/thehealthygutsolution Follow Roslyn on Instagram: www.instagram.com/plantsfirstnutrition

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Gut-Thyroid Connection: Your gut microbiome influences hypothyroidism and the autoimmune subtype, Hashimoto's Disease, and how a plant-based diet can help - with Dr. Travis Cox and Roslyn Kent on The Gut Plant Powered Gut Show

Plant-Based and Healthy

Play Episode Listen Later Mar 13, 2022 39:28 Transcription Available

In Episode #8 I feature Roslyn Kent's podcast, The Plant Powered Gut Show, and our recent interview where we discussed how eating a plant-based diet can positively impact your gut-thyroid connection and so much more!In this conversation we also discussed:- What the thyroid hormone pathway does for your health.- The most common signs and symptoms in hypothyroidism.- What blood tests to consider for measuring your thyroid health. - How your gut microbiome can influence your thyroid hormones, for better or worse!- SIBO, dysbiosis and gallbladder issues and the thyroid. - Diet and lifestyle strategies to consider for managing autoimmune hypothyroidism. Resources:Roslyn Kent is a plant based Registered Holistic Nutritionist living in Vancouver, BC. She specializes in the microbiome and gut health and through her online programs and courses, Roslyn helps ambitious women struggling with IBS and similar imbalances conquer their symptoms through evidence based, plant based nutrition strategies when conventional medicine has failed them. When Roslyn isn't working with clients online, you can find her in the mountains backcountry skiing, hiking in the alpine, or mountain biking.- The Plant Powered Gut Show - https://podcasts.apple.com/ca/podcast/the-plant-powered-gut-show/id1542786237- Plants First Holistic Nutrition - https://plantsfirst.ca/- Microbiome in Hashimoto's - https://pubmed.ncbi.nlm.nih.gov/28903182/- Changes in gut microbiota with hypothyroidism - https://pubmed.ncbi.nlm.nih.gov/29320965/- Thyroid hormone balance via the gut microbiota - https://pubmed.ncbi.nlm.nih.gov/25516464/- Thyroid hormone metabolism & the gut microbiota - https://pubmed.ncbi.nlm.nih.gov/28167127/- Hashimoto's and Gall bladder connection - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6129049/Want to support the show? Help us by subscribing and leaving a review on Apple podcasts or wherever you listen to your podcasts. It only takes a few minutes and helps more people find the episodes.About your host: Dr. Travis Cox - BA, DC, MSc is a Doctor of Chiropractic with a focus on Functional Medicine and plant-based nutrition. He is the creator of PBandHealthy.com and host of the Plant-Based and Healthy podcast. Connect with him on Instagram, Twitter and Facebook @yourvegandoc #pbandhealthy. And remember, individuals inspire and communities create change!Audio credit: Thank you @katetrajanmusic for your lovely voice on the intro/outro and @craigritchiemusic for the super catchy music track for the intro/outro... many thanks!

How To Share Your Story | Pastor Robert Favela & Travis Cox : The Making (Of Disciples) Unpacked

Cottonwood Church: Weekly Audio

Play Episode Listen Later Mar 9, 2022 35:40

Each of us has a story to tell that could potentially help somebody else. Pastor Robert Favela is joined by our Celebrate Recovery ministry leader Travis Cox to discuss the importance of sharing our story and being ready and available when God wants to use our testimony to help others and in turn, also make disciples of Christ.

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Travis Cox: Ecopsychology and Psychedelics

Mindful U at Naropa University

Play Episode Listen Later Feb 16, 2022 58:27

Travis Cox, PhD is back after our first conversation, four years ago, this time adding on the lens of psychedelics to look at ecopsychology as a radical intervention. Explore the negative consequences of our disconnect from planet, personal, and spirituality and how it intersects and impacts ecopsychology when we introduce psychedelics to explore reconnected. Special Guest: Travis Cox, PhD.

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EP1 – Introduction with Travis and Charles

Coffee Hour

Play Episode Listen Later Feb 2, 2022

Welcome to our first episode of the Calvary Coffee Hour hosted by Travis Cox and Charles Rikard. In this first episode, we wanted to introduce you to us and set some vision for this podcast moving forward. Hopefully you learn some neat things about us and the staff here at the church. If you have […]

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The Full Court Press - Ridgeline Football - Travis Cox

The Stormchaser Improv Podcast Show

Play Episode Listen Later Aug 3, 2021 13:34

Ridgeline Head Football Coach Travis Cox joins the show to talk about the upcoming season.

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35: Stormchaserology - “Throwing Daggers” by Travis Cox - Being Deliberate, Trusting, and Vulnerable

Play Episode Listen Later Jul 5, 2021 10:48

Improv assassins unite! Travis has cooked up this bite-sized Stormchaserology episode to cover “throwing daggers.” He talks about how to make your improv more exciting by improvising more deliberately, how to treat you and your partner's choices as important by trusting that those moves are exactly right, and how to be vulnerable and open yourself up to stabbing and being stabbed! So all you improv assassins better listen up because it's time to sharpen up your improv! You can connect with Travis on Twitter @TravLCox and on instagram @travislcox and you can connect with Stormchaser on instagram @stormchaserimprov and our website stormchaserimprov.com. Before you go, if you've enjoyed the podcast, please consider leaving us a review on Apple Podcasts! Reviews are a great way for us to lure unsuspecting guests into our deadly podcast trap!

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13-year-old racer Elliot Cox, Dr Joe LaPlaca of Ares Elite Sports Vision and Elliot's father Justin Cox join Rico and Ken in the studio

The Skinny with Rico & Ken

Play Episode Listen Later Jun 24, 2021 66:27

Elliot Cox is a 13-year-old racer with a dream to become the youngest winner of the Indy 500. He is a Development Driver for Sarah Fisher Hartman Racing Development in their new F4 program. He is also am MPG Motorsports/Will Power Kart Team Driver. In 2018 Elliot founded Driving for Dyslexia, using motorsports as a platform to raise awareness and funds for people with Dyslexia. Dr Joe LaPlaca is the founder of Ares Elite Sports Vision, which combines traditional optometry methods with cutting edge technology in order to help athletes take their game to the elite level. Travis Cox is Elliot's father and President of Ares Elite Sports Vision. Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

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Ep 25: Staging

Cache Valley Football Podcast

Play Episode Listen Later Apr 5, 2021 36:05

Episode 25: StagingWhy Staging is so important in an Active Shooter Event, how it works, and how it can save youBill Godfrey:Welcome back to our next podcast. Today's topic is going to be staging. That probably sounds a little boring to some of you, but it turns out it's pretty important to having a successful response to an active shooter event. My name is Bill Godfrey, your host for the podcast. I'm one of the instructors here at C3 Pathways. And I am joined by three of our other instructors, Ken Lamb law enforcement Sergeant. Actually Ken you're up for promotion, aren't you?Ken Lamb:I am, a couple of months. Looking forward to it and looking forward to talking about staging today.Bill Godfrey:Well, welcome, Ken. We're also joined by Robert McMahan recently retired as chief deputy out of Colorado. How's retirement feeling Robert?Robert McMahan:It's awesome. It's awesome. Really enjoying it.Bill Godfrey:Absolutely. And of course, many of you are familiar instructor to the podcast, Bruce Scott, retired from the fire service. Bruce. Thanks for coming in again.Bruce Scott:Thanks a lot, Bill. I appreciate it.Bill Godfrey:So we're going to talk about staging today, as we said, and this is a familiar topic to the fire service and in some cases it may even be a yawner, or a gloss over, but it really shouldn't be. As we talk today, we're going to talk a little bit about some of the differences between doing staging in an active shooter event versus how we might stage in a structure fire. So there's certainly some important stuff here for the fire service overall, but clearly the fire service is familiar with the idea of staging, use it almost every day and use it regularly enough to be pretty good at it in most cases. But what about law enforcement? Ken, Robert, is staging important to law enforcement? Is it something that law enforcement by and large sees as a necessity in events like these or in large events?Ken Lamb:Right. So in events such as an active shooter event, staging is important and it is part of the, it's really embedded in our policy as far as making sure that our units are staging prior to arriving after the first five or six responders have made it on scene to neutralize the threat. Where it does become problematic is that you have a lot of radio traffic that's taking place in that initial response. And sometimes people get caught up in initial response and forget about the staging so that it can complicate efforts, if you don't have one person that's thinking about staging, stop short, starts relaying, or communicating to responding units, to move to staging.And what we see is an over convergence on the target, if staging isn't set up and it also, what we find out takes some pretty skillful communication with fire rescue in order to coordinate that staging location because most times, as you mentioned, fire rescue has already established staging. So even if we have that one person that says, "Hey, I'm going to stop short and I'm going to stage here," we have to make sure we're staging with fire rescue because if not, it can surely complicate matters as well.Bill Godfrey:Robert, Ken's talking from a perspective of, I think an agency that's already culturally kind of adopted that posture, or at least in the process of doing that. And I know that the agency you came from had done that as well, but it wasn't always that way, you kind of led through that transition. Can you talk a little bit about that?Robert McMahan:Sure. Ken makes some great points and one of the problems that we had in one of our active shooter events was not getting law enforcement and fire to staging together. And what it resulted in is an inability to get sufficient security assigned to RTF so that they could be ready to go down range and take care of patients. And the over convergence pieces is huge. That's the first thing that's going to happen if responding officers don't respond to staging and once you get those initial contact teams going. And they're going to overwhelm your incident, they're going to run over the top of you. And you're going to spend all your time trying to get your arms around that instead of doing other critical things that get patients to the hospital and save lives.Bill Godfrey:So you're talking about one of the lessons that you guys learned, and Robert, if memory serves me correctly, you've responded to three active shooter events in your career. Am I remembering that right?Robert McMahan:Yes.Bill Godfrey:As we always want to try to draw lessons learned from that, I know you shared with me and with the audience now, some of the lessons learned from that particular response, but has the message penetrated in the organization that you were a part of and in your surrounding communities, what's been the net effect of that? Was kind of learning that lesson once enough to turn the water?Robert McMahan:You would like to say so, but not always. I think we turn a little bit each time and we get a little better each time, but it does take a lot of effort to get law enforcement to change and adapt to go with the staging models that we're talking about because, we're cops, we want to run to the gunfire. We want to go take care of the bad guy and that's well and good, but there's other things to do in the incident besides that. And over time, I think law enforcement has gotten a lot better, but we certainly have to be more disciplined in the staging process and getting our resources to a place that they are ready to deploy with a mission and get a job done.Bill Godfrey:Before we leave this topic, can you share a little bit more for the listeners on the details of the incident that you're, you don't have to necessarily give the specifics, but just kind of set the stage form a little bit and tell them the practical of what happened to you guys.Robert McMahan:Sure. We had an active shooter incident in Colorado, not too long ago, just a few years ago that resulted in eight students being shot. And initial response was handled very well by the initial responding officers they got in and, and took care of the threats. And, but it was the other officers that kept coming. We had some neighboring agencies and they just overwhelmed us. They just kept coming and coming and coming right on top of the incident. And that resulted in an over convergence like Ken talked about, on the incident and creating chaos in the incident that didn't need to happen. These incidents are chaotic enough without having an over convergence of resources that you're not in control of.And the second thing that resulted was not having enough officers to assign to the RTF teams and they just would not move out of staging without that, and they're not supposed to. And so our officers adapted to that and they got the students out and to medical help quickly anyway, but that would have been a much better response to provide medical personnel to them at the casualty collection point, rather than having to drag them out and put them in ambulances on the street.Bill Godfrey:So if I'm understanding you correctly and reading between the lines, you had a staging location that was established, that your organization had set up and had effectively up and running. But when you're neighboring agencies, mutual aid, I presume rolled into the incident, they didn't go to the staging area you'd set up?Robert McMahan:That's correct. And one of the reasons for that is they were listening to their main channel, instead of going to our channel, which the incident was occurring on. And that's one of the things that we have talked about in the past. And one of the agreements that we had in place at the time was to go to the main agencies channel to get those instructions and that didn't occur and we debriefed it. They owned it and that's fine. And I think they're learning from that. I think we learned from that, but we did establish staging right away and our fire brothers were great at doing that. And so we had staging, but just no cops at staging that could be deployed to specific duties.Bill Godfrey:So Bruce, Robert's talking about having the staging area set up and having fire rescue ready to go. Can you talk us... I know you've done it hundreds, if not thousands of times in your career rolled into staging for a structure fire or other incident, but can you talk a little bit about what makes staging a little different for fire EMS in an active shooter event than a structure fire.Bruce Scott:Yeah. And there's a whole lot of difference Bill. Number one, on an active shooter incident, the first thing that's going to be different is ideally you're going to have a law enforcement staging manager there side-by-side with you. So you can begin, as Robert was alluding too, you begin forming up those rescue task forces with that law enforcement staging officer. Typically on the fire department, we stage, we wait for the incident commander to say, "Hey, engine one, come on down to the scene," or "Engine two, lay me a line," or "Ladder one, ladder the rear of the building." And you get those orders directly from the incident commander and the model that we use and we teach nationally now, as a standard, you may be getting those orders from tactical.You may be getting those orders from triage. You may be getting those orders from transport to fill those resource requests. So the only way to overcome this, so you don't figure it out on the day that bad things happen, adopt it as policy, train to those policies and then exercise those policies with all the agencies that may be involved. And that's the only way you can overcome it. So you don't deal with this problem when the bad things happen.Bill Godfrey:So one of the things that jumps out at me is in most models, you've got a single staging manager and maybe a deputy manager. We found out years ago that doesn't work very well here. You need at least one law enforcement staging manager. You need at least one fire EMS staging manager. If EMS is separate, you need a staging manager for them, basically for each one of the radio channels that you're using.Bruce Scott:Absolutely.Bill Godfrey:You're going to need some. And those staging managers together literally have to be together, working together. It's not like they stand on different sides of the parking lot. They're standing working together to make the team assignments. Can you talk a little bit about that?Bruce Scott:Absolutely. So they're in their hip pockets. So if Ken and I were working staging together, we be talking constantly. Him being a Sergeant, soon to be a Lieutenant on the Sheriff's house. He has some authority, so he can tell those officers, he can direct those officers. And myself as a captain of a fire department, I could certainly tell these units, "This is what we're doing." So we have some authority in the staging manager positions that can kind of direct those folks. In the fire service, you know this Bill, you spend a long time in the fire department. We used to use our, I hate to say this, our weakest link to be our staging manager. We knew they were probably not do well down at the fire scene so we would use that resource to the best of our ability. That cannot be the case in an active shooter incident. You need to have your well-trained, well-versed that can listen to what's going on, onto their radios and lean forward and prepare for what they think may happen next, go ahead and begin assembling those resources.Bill Godfrey:I completely agree with you there. Culturally, do you think it's a challenge for the fire service to kind of recognize that active shooter event is a little bit different than the way it gets managed and to let go of some of the, I'm not even sure what to call it, the rigidity of the ICS of having to flow those things through the commander that they... I'm not even sure quite how to phrase that question, Bruce, but you know where I'm trying to go. Culturally, how difficult is it for us to get fire service to recognize that just because of the way they do it on a structure fireworks doesn't necessarily mean that's the best model here and that that's all still okay under the incident command system. The incident commander can designate that authority to the staging manager, delegate that stuff.Bruce Scott:He should. He should delegate that authority to staging manager.Bill Godfrey:What are the cultural things that you think get in the way of that and how do we overcome it?Bruce Scott:Again, I think the only way to overcome it is to practice it where it becomes part of your normal organizational culture. You can't expect to have a plan and do something one way 99.9% of the time and then on this one particular type of incident changed the way you do things. So I think again, practicing it, using special events to practice it where you're staging extra officers or extra fire rescue folks at special events. Use every opportunity you can have available to you to practice it, but our own organizational cultures get in our way. We used to say in the fire service, we spent 200 years of tradition unimpeded by progress.Bill Godfrey:Yeah. It's funny. I was thinking that when Robert was talking about how law enforcement is slow to change, I'm thinking, no, not compared to fire service, it's like comparing a glacier to a flowing river.Bruce Scott:Yeah. We've gotten better at it. I think we're constantly in this training mode now and recognizing the importance of training. But again, I think the only answer to this is to adopt a policy, train that policy and practice that policy. And that's the only way you're going to overcome it long term.Bill Godfrey:So Ken, we're talking about the culture of the fire service kind of getting in the way a little bit here and having to overcome that. What about the culture in law enforcement towards staging?Ken Lamb:Right. So.Bill Godfrey:If your organization made the shift or at least is trying to make the shift, of the four of us here, you're the only ones still on active duty.Ken Lamb:Right.Bill Godfrey:What was that like? What's that culture shift like and what do you have to say to get officers to understand it?Ken Lamb:Right. So what I like to tell my officers, I learned from Billy Perry, which you're obviously familiar with is we need thinkers and doers and shooters. So I need officers that want to be part of the solution, but also need officers to have the ability to think outside of the box. So if they recognize that there are enough resources downrange taking care of the problem, then take a step back and realize what else needs to be taken care of. And in this case say, "Hey, I'm going to set up a staging area at this location," and coordinate that with the dispatcher. And one thing that I love about your programs is that it incorporates a dispatcher because I think the dispatcher or the telecommunication expert can be a critical piece of this and constantly putting over the radio when they're able to, the location of staging and reminding officers to respond to staging instead of going to the target location, because oftentimes the tunnel vision sets in with these officers, and understandably so traumatic event is taking place and they want to get there and be part of the solution.Right. So what I like to tell my officers, I learned from Billy Perry, which you're obviously familiar with is we need thinkers and doers and shooters. So I need officers that want to be part of the solution, but also need officers to have the ability to think outside of the box. So if they recognize that there are enough resources downrange taking care of the problem, then take a step back and realize what else needs to be taken care of. And in this case say, "Hey, I'm going to set up a staging area at this location," and coordinate that with the dispatcher. And one thing that I love about your programs is that it incorporates a dispatcher because I think the dispatcher or the telecommunication expert can be a critical piece of this and constantly putting over the radio when they're able to, the location of staging and reminding officers to respond to staging instead of going to the target location, because oftentimes the tunnel vision sets in with these officers, and understandably so traumatic event is taking place and they want to get there and be part of the solution.And what we've been taught since maybe officers is stop the killing, stop the dying. So they want to go and achieve those two objectives. But the reality is it doesn't take many officers to achieve that objective. And we have a whole lot of other people, a whole lot of other responders trying to be part of the solution coming, and we need to start getting our arms wrapped around this. And when we have thinkers, doers, and shooters, I think that finding their place in those three is really key to organizing this response and having a successful response and achieving this, stop the killing, and stop the dying and getting those people who were injured or survivors who are injured to the hospital within that golden hour.Bill Godfrey:So Ken, Robert was talking a little bit about his personal experience in an incident there. I know you were a responder on one of the active shooter events in Jacksonville.Ken Lamb:Absolutely.Bill Godfrey:What were your experiences? Can you talk a little bit about that?Ken Lamb:Absolutely. So one of the challenges that we had is that we had placed our incident location, staging command post, our witness holding area. We had placed those very close to the target location, that complicated efforts for a variety of reasons. I mean, the first being that you had a large amount of resources right across the street from the incident location, which led to folks who were not in the field level management diving into the field level management, if that makes sense to you. And it also was confusing as to who was checking into staging, who was assigned, who was doing what? And I think a lot of those problems can be solved by having some distance between those locations.And when we talk about staging, having that staging in a cold zone and easily identifiable by all the responders, as well as individuals on that are assigned to the incident so that you know where to go get available resources, because many times you would run across an officer and, "Hey we need someone to do this," and, "What are you doing?" "Well, I'm doing this," and, "I'm doing that." And it was difficult to differentiate who was doing what, and I think that some distance in that staging location would have assisted.Bill Godfrey:If I'm understanding, you're saying that your staging location was almost literally across the street from the attack site?Ken Lamb:Right. And I don't necessarily fault the initial response because there was a lot going on. Understandably so, there was some conflicting information that was coming on or coming in, which led them to stage at that location. But I think that at some point in time, when additional resources arrive and you recognize probably change this location and back this up a little bit and identify this as the new staging location and move in any available resources in that location so that we know the pool to draw from. And it eliminates a lot of the confusion in an already complicated situation.Bill Godfrey:Well, that makes sense. So you're describing a problem that's a little bit different than what Robert was talking about. Did you have any problems with mutual aid or non-agency units-Ken Lamb:Yes.Bill Godfrey:... Not coming to staging or things like that?Ken Lamb:We had problems with units that were not of our agency coming to the command post. So they weren't even checking in and staging, they were just coming straight to the command post. And part of that was due to our setup and the fact that we were so close, but I remember numerous alphabet agencies in the command post that had not checked into staging. And it certainly did complicate things.Bill Godfrey:Does that sound familiar, Robert?Robert McMahan:Yes it does. I want to talk a quick, about a point Ken brought up about dispatch helping out with reminding where that is. And I think that's very important. You get that information out repeatedly so that people coming in to service that, Oh, we heard something's going on. They go jump on the radio. They get that information about where staging's at. I went as far with our dispatchers to, I gave them the checklist. And one of the roles that tactical has is to set up staging right away. I told dispatch if tactical gets up and running and he doesn't tell you where staging is ask him where would you like staging? And that reminds him, that's a conversation that everybody's having like, Oh yeah, we got staging. We got to do that. And that helps get the process rolling in the right direction.Bill Godfrey:It's interesting how much sway dispatchers can have on an event going smoothly. And the idea of having them prompt that is something we try to reinforce in training. Sometimes it works, sometimes it doesn't, but giving the dispatchers the checklist, making sure that they're just as educated on the checklist and the items and the terminology as the responders, I think is critically important. Bruce, would you agree?Bruce Scott:Absolutely. And I'm glad Robert brought the point up because that's the point that I wanted to bring up as well. Right. I don't know how many times in my career our dispatcher saved my button reminded me of things that I had forgotten about. Just simple little things like, "Hey, command, where, where where'd you put your staging area?" Dang, I didn't put a staging area. Maybe I should do that. So I don't know how many times they've saved us.Bill Godfrey:Absolutely. And I think that those items not only empowering the dispatchers, but the other piece is that, they've got to have the training, which I think is one of the reasons it's so important as Ken mentioned, to have dispatchers be part of the training we do, is they need to know what the process is supposed to be. What is it supposed to look like? What is it supposed to sound like? And what are the elements that are critical that if they're missed, as you just saying Bruce, I probably ought to provide a gentle reminder.Bruce Scott:Yeah.Bill Godfrey:That we need that benchmark. So Ken, I'm interested to know if you're comfortable talking about it because I realized this wasn't that long ago.Ken Lamb:Right.Bill Godfrey:With the staging area, almost literally across the scene from the attack site, was it a problem for you to get your fire department to stage with you in the same staging area?Ken Lamb:So the interesting part of that response is, by the time the following resources arrived, the fire department had already taken the survivors and transported them to the hospital. So they were gone. So it was kind of chaotic. We did eventually get them back and be part of our response, and Bruce can comment more on this than I could, but in my experience, they travel as a package. So when they arrive as a package, they're all leaving as a package.Bruce Scott:And the interesting thing on that particular call is that, the first responding fire units, weren't dispatched.Ken Lamb:Right.Bruce Scott:They were literally across the street doing some training exercises at a parking garage and heard the shots and people screaming, running out of the landing. So the firemen did what firemen do.Ken Lamb:Absolutely.Bruce Scott:They ran to it, without any help.Bill Godfrey:That's a whole new meaning to a first responder.Bruce Scott:Absolutely.Ken Lamb:Right.Bruce Scott:I think that led to what Ken's leading to is some difficulty getting them out of the hot zone because they were already in there treating them.Bill Godfrey:So Ken, more recently you had a civil unrest incident that required a fairly large response.Ken Lamb:Right.Bill Godfrey:And if I remember correctly, you inherited the staging manager role.Ken Lamb:Absolutely. And I was excited to do it because obviously been to this training, assisted in the instruction, so it was excited to take on that responsibility. And I remember watching this play out on TV and I was like, Oh, I can totally run this staging. Let's do it. And I got the call.Bill Godfrey:How did it go?Ken Lamb:It went really well. At first, so there were a lot of challenges. The first challenge that I had to overcome is, and we really don't think about this in time, but you have to get permission from individuals use their property. I mean, we're police, we just can't go take over someone's property and fortunately.Bill Godfrey:You can't?Ken Lamb:No. You can't.Bill Godfrey:I thought you could.Ken Lamb:We can't park 500 police cars on someone's parking lot and just say, "Hey, this is our parking lot for the next seven days." But fortunately we have really good partnerships in that area. And we had reached out to the local community college, their head of security, and he was gracious. It was during COVID. So they weren't having class anyways. Or if they were, it was very limited. And he gave us permission to use their entire parking lot, which had a good access control point. That was my first thing I was looking for is how can I control access to this? Because I feel like security is really important, particularly in this situation, we didn't want any of the protestors coming to our staging location and essentially starting an additional protest at that location, which brought up our second challenges that the protest was constantly moving. Like it started at this area and then we would find on social media that now they're going to do a protest in this area, which there was a park right next to our staging location, which meant we had to move our staging location from the parking lot.We are currently in to another parking lot. So I had to find an additional staging location and work through all the logistics of moving 200 plus police officers in addition to a change of shift, to a different location. And the communication there in was certainly complicated. But using many of the processes that we teach as C3 Pathways that really enabled a smooth transition and in my mind, my number one priority is I want to ensure that the officers know where they're going, what they're doing, and why they're doing it so that they're not disgruntled. Because I know this will be shocking to all of you guys, but there's nothing worse than disgruntled police officer, particularly in staging. They find creative ways to do things, but just drive you a little nutty.Bruce Scott:Affirmative.Bill Godfrey:And what's your joke about the three steel balls?Bruce Scott:Yeah. You put a fireman in a room with three steel balls, come back an hour later, one will be missing and they won't know nothing about it.Ken Lamb:Absolutely.Bruce Scott:And you and I ran into this when we were going to Katrina. We stayed for a long time with our task forces. And the worst thing you do is have them just standing around. They're tearing stuff up.Ken Lamb:Absolutely. I tell you, one of the things or the aspects of staging that I didn't think about until I was doing this and I had the large amount of resources is, I was working with the ops section chief, which was Travis Cox, he's also an instructor here. And he wanted to know what are my resources in staging and create that common operating picture. And that's where we started kind of really thinking of some innovative ideas where a separated command post or a separated law branch or whatever branch could understand what was in staging because they're ordering resources but sometimes in the communication there would be some hiccups and you would order 20 police officers and 40 police officers would show up.And when you talk about finances and overtime and all these other aspects that come into play, when you have these resources, you want to know, do I have what I ordered? And if I don't, what do I have? Is it less, is it more? So that they can adequately staff, whatever group or resource or strike team that they're trying to form and put in a place that they have the adequate resources for that?Bill Godfrey:How many folks did you have working with you, Ken in staging?Ken Lamb:Yeah, I had an assistant staging manager and I was able to get many of the, the resource unit leader team members over to assist with the check-in and kind of managing that flow into staging because as I had mentioned, we wanted to make sure we had a access point and an exit point so that we just didn't have officers kind of going in different ways, either coming in or leaving. And it was easier to keep accountability of folks when you had one point of entry and one point of exit. But the challenge is that you didn't want to have a large line of resources checking in and just killing time waiting in line. So we got a bunch of resources check them.Bruce Scott:Yes. The reason I ask is that, you think of the staging models and even the one where you're using where you have one law enforcement officer, one fire EMS person, but you do what you need to be successful. Right?Ken Lamb:Right.Bruce Scott:And again, instant command system allows that. If you're practitioner of the incident command system that allows that.Ken Lamb:Absolutely.Bruce Scott:It allows you to do check-in and staging, it allows you to do those things that you need to do to be successful. But Bill, the one point that I wanted to make, I think is really important. I think the mentality is, if I stop in staging, we're wasting time. And really the truth of the matter is if you stop in staging, you get an assignment, you get a task, you go down range with that assignment and task, you have the information you need to be successful, it's actually faster. And I think that's the important thing.Bill Godfrey:Bruce, I completely agree with you. One of the, and having been doing this for so long now, I mean, we've been doing the training and teaching this for over a decade. And I remember some of the early conversations with some key law enforcement figures, as we were working through processes and procedures and saying, because they kept saying, I need every gun down range. And I said, "Look, I agree, but don't you need every gun exactly where you need them when you need them?" And they said, "Well, yeah." And looked at me kind of puzzled. And I said, "If you've got 10 guns, 12 guns, 20, whatever that number is, how are you possibly going to make sure that each one is where they need to be when you need them there, if you don't organize this a little bit?" And that was kind of a breaking point. Now Robert you've in the business a long time, how many years on total?Robert McMahan:32.Bill Godfrey:32 years. And you've seen a lot in your career change. How does what we're doing now what we're training now compare and contrast to the very first one you experienced?Robert McMahan:It's a light years ahead of where we started. And you guys talk about managing resources and making sure you have guns down range where you need them. And that's very important. And we talked about the time factor here and saving time and Ken alluded to how law enforcement often has to go find somebody and what are you doing, and try and repurpose them. If you have officers in staging, when that next tax comes up, like perimeter group or reunification security or whatever it is, you don't have to go try and pick them out of the mass that's out there and try and repurpose them and figure out if they're doing something essential now, or can I repurpose them for something else they're going to be there that will save time, that will drive towards a better result in these things.And we just have to remember that from Columbine when we experienced that to today, that the way we do this has changed and it's got to keep changing it and we got to keep getting better at it because at the end of the day, we're here to save lives, but that's not the only thing we do there. We've got a whole other incident to manage. Once we've saved the lives, it's still an incident.Bill Godfrey:Yeah. It's we have to save lives and not just the traumatic injuries of the physical body, but also the recovery of those survivors. And as we've all learned sometimes painfully so, how that incident gets managed can have a positive or a negative impact on the long-term recovery of survivors, the recovery of the community, and the ability to pick yourself up and not let that define you. I remember my conversation vividly with a young lady that was a survivor of one of these horrific events. And she said, the turning point for me in my recovery was when I shifted from seeing myself as a victim to seeing myself as a survivor and this thing happened, but it doesn't define me. And I thought that was a really, really powerful message.Robert McMahan:It is.Bill Godfrey:Really powerful message. We talked just not that long ago with John Michael Keyes and about the idea I was reminded as I relistened to that because that podcast, we originally courted right before COVID in December of 2019 before COVID and I had forgotten, we were talking about reunification. We were talking about the new SAVE them programs, school safety and violent event incident management course, we're doing. And the tail end of the conversation, we got talking about this idea of an emotional responsible room entry. And I'd kind of had forgotten about that conversation because COVID just kind of derailed everything that we were working on. And I realized that we needed to pick that back up. And I know it can be a difficult challenge for us to think about as responders, but when these events occur, especially when they occur with young kids and you've dealt with the threat, you've dealt with the injured. Now it's time to start clearing and moving the kids to a secure offsite reunification.How you do that, how you make those room entries can either help or harm the emotional health of the traumatization of the kids, of those children. And the conversation we were having and this is one I think that law enforcement really needs to grapple with. And there's not an easy answer. And that's part of the frustrating part is there's not easy answers to some of these things, but how do you do a tactically safe room entry without scaring the bejesus out of a bunch of little kids? What does that look like?Ken Lamb:Right. And from my professional experience, if the threat is neutralized or you have good information to believe that the threat is not in that location, then it's a slow and deliberate room entry, which is doing clearing as much of the room as you can from the outside of the door, which means a less dominating room entry. So if we're just conducting a pie from outside the room, you're able to identify the people inside the room. You can talk to them, their emotions aren't as high because you're taking your time. And I know from my agency's perspective, that's the tactic that we adopt once the threat has been neutralized, or we have a known location for the threat is that the rest of the structure is just a slow and deliberate. We're using mirrors, we're using cameras, we're using any and all technology that we can leverage to clear the inside of that room from outside.Bill Godfrey:Interesting. I think we probably could and should do an entire podcast just on this topic and maybe do a round table of some of our law enforcement instructors to kind of talk about what that might look like. Robert, I know that you have some personal passions on this subject. You guys, Robert, you mind coming back and talking about that in another podcast?Robert McMahan:Oh, absolutely.Bill Godfrey:All right. Well, we'll get that one scheduled in the future. It was an interesting tangent from a staging podcast. I'm not even sure how we got there, but gentlemen, thank you very much for coming in and talking about this important topic. Ken, Robert, Bruce, it's always a pleasure to have you here.

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Interview with Coach Travis Cox

Play Episode Listen Later Mar 28, 2021 41:13

Jeff interviews the head coach of the Ridgeline Football team Travis Cox.

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Episode 105 Travis Cox Streaming, Family & Geeking Out

Conversations About...

Play Episode Listen Later Jan 9, 2021 88:24

So when a buddy starts streaming on Facebook, I have to talk with him about it. Travis is a family man, a wrestling fan and geeky. So we get into video game streaming, setup ups, how to start streaming, wrestling, comic books, movies and a whole gambit of topics. Join the conversation. Find Travis streaming here: https:fb.gg/Epsilonlive --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/conversations about.../support

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Episode 7 - How Inductive Automation has enabled industry disruption and created innovation

IoT at the Edge

Play Episode Listen Later Jul 20, 2020 35:07

The automation industry is a slow-moving machine. It’s encumbered not only with complex, specialized processes and long-life legacy equipment, but also the lasting effects of automation vendors focused on closed systems and vendor lock in. Taken together, it’s created a landscape primed for disruption. That state has been further exposed by IT/OT convergence and digital transformation. In today’s episode, I talk with Inductive Automation’s Travis Cox about the state of the industry, how Inductive Automation approach has enabled industry disruption, and forward looking trends on where the IA community is creating innovation.

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Travis Cox & Arlen Nipper Talk MQTT & Digital Transformation

Inductive Conversations Podcast

Play Episode Listen Later Feb 2, 2020 36:14

Travis Cox and Arlen Nipper take a deep dive into the world of Digital Transformation and IIoT. They discuss the success of the MQTT protocol, the importance of education in continuing adoption of MQTT, the hurdles companies face when approaching the Digital Transformation, and how a strong ecosystem can achieve a solid IIoT infrastructure. They also touch upon the importance of the Eclipse Foundation, Sparkplug Working Group and much more. Learn more at inductiveautomation.com

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Travis Cox Testimony

Cottonwood Men Bible Study at Cottonwood Church

Play Episode Listen Later Jan 20, 2020 35:37

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The Full Court Press – Mike Hansen – December 10, 2019

Phoenix Bats Uncut: The Baseball Podcast

Play Episode Listen Later Dec 11, 2019 18:41

Ridgeline High School Athletic Director & former Logan High School Head Baseball Coach, Mike Hansen joins the Full Court Press to talk about the new Football hire in Travis Cox, what the process was like and why they chose Travis.

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# 4: Travis Cox

Forge Resilience Podcast

Play Episode Listen Later May 17, 2019 56:04

This week we sat down with Travis Cox, a veteran turned strength and conditioning coach for the San Antonio Spurs, turned business executive. Travis got real with us as they discussed how mentors, connections to the veteran community, his faith, and his work with non profit organizations has helped him to thrive. He served 8 years in the Reconnaissance community. If you are unfamiliar with what that means, which is an elite special operations unity within the marine corps. He served one deployment in Iraq as a point man & designated marksman in a Force Recon Direct Action team. He finished his time in the Marine Corps as the Chief Scout and headed up all sniper training within his recon unit. After returning from military service, like so many veterans Travis struggled to find a direction and found himself moving down a dark path with substance abuse. In the podcast he talks about his struggles with substance abuse and how he found his way back to health and happiness through recovery.

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Episode 7 - Special Guest Travis Cox of the Worthington Wood Bat Tournament - NL East Predictions

Play Episode Listen Later Mar 13, 2019 58:48

Phoenix Bats - your favorite bat company - is now podcasting! Join host Joel Armbruster - CEO of Phoenix Bats - as well as his fire throwing teammates Brian Chenetski and Rick Antinori, as they discuss the Worthington Wood Bats Tournament (@WoWoodBat) with tournament director/founder Travis Cox. The guys make their NL West predictions and touch on the week in baseball news. #TeamPhoenix Twitter:@PhoenixBats@JoelArmbruster@B7aylor@BrianChenetski@WoWoodBat Instagram:@PhoenixBats@JoelArmbruster@b7aylor@Chenetski Email: podcast@phoenixbats.com

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Episode 07: Tactical Training for Leadership

Play Episode Listen Later Aug 26, 2018 32:07

Episode 07: Tactical Training for Leaders Discussion of leadership engagement, tactical training for leaders, and leadership modeling. Bill Godfrey: Hello, and welcome to our next installment of our podcast series on active shooter incident management training. My name is Bill Godfrey, a retired fire chief, and one of the instructors for C3 Pathways. I'm your host today, and with me is Michelle Cook, also one of our instructors but recently retired from the Jacksonville Sheriff's Office after 26 years. Michelle retired as the director of patrol and enforcement, which in layman's terms, Michelle, basically you were the ops chief - Michelle Cook: I was chief, yes. Bill Godfrey: About 1,200 uniformed officers. Michelle Cook: Yes, sir, 1,200. Bill Godfrey: And now she is enjoying life. For the last year, she is the police chief of Atlantic Beach Police Department, a small, beach-side community, beautiful little area, with ...? Michelle Cook: 30 officers. Bill Godfrey: 30 officers. Michelle Cook: 30 total officers. Bill Godfrey: From 1,200 to 30. Michelle Cook: 30. Bill Godfrey: So something tells me we're going to be coming back to some stories there about the difference between large agencies and small agencies. But in this episode we are going to be talking about tactical training for leaders, both on the law enforcement side and the fire department side. Michelle, you've been on the job for 27 years so you were around when Columbine occurred in '99. And as we all have so often pointed to this kind of watershed moment of, "Wow. Things need to change here. We need to make an adjustment," give us a look back from your perspective on the changes that you've seen both in the tactical training for line officers, for patrol officers, and then also the training that went with that for leadership on the law enforcement side and how to manage these incidents differently. Michelle Cook: Sure. So Columbine happened in 1999 and in that year, and the previous couple of years prior to that, I was working part-time at the police training academy. So when Columbine happened, I was there when we evolved our tactics. We knew that, at that point, surrounding the building and calling the SWAT team was no longer going to work. People were dying because that was our strategy, and so we knew that wasn't going to work. So following Columbine a series of evolutions came out, tactical evolutions, that saw the introduction of contact teams. You know? First they were diamond shaped with five people inside, and then it went to three people, and we've evolved so far today that a lot of agencies are pushing the solo officer entry, if that is the best route for that officer at that moment, at that event. So tactics have definitely evolved since 1999, and they continue to evolve. Up until C3, what I haven't seen is the evolution of, "How do you manage these incidents or events?" So pre 1999, I'm a patrol supervisor on the street; an active shooter call goes out. I tell my officers, "Surround the building. Wait for SWAT." SWAT shows up. SWAT command does their thing; they take charge of the building. When tactics change for a patrol officer to make entry, we never trained the supervisors on how to lead or manage that entry. So as tactics have changed, leadership and management of these incidents and events hasn't evolved, and that's really where we have a training gap now. Bill Godfrey: It's interesting the way that you've put that. I think in a lot of ways, we have a very similar gap on the Fire-EMS side. Of course, the fire service has been using ICS for years, and in some ways that has grown a level of self-assured confidence that we can kind of manage or handle anything. And one of the things ... You know? You mentioned C3 beginning the work in this area quite a few years ago now. One of the things that led us to that was kind of the "whoops!" moment where we went, "Okay. The way we manage a fire applied to an active shooter event is not having the kind of outcome that we want, and we need to perhaps look at this and see if there aren't some things that are different." And of course, there were, and there are some things that we train to very, very differently on that front. It reminds me though ... You know? Sheriff Kevin Barry in one of our previous podcast episodes was talking about the challenges of being the chief, that the higher level leadership ... You know? You're inundated day to day ... And I remember this from my time too. You're inundated day to day with budget meetings, and paperwork, and HR issues, and purchasing stuff. It can be very difficult to say, "I'm going to take an entire day and go to training. I'm going to take a week and go to training and set that time aside." It's very easy to push it away. And Kevin was making the point that sometimes as a leader, you've just got to suck it up and get it done and recognize that it's a priority. Do you think that that is impacting, in a negative way, our ability to get leadership across the country prepared to manage one of these events? Michelle Cook: I think that's part of it. I think there's a couple of other things that are happening too. You know? We have the busy schedules. We also have this, "Well my guys will handle it. My guys will go in there and kill the bad guy, and my guys will handle it and it'll be taken care of," and what we've learned is active shooter incidents are much bigger now than just going in and killing the bad guy. And up until C3 Pathways, there was never a template of how to manage these incidents so that the tactics guys were knocking it out of the park with the evolution of how to go in there and mitigate the bad guy. What wasn't happening prior to C3 Pathways, there was nobody saying, "Hey, this is a way to manage it. Here's a template for you to use. This is how you, as leadership, can manage this large event that is going to expand very rapidly. And within minutes you're going to have hundreds of resources there." There never really existed a template for leadership so the combination of being really busy, passing the buck to your guys to handle it, and a template being out there, I think, all led us to where we have found ourselves, which is a lot of leaders have been caught on their heels, so to speak, not understanding what's happening or how to manage it. You know? I'm not going to point out any particular recent event but if you look at them as a whole, how many times did you hear on the radio we had line level officers, Fire-EMS trying to do their job and somebody in management was saying, "Well hold on. Wait a minute. Wait until I get there. You guys don't go in yet"? And that's because that leader failed to understand the tactics that were occurring, and failed to prepare themselves to manage those tactics. Bill Godfrey: That's a really interesting point. When you think about some of the exercises that both of us have done and been involved in, we've seen that occur just in exercises and training, where the command post ... And I've seen it happen on the medical side as well, in Fire-EMS. There's this challenge of, "When is the warm zone really warm?" or, "When is it warm enough?" and hesitation from the command post in wanting to let the rescue task force go downrange, or wanting to let them move downrange, and I always kind of found that interesting. Because you're trying to get your head wrapped around something that you can't directly see and observe, as opposed to the police officers that are already downrange who are saying, "We're ready for the medics. Send me the medics. Send the rescue task force." And they know what that means. They understand what they're asking for ... Michelle Cook: But the leadership doesn't. Bill Godfrey: Right. Michelle Cook: Because the leadership has not attended any training, looked into what their guys are actually practicing, or attended any training themselves. So if my guys are using terms downrange, and describing things that I've never heard before - warm zone, hot zone, cold zone, red, greens, casually collection points - if I don't know what those mean as a leader, the natural tendency is to say, "Well hold on, guys. I need to come look at this before I let anything happen." Bill Godfrey: "I need a minute." Michelle Cook: "I need a minute." Because, you know? You have to prepare the brain for the actual event. And if you as a leader have failed to prepare your brain for what can eventually happen, then you're going to get caught off guard. And that's the lapse that we're seeing. That's the, "Hold on, guys. Wait a minute. Wait till I get there," that we've seen in recent events, and unfortunately people die because of that. Bill Godfrey: And I think that's my frustration in trying to communicate the challenge sometimes. It's not about right or wrong. Michelle Cook: Correct. Bill Godfrey: It's not about right or wrong. It's not about, "There a right way to do this and a wrong way to do this," or even a best way. It's a question of the clock. You've got two things that are going to kill people: the bad guy and the clock. I mean, law enforcement, last 10 years - you can look at the numbers and look at the data - historically, putting the bad guy down very quickly. Michelle Cook: Correct. Bill Godfrey: That active threat is ending in minutes. It's very quick but yet we keep managing to fumble the opportunity to quickly get medical care in to patients, and then quickly get them transport. That's the other thing of this, is ... You know? It's not just enough to get the RTF downrange; we've got to get those patients out again. And so that whole hesitation from the command post that says, "Oh, I need a minute to get comfortable with this ..." Michelle Cook: Correct. Bill Godfrey: We're just burning clock. Michelle Cook: Sure. And we haven't trained with our counterparts on the Fire and EMS side. So not only have I not trained to the tactics that my guys are using and understood those, I haven't trained with the Fire-EMS guys. So when the guys downrange are talking about rescue task forces and I have an EMS person walking up, I don't know what they're talking about because I have failed to prepare myself. Bill Godfrey: I think the fire service as a whole ... EMS as well, but I think the fire service kind of takes the brunt of this. We've missed an opportunity to make it welcoming to the Incident Command System. You know? Between the fire service being very rigid- Michelle Cook: Sure. Bill Godfrey: Very rigid. Very black and white, very rigid, very dictatorial about how ICS is supposed to be, and have to do it this way and have to do it that way. Michelle Cook: And policemen think ICS is a bad word. Bill Godfrey: Yeah, exactly. Michelle Cook: Right? Bill Godfrey: Which is largely our fault, and FEMA played a part in that a little bit too. Somewhere along the lines, law enforcement, they not only think ICS is a bad thing, is a bad word, they think a tractor trailer full of paperwork is going to back up to your scene and dump 10 tons of paper on you scene. That's not what it's about at all, and I think we've got some work to do there, but I think even on the fire side, there are some gaps for us as well because the functions and the command posts in an active shooter event are very different than what they typically are in how you run a fire. In a fire, it is typically a fairly flat hierarchy. It's the, the battalion chief is in command, and he is directly ... All of the troops that he's directing are direct reports. We don't see a lot of these where there's a bunch of divisions and branches. It happens sometimes, but it's not very common, and the incident commander, as that battalion chief in that fire, is actually providing not just strategic directions but tactical direction. That doesn't work in an active shooter event. No, that tactical direction has got to come from the tactical and triage level- Michelle Cook: Who are at the scene. Bill Godfrey: -at the scene, at the edge of the warm zone, and the command post has a whole host of other issues that they've got to deal with and manage, and I think that from the fire side, there's just a failure to understand that not only do we need to implement those layers, but we really ... These things are a bottom up driven event. You have got to trust the eyes and the ears, and the judgment of the people down range and support what they're trying to accomplish rather than trying to dictate the tactics that they're going to execute. Michelle Cook: Sure. Sure, and that goes back to if you understand and train with the guys at the line level on what they're doing and what their competency is, and you have a trust in them, and you trust your fifth man, you trust that tactical person to be making those calls. If you're at the command post, and this is another interesting thing about police work, is in many cases, for years, the police command post has been at the scene, like on top of the scene. I know firemen are guilty of that as well, but the closer we can get to it, the better, and that's just not going to work here because if you trust your line level officers to be handling the job, and you trust your tactical to be working with triage and transport to get the injured off the scene, there's a whole host of things that need to be happening at the command level that you cannot do if you're in the weeds at the scene. But because we haven't trained on what's going on, we resort to what we know, which is getting back into the weeds. I've listened to audio clips where you have captains and police officers of higher rank trying to dictate line level tactics at the scene, and they're not even there. That's another kind of cultural change in the industry that we have to see. Bill Godfrey: Officers, you trust them with a gun and with bullets, and on the fire side, we're trusting the medics with drugs and a defibrillator and an advanced airway, but somehow, now all of a sudden, in this environment, we're hesitant to trust their judgment a little bit. It's interesting. Michelle Cook: Well, I'm not sure if it's hesitant to trust their judgment. I think we're hesitant because we don't know what they're doing, because we haven't been there to train ourselves. It goes back to, "Well, I'm too busy. My guys can handle that. It'll never happen here. I'll send my guys to the training." We've hosted several training events over the past year here, and I'm getting line level officers, which is great, but we're trying to teach incident management here and they're sending line level officers. I think it's hesitancy because they don't understand what's happening, and they're not prepared because they haven't engaged in training. Bill Godfrey: Meanwhile, the sergeants, lieutenants, captains are going to be the ones there that are going to be expected to put their arms around the thing and there's a gap. Michelle Cook: Sure. Sure. Bill Godfrey: So, given this gap that we've so eloquently discussed here, what's your short list? What are the things that a leader ... What's a modern day law enforcement leader need to know about managing an active shooter event? What's your short list? Michelle Cook: I think you have to research active shooter incident management. C3 Pathways is a way. For me, it makes sense. It works, so I think you, as a law enforcement leader, have to find some active shooter incident management training out there somewhere and you have to attend it. Don't send your people. You've got to go yourselves. I think you also need to attend active shooter tactical training that your officers attend. Number one so you understand it and number two, there's a chance, especially for somebody like me who works at a small agency, there is a chance that I could be a first responder, and so you have to understand what tactics you guys are training to so you don't muck it up the day of. I think those are probably the biggest things. Then, you've got to make nice with the firemen and EMS that work in the area. I think you've got to do that, and you've got to talk these concepts with them so that game day, everybody is on the same page. Bill Godfrey: If I were to have a short list on the fire/EMS side, similar in many ways, I think that leadership of fire/EMS needs to get to the training that the line people are taking. They need to see it, they need to understand it, they need to go through it and have the opportunity to ask some questions. I also think at the command post, they need to understand that where you normally in your role of leadership in the fire service are very tactically driven. You're very operational and hands-on, that in the command post, that's not going to be the role. That role is instead going to be handled down range by the tactical triage and transport officers that are operating at the edge of the warm zone, and that it has got to be a bottom up driven event. This idea, and I think the other piece of this, and they're kind of tied in together, is the idea of over-driving it, or what I'm going to call micromanagement from the command post has got to stop- Michelle Cook: Got to stop. Bill Godfrey: You've got to get that out of there, it's got no place, and then the other thing is this false security blanket of unified command is going to solve everything. We, of course, know you were part of the research that we did when we had some gaps that came up because of relying on that. If you stovepipe through the top and try to run everything operationally through the command post- Michelle Cook: It's not going to work. Bill Godfrey: -through unified command, it's not ... Well, in fairness, it's just not going to be fast. Michelle Cook: Right, it would be slow. Bill Godfrey: You'll get there. It's slow. Michelle Cook: Yes. Bill Godfrey: It's not going to get the job done quickly, and I think what has happened is we've confused, in the fire service, unified command, which is a very specific term with a very specific meaning, and as an old guy who was on the job when we invented it and added it to the ICS vernacular, it was developed to deal with this situation where more than one entity had a legal authority to be in charge of the incident, and we've confused the idea of unified command with what I think we really should be talking about, which is unified management. Up and down the food chain, we need to have line level law enforcement officers and line level medics that are trained and know how to work together on their teams, be it rescue task force or other functions. We need first level supervisors, sergeants, in some cases lieutenants too, or corporals or advanced level officers on the law enforcement side, and company officers on the fire and EMS side who understand the role of tactical triage or transport, and understand how that fits together. Then, the leadership, the executive level leadership, needs to understand that the role of the command post is to support those missions but also the much larger community impact, the messaging, if you're dealing with one of these- Michelle Cook: Sure. Bill Godfrey: -events at a school, you and I have had these conversations so many times. Michelle Cook: Sure. Bill Godfrey: It used to be you could wait 30 minutes before you started putting the message out. Your parents are going to be at these schools before your full response shows up. Michelle Cook: Sure, and I want to go back on something you just said. I was recently invited to a law enforcement panel discussion with the community, and there was probably about 100 citizens there. There was three law enforcement leaders there, including myself, and a citizen asked "If an active shooter happened at XYZ location, who has jurisdiction?" My response to that citizen was, "If we're all training together or working together, until the last injured person is transported off that property, it doesn't matter who has jurisdiction because we're all on the same team, and the team is there to stop the killing and stop the dying. Then we'll talk about who has investigative jurisdiction." I think that lends to the value of leadership training and leadership relationship building with those jurisdictions around you, both police, fire and EMS. Bill Godfrey: Fantastic point. Travis Cox, who you know, a lieutenant with Jacksonville Sheriff's Office, one of our other instructors on another episode, he made the point that if this comes to your hometown, it doesn't matter what patch is on your sleeve. It doesn't matter whether it's a law enforcement patch, a fire department patch, an ambulance patch, a hospital patch. It doesn't matter. It doesn't matter what jurisdiction. We are there to save lives, and we've got to work through all of that. The other point that he made that I thought was really very critical is that the ability to work together doesn't happen automatically. Michelle Cook: No. Bill Godfrey: You've got to make an effort. Michelle Cook: You have to make an effort, and as a leader of an organization, you have to lead by example. If you expect your line level guys up and down your chain to be making relationships with the other agencies around them the other officers around them. You as the leader need to be leading by example and they need to see you having conversations and training with both Fire, EMS and other police organizations. Bill Godfrey: Interesting. So I'm gonna come back to this size shift from the Jacksonville Sheriff's office of 1200 down to Atlantic Beach police Department of 30 officers. Michelle Cook: That's 30 including me. Bill Godfrey: 30 inclu ... well you know, we actually have had a number of active shooter events across the country where the police chief was one of the first ones in the door so you're right it's not unheard of but it does make me think. In law enforcement ... I mean across the country aren't most law enforcement agencies smaller agencies as opposed to these gigantic metro organizations? Michelle Cook: Absolutely, absolutely. Most ... about 90% of law enforcement agencies have 25 officers, 50 officers or less. So most are small and it's really recognizing that has really made me step up my tactical game because I understand that being one of five or six people who may be on duty during the day, there's a good chance that if something happens in my community or on one of the neighboring communities, I'm gonna be a first responder. Bill Godfrey: Interesting. So you are in what I would consider to be a very unique position to have the perspective from a large agency down to a small agency. We just talked about what was on your hit list of leadership training. For the chiefs of police, sheriff's of rural communities and the leadership at the larger ones. What do you think are the differences? So we talked about the things that you needed to hit but tell me a little bit about how that impacts the large agency versus the small agency. Am I asking that? You're giving me the puzzled look. On the scale of the leadership of these large agencies, what are the things that they need to focused on versus- Michelle Cook: Leadership of a smaller agency. Bill Godfrey: The leadership at a small agency. As you're moving down the scale and size, what are the differences and challenges? Michelle Cook: Well I think with the larger organizations you've got to stick with the tactical training and you have to make sure that your line level supervisors, sergeants, lieutenants, assistant chiefs or captains, whatever you have. All have both tactical training as well as management training, active shooter incident management training and can fill those roles. When I was at the Jacksonville Sheriff's Office being the number three in charge there was probably very little to any chance that I would ever be out and about near an active shooter scene in fact- Bill Godfrey: Did they even let you carry your gun back then? Michelle Cook: I got to carry my gun but I was usually 30 to 45 minutes away so all the good stuff had happened by the time I got there. So I was really more in the management lane so to speak on those. The smaller agencies, you got to know from top to bottom. I got to know everything from tactical ... being a contact team. First person in the building all the way to briefing the governor an hour later when he calls. So I've got to be prepared for all of that. Both the first responder role to the command role and everything in between and it's ... the training's a lot more fun 'cause you get to engage some more of the hands-on training but especially if you're in a rural area and you don't have a whole lot of resources you need to be on your A game, all the time. Because there is ... you're it, you're it and if you don't know how to respond that's gonna be a problem and if you don't know how to manage it. To me the problem is going to be worse because in Jacksonville if 600 policemen responded they worked for me. So they all knew my language, they all knew the codes, they all knew what to expect, they knew me. Something that happens out here in Atlanta beach, I've got probably six to 10 different agencies responding. They don't all know Michelle Cook so if I'm not making an effort to get out there and tell them what I expect in Atlantic Beach. Tell them how we're going to respond in Atlantic Beach and they understand what's gonna happen when they come into our jurisdiction then that adds to an already bad problem and I think you've seen that in a lot shootings. So many jurisdictions show up and they haven't trained together. So that is a problem that I think smaller, rural communities face is not only are a lot of resources coming but a lot of resources who have no idea what to expect are coming. Bill Godfrey: Interesting. So let me ask you this one from these different levels that you've been at from large to small. For your contemporaries out there on the law enforcement side, law enforcement leadership. What are the suggestions or tips that you would give them about working with their fire services EMS counterparts? How do they engage, cut through politics, budget talk, hard feelings left over from 20 years ago of XYZ thing. How do you get the job done? Michelle Cook: Persistence. We're very fortunate we have a fire station next door that is affiliated with the county not with the city and there are ... when I have a few minutes I walk over there and I start talking to them and I'm dealing with three different shifts so I got to hit them three times. I'll walk over there with diagrams, with a list of definitions and I'll just leave it on the table where they eat and hope they look at it. I invite them to every single training that we have and encourage them to come over even if they can only stay a few minutes. At least they're getting something out of it. And just persistence of, "hey guys" in fact this week they were watching the fire truck and I said, "Hey guys, what's the status of your body armor." And so they were talking about how their agency is gonna handle body armor so we had some conversation about well what if something happens out here at the beach? How are we gonna handle it? And so even those little informal touches I think all lend to the relationship. It doesn't have to be formal meetings. It can be, "Hey I'm gonna come sit down with you while you're eating, hey let's talk about this." But I think you have to be persistent about it. You can't let it go, it's so easy. It's so much easier to just let it go and think, "Okay it will never happen here." But I don't wanna be that guy who's named in an after-action report or who's face appears across national news as failed to do her job. And I don't wanna let the kids down, the people down, the community down or my agency down and I think that if you're not looking at this realistically. If you're not making any effort to address this at your level then you're letting your community down. I'll just be point blank about. You're letting the community you serve down by not preparing for this. Bill Godfrey: I think that's very well put. On the far side I think it's part of just going to have the conversation. Making a deliberate purposeful effort to say to the Police Chief or to the Sheriff or to the Commander or whoever you've got the relationship with. To open the door and say I really wanna talk about this. We need to talk about this some more and start small. You mention inviting them to training, I think anytime you can do joint training between law enforcement, fire EMS and include the dispatchers it's a game changer in getting things done but I think the other thing on the fire services, we also need to not overstep our area of expertise. Active shooter events are essentially a murder in progress. Michelle Cook: Absolutely. Bill Godfrey: And at no point is a fire department going to have legal authority to be in charge of a murder in progress. Not while somebody is trying to murder and while yes, we may be in charge of patient care. We can't do that patient care without access to the patients that is limited and controlled by law enforcement in an unsecured scene and certainly we're not gonna be in charge of the investigative stage. So I think a little bit of this, I don't wanna say, it's not so much a hat in hand approach but a knowing where we fit. That this is a type of incident where we are a supportive role. It's an important part of it but if we're going to save lives we have to work together. We might have the best medics in the world but if you can't physically get access to the patients because you haven't trained with you law enforcement officers, it isn't gonna do any good. Michelle Cook: Correct. Bill Godfrey: If you're transporting patients in the back of a police car there's not patient care going on in the back of that police car. Michelle Cook: Or you're taking them all to one hospital because we haven't prepared to manage this. Bill Godfrey: Exactly, exactly so I do think it is very much a two-way street but you make a really interesting point. Wow the time really flew by. Anything else that's on your mind that you wanna talk about as we wrap up here? Michelle Cook: ICS is not a bad word. No this has been good. I just ... I encourage police leaders. Make the effort, make the effort because lives depend on it. Bill Godfrey: Michelle thank you very much for taking the time to do this today. I look forward to the next one. Michelle Cook: Thank you. Original Source: https://www.c3pathways.com/podcast/tactical-training-for-leaders

leadership training fire active jacksonville sheriffs commander surround fema swat ems police chief columbine xyz active shooter ics rtf incident management tactical training atlantic beach fire ems michelle cook incident command system original source travis cox jacksonville sheriff's office c3 pathways bill godfrey

Episode 06: What Makes Managing an Active Shooter Event Different?

Play Episode Listen Later Jul 16, 2018 21:26

Episode 06: What Makes Managing an Active Shooter Event Different? Discussion of what makes managing Active Shooter Events different from other types of incidents Bill Godfrey: Hello, and welcome to the discussion this afternoon. Today we are going to talk about what makes managing active shooter events different from all of the other types of incidents that responders go to. Today, we have with us Adam Pendley, assistant chief with Jacksonville sheriff's office, Travis Cox, lieutenant with Jacksonville sheriff's office, Tom Billington, retired fire chief, and I'm Bill Godfrey, also retired fire chief. Our topic today, Adam, what do you think sticks out in your mind, makes things different? Adam Pendley: Well, I think it's a great number of resources that respond very quickly in an active shooter event. While that makes it different than a lot of other types of incidents that you would use, let's say, the Incident Command System to manage, an active shooter event is also the same in the sense that it's very important to focus on the fact that the Incident Command System allows you to build operations quickly from the ground up. It's different than a lot of your day to day incidents in the sense that there's so many resources across the country that have trained to respond to an active shooter event and so many of them are going to arrive so quickly. What can be the same is that you can still use many of the concepts of the Incident Command System if you remember that truly the Incident Command System is designed to build operations from the ground up for an unplanned event and get them in a manageable span of control quickly, set up a Unity of Command quickly, and start acting proactively in a management by objective sort of way to accomplish certain tasks and certain things that need to get done right away on an active shooter event. Bill Godfrey: Travis, what about you? What sticks out in your mind? What makes managing an active shooter event different from all the other stuff you've responded to? Travis Cox: Well, there's a couple things that come to mind when you talk about an active shooter event. One of the things is that you're going to have resources like Adam said. You're going to have a lot of resources, not only responding, but they're going to be self-dispatching or they're going to be responding without being sent by a dispatcher. They're going to be self-deploying to this incident and we want them to self-deploy, because we're going to need the resources. But that's something that's different, that doesn't normally happen on the day to day basis. Secondly, you're going to have resources from other agencies that may not normally respond to things in your jurisdiction, but because of the nature of the incident, you may have other police departments, sheriff's office, neighboring counties, other municipalities within your county responding to this incident. You may have airport police. You may have campus police, school board police. You may have a number of different agencies responding to one incident. You have to figure out your interoperability. You have to figure out the different tactics that you may have been trained on to make sure that everybody's functioning off the same page of music. That's one of the things that has to be done. The second thing that comes to mind is in an active shooter event, you have a crime scene. You may also have a Hot Zone where there's still danger there. So you may get a person that has to assume command of that scene without being involved in that scene or not being able to see the scene, so they have to rely on the information that they're given from the officers that are actually inside the crisis site and manning the information they're given via radio or via some other avenue besides being able to be seeing it from ground zero level. So those are the one big things that I see. Bill Godfrey: So Tom, we got a couple of interesting perspectives from the law enforcement guys. You and I are on the fire side. What jumps out at you as the big differences from the fire side of an active shooter? Tom Billington: Well, the big difference is, our leadership needs to let control go. You need to make sure you have key people in right positions. They're going to be down, down on the scene in the Warm Area and you have to let them do their jobs. You cannot run this scene from a command post. Most firefighters, that's the way we think. As a battalion chief or a deputy chief, we think about going to the command post and monitoring everything and giving out orders or direction. This is a case where you have to let your people on scene do their jobs. We're fighting the clock. Usually by the time we get in there, hopefully our law enforcement brothers have neutralized the threat and we're going against the clock. Seconds count. It's a little bit different. It's like you said. It's bottom up instead of top down, letting these folks get these patients treated, transported, and to a surgeon as soon as possible. Bill Godfrey: You know, that's exactly what jumps out at me, too, on the fire side is that traditionally, and I'm not sure I ever really realized this when I was still working active duty. But the fire service, the way we managed scenes, it's a very top down driven approach. The first company officer arrives and he might be in command for a couple of minutes and then the battalion chief takes over and they're in charge and they're directing everything from the top down, not just at the strategic level, but in some cases, they're directing tactics. They're directing which door the hose line's going to go to, which side of the building we're going to vent, the window, the roof, whatever the case may be, where we're going to ladder up. It's a very top down driven approach where the incident commander in many cases is directing the resources in a very flat level. So there's no layers. You don't have a bunch of branches and divisions and groups in most of these things. They're directing those Tactical operations. What really caught my attention about the active shooter events, is that that gets us into trouble real quick because we don't see the lay of the land, if you will, to be able to know the right tactics to call out, where the teams should be exactly, what rooms they should operate in. Where's the best place to set a Casualty Collection Point? Where's the best place for the ambulances to go? It would be in, to me, it's kind of the analogy of trying to run a fire the way we normally run the fire, but doing it from two miles away without ever being able to see the building or seeing what's going on. What's different here to me for the fire service, is that we've gotta reverse that process. We have to push the resources Downrange and then let those resources tell us what they need and where they think these things need to go and what needs to happen. We're pushing the resources to them. We're giving them what they need and supporting them in that role more so than telling them how they're going to do it. They're going to tell us how they're going to do it and we've gotta support that to the degree that we can and make that happen. Of course, coming back over to the law enforcement side, sometimes there are issues that come up where the guys Downrange may want to do something that Command or Tactical may say, "That's not a good idea." Right? Am I saying that right, Adam? Is that how you'd put it? Adam Pendley: Absolutely. I think a lot of stuff is already happening from the law enforcement side by the time fire EMS takes the medical branch role and starts organizing their resources. For example, if all goes well, Contact Teams have started to call injury counts out to their Tactical group supervisor, who is hopefully now working with Triage and eventually a Transport officer as the eyes and ears that are Downrange. What's interesting about this, when you talk about the reversals of what we're used to, if we go to a large structure fire as law enforcement, we have no problem believing that the fire department has Incident Command and we're really just the law enforcement branch being directed by the fire department to say, "Hey, we need a unit on the end of this street to protect our five-inch line. We need a unit over here to keep people from coming Downrange, and also we believe there's some Hazmat involved, so people need to stay upwind." From a law enforcement perspective, we have no problem understanding that we work for the Incident Commander that's the fire department on a large structure fire. For active shooter events, it's actually kind of the reverse. Law enforcement is in command early on and as the fire EMS supervisor arrives, they request the medical branch, and they take direction from law enforcement. They say, "Hey, we have a Casualty Collection Point established at this location. We believe it's safe to go in this location. This area has been established as Warm Zone." And hopefully, as the culture changes, the fire EMS supervisor can understand okay, we're going to take that from Incident Command and we're going to make that work and we're going to use them as the eyes and ears and we're going to trust the people that are already Downrange, that are already accomplishing tasks and we're going to fill in and start doing the lifesaving that needs to happen based on that information. Bill Godfrey: Travis, what do you think? Travis Cox: Yeah, that's a great point, Adam. I just feel like this. The bottom line for us here as First Responders on the fire service and the police side, if we're going to save lives, we have to bring our two disciplines together and we have to work together. Communication is vital. There is no way we're going to be as successful as we can be if we're not communicating. Regardless of what patch is on someone's sleeve at these type of incidents, we have to be able to communicate, work together, work in unison to save lives. Because once the shooting stops, we have ... You always hear the cliché, stop the killing, stop the dying. In order to stop the dying, to get the medical services to those folks that need it as quick as possible, we have to have good communication from those that are Downrange, those that are working in the Warm Zone, and those that are in the Command Post. All three of those different entities have to work together, communicate well, effectively, directly, and ensure that information is flowing back and forth up and down the chain of command so we can be successful as responders to save lives. Bill Godfrey: Tom, what's your thoughts on this? We've kind of come full-scale. You and I are both in agreement that we certainly need to shift gears on the fire side and not try to drive it from the top down. But Travis is talking about the integration up and down the food chain. What jumps out at you about that that's maybe different than the way we used to do it 15 years ago or maybe even what most of us expected? What sticks out to you as the important pieces of the integration? Tom Billington: Well, I like what Travis said. It doesn't matter what patch you have on your arm. We can help each other out. When we have people bleeding and the threat has been neutralized, getting the law enforcement officers to help with the medical part, like Travis said, very important. And vice versa. If law enforcement needs some assistance with something, radio traffic, delegation of some tasks, if there's fire personnel available, we should be able to provide that to the law enforcement. But the big thing is, we do not want to wait to be on an active shooter to figure this stuff out. This is the stuff that we need to talk about beforehand. We need to train beforehand and work through these issues. Again, I like the patch idea because we're all one team when we get there and we're fighting that clock. So very good points, Travis. Bill Godfrey: What jumps out at me from, and it feels like an eternity ago, but not that long ago we were looking at this a little different. We were trying to integrate really just in the Command Post, relying on Unified Command alone to be the integration piece between our disciplines and we found out, all of us, kind of found out the hard way that while you can make that work, it is not very fast. It's prone to some of the very mistakes and errors that we were talking about of driving things from the top down and forcing some bad Tactical decisions Downrange. What really jumps out to me is the level of integration that it really takes in order to take time off the clock. We always talk about the two things that are going to kill people is the bad guy and the clock. We can put the bad guy down quick, but if we don't get to people and get medical care going, the clock is going to kill them just the same as if we'd left the bad guy up still shooting people. What really struck me, going through this evolution over the years, is the need to integrate really all up and down the food chain, even at the line level. That rescue task force really only works because you've got the law enforcement and the medical guys now in the same team. The law enforcement guys are communicating with Tactical to stay in tune to the picture that's going on and make sure we don't end up bringing the medics into the wrong place and getting them into a Hot Zone when we didn't want to. The medical side, communicating back with Triage, they're all there working face to face Downrange, but they're back-hauling that information up to Tactical Triage, who are then comparing their bigger picture notes because they might be managing multiple contact teams, multiple rescue task forces, and then above them, we've got the integration in the Command Post between medical branch and law enforcement branch. Travis, how does that strike you? What do you see is the critical importance in that integration? Travis Cox: Well, that is key like you said, Bill. We have to be able to work together on all levels up and down the chain of command. For law enforcement and our rescue task forces, with our medical folks, when we go into these crisis sites, we have to be able to work together. We have to communicate. We have a built-in redundancy in our communications when we have the two entities working together. Again, it's all about saving lives. At the end of the day, it's about what can we do to work better, work faster in order to save lives of the citizens that live in our jurisdictions. Adam Pendley: And to add to what Travis is saying, I think the way that happens is again, those first arriving units start forming teams that have a specific task and purpose, if they stay in their lane. On the law enforcement side, you have a Tactical group supervisor that starts applying the strategy. On the fire EMS side, you have a Triage group supervisor that comes down shoulder to shoulder and works at the edge of the Warm Zone to do that actual lifesaving. There are so many other types of resources, so many other officials, elected officials, and other things that are coming, the job of Command where it's different from a lot of your day to day incidents, the job of Command is to now look outward. There are lots of pressures coming from the community from reunification, additional information, the public information side. The Incident Command takes on a new role of having to not only oversee the lifesaving that's happening into the Tactical Triage and Transport level just to ensure that they're hearing certain benchmarks are happening at that level, but also to look outward to constantly think about the things that are going to happen next. Even if your scene is 100% under control, the bad actor or the suspect came from a location. He arrived in a vehicle. There's hospitals that have to be managed. There's a lot of other things that happen. Unfortunately we don't have the luxury for every resource that comes to the scene to all focus on one task of, let's say, that threat that's Downrange. There are too many jobs that need to be done that if you don't parse those out to different teams with a different task and a different span of control, you're going to lose control of your incident right from the start. Bill Godfrey: Yeah, Adam, I couldn't agree with you more. I think you mentioned two things there, the layers of Command, and then the idea of staying in your lane. Really, the structure and the approach we use, what's interesting to me is that a lot of responders that I talk with, they see managing an active shooter event as really kind of the piece of it that's at the Tactical Triage and Transport level, just managing that Downrange piece when there's actually a lot higher level to it. We need the layers to be able to keep our arms around it with Tactical Triage and Transport staying in their lane, doing what they're supposed to do and then Command Post, medical branch, law enforcement branch staying in their lane. Tom, do you see it same way? What are your thoughts about that responsibility of staying in your lane and the consequences of when we drift off a little? Tom Billington: Well, staying in your lane's a good analogy. If you have five lanes of traffic and somebody pops in another lane, everything's going to turn into a disaster. Actually, I think on the C3 website, C3 Pathways website, the checklist is available. The checklist, active shooter checklist, is a great tool for staying in your lane. It lays out the responsibilities for each position. You go right down the list, make sure you're doing everything you need to do. As I said earlier, we want to help each other out, but we want to make sure we're doing our function and staying in that lane. When you do that, you're going to beat that clock. We're running against that clock all the time. So very important point that you made about staying in the lane. Bill Godfrey: Yeah, that does really sum it up. It is about not just getting the bad guy, but beating that clock to save lives. We're coming up on the end of our time. You guys have anything else you want to add on this subject? Any other thoughts, Tom? Travis? Travis Cox: I'll just say one thing. Integration and working together, the two different disciplines, does not happen automatically. This is something that you have to train, you have to utilize on maybe smaller events to get comfortable with working with the fire service or working with law enforcement. Then if this incident does happen in your jurisdiction, you're just that much better prepared for it. Bill Godfrey: Oh yeah. That's absolutely true. In fact, Travis, why don't you tell everybody who's listening about what you guys did in Jacksonville with your special events and using that as an opportunity to socialize the rescue task force concept and put people together. Travis Cox: Sure. We have several large special events that happen in Jacksonville every year. As we prepare for those events, one of the things that we do is we stand up an Incident Management Team to manage those events. But we pair our law enforcement and our fire service together and we develop rescue task forces for those large events. Whether it's a large football game, whether it's a professional game or a college game, we put those responders together so they get used to working, law enforcement and fire service together, and they're working to handle incidents, those small incidents, that one person down, or that small fight they may be to break up on these smaller incidents to get that experience of working together as a rescue task force. Bill Godfrey: Which I just think is a fantastic program. I don't know anybody else that did that. Every chance I get, I tell people about that because I just thought it was such a fantastic way to normalize that role and begin to build those relationships. Adam, any final words? Adam Pendley: No, again, I couldn't agree more that this idea of, not only for the special events, which often are planned from the top down, you have that luxury in a special event to put all the pieces in place. But the other way you can practice this is on the slower-moving, unplanned events. If you have a ... law enforcement has come across a meth lab or has come across a suspicious device, use that opportunity to build teams and as the layers are added, integrate law enforcement and fire to establish teams, ready response teams and even rescue task forces, so if something happens at that incident, you have those things ready. Or even on missing person events. So you have unplanned incidents that move slow enough that you can practice some of these same concepts so again, when the high stress, fast speed event happens, you're already, like you said, you've already normalized those relationships and those team assignments and building your operations from the ground up using these same concepts. Bill Godfrey: I think that's a great idea. Well, this has been a fabulous discussion. I've really enjoyed it this afternoon. Gentlemen, thank you very much for taking the time. Look forward to the next one. Tom Billington: Thank you. Original Source: https://www.c3pathways.com/podcast/difference-of-managing-active-shooter-event

law managing event unity integration jacksonville command gentlemen transport tactical first responders ems triage active shooter ics hazmat hot zone incident management incident commander downrange command post incident command incident command system original source adamis travis cox active shooter events c3 pathways

Episode 05: Casualty Collection Point and Ambulance Exchange Point

Play Episode Listen Later Jul 2, 2018 27:16

Episode 05: Casualty Collection Point and Ambulance Exchange Point Discussion of Casualty Collection Points (CCP) and Ambulance Exchange Point (AEP) in Active Shooter Incident Management (ASIM) Bill Godfrey: Hello, and welcome to this next installment of talking about some of the challenges that we see on active shooter incidents. Today we are going to talk about Casualty Collection Points. My name is Bill Godfrey, a retired Fire Chief and one of the instructors at C3 Pathways. I have with me part of the Instructor cadre team, Adam Pendley, Assistant Chief with Jacksonville Sheriff's Office. We've got Travis Cox, Lieutenant from Jacksonville Sheriff's Office, Kevin Burd, Lieutenant with the Huntington County Prosecutor's office. All three of them are law enforcement, obviously. Then also with me we've got Robert Lee, retired Battalion Chief, Paramedic and Tom Billington, also a retired Fire Chief and a Paramedic. Welcome guys, thanks for taking the time this afternoon to talk about this. So the subject today is Casualty Collection Points, and some of the challenges, what makes a good Casualty Collection Point, what doesn't, how do we manage them, how do we work them together, how do we deal with some of the law enforcement issues and then some of the EMS issues. Adam, you want to kind of set the stage for us on what we're talking about as we move into a building. You make entry, we've presumably dealt with the threat, or there's a team in process of dealing with the threat. But the first ones through the door are going to be law enforcement. Law enforcement officers, in some element of a Contact Team, it may just be two or three guys, or it may be four or five. Set the stage for us of what this looks like as the Contact Teams are working in the building and making a decision about where they're going to set up a Casualty Collection Point, and what they're going to pick. Adam Pendley: Sure. I think we're all familiar from the law enforcement perspective that there's this push towards dealing with the threats, stop the killing. But along the way, those first Contact Teams are going to identify areas where there are Casualties, where there are injured folks that need to be cared for. It becomes important to ... whether it's the initial Contact Team that is no longer being driven by some sort of move towards the threat that they have to make a decision to go ahead and establish a Casualty Collection Point, or communicate that there's injury in a particular place and a follow on team is going to establish a Casualty Collection Point so you can quickly or simultaneously both deal with the threat and start worrying about your second priority, which is the rescue, dealing with those folks that are bleeding and need immediate care. I think it's important for law enforcement to understand that initial team that is going to establish a Casualty Collection Point so you can make it to your next priority. I think Kevin can probably talk a little bit about what that team is going to do when they enter a room that has a number of Casualties in it that we need to move towards. Kevin Burd: Okay, so once we've identified in an area where we may have multiple Casualties, regardless of the tactics that are used to enter that room, once we get into that room we want to establish points of domination. They'll mention we may only have two or three officers, maybe we have four or five at this point. But once we enter that room we want to have points of domination so we can put folks that are in that room in an area that's Tactically advantageous to us. What we're trying to look to establish is obviously securing that room, and also looking at is this room advantageous to us where we can eventually set up an Ambulance Exchange Point. Maybe that room, if it happens to have exit doors, or an exit door, some place where we can eventually get to move those patients out, we want to make sure that we've secured that entire area. If we have multiple Casualties in that room, we're going to put them in an area where there're no issues from the law enforcement side in that we could be putting them in a position where we could have cross-fire issues where it may be near an exit door where they could possibly get away from us. We have to identify who they are first and foremost. One of the important things to remember, too, is once we establish those points of domination we have to control and secure that room and make it defensible because others will be coming in eventually to provide assistance. When you're in that room and you're in that area, a couple of things you want to be cognizant of is what could be used against us, if you will. If there are areas where we can't secure that area, we may have to look at collapsing other Casualties in the room into our area, or possibly setting up secondary Casualty Collection Points. But primarily the first room we go into, if we have several of the Casualties, or a majority of the Casualties there, we want to establish those points of domination, make sure that we have enough resources there, we may be calling out requesting additional resources because we want to secure that area so any follow-on resources that come in to assist us, it's completely secured. In dealing with the Casualties themselves, I think Travis, you can touch in on that. Travis Cox: Absolutely. One of the responsibilities of law enforcement inside a Casualty Collection Point is to do some type of Triage of the victims or the patients that are inside that room. One way the law enforcement can do that very rapidly is basically by addressing the folks that are inside that room and asking those that can move, ask them to move to one side of the room against the wall. Once you have that one group against the wall, you still may have some people that are injured that can't move, and they'll still be on the floor. Obviously, you're going to use good law enforcement commands, tell them to keep their hands where they can be visible for all of law enforcement to see, but you want them to move against one wall. Once you separate that group, you have one group on the ground still, and you have one group against the wall. Once you have that group against the wall, you're going to give a second command to say those that are standing against the wall, if you're not injured, or you've not been hurt in any way, move to a separate wall ... a second wall. So now you've basically separated that room into three groups. You have the injured folks that are on the ground that cannot move, you have a second group that did move but they're injured and they're standing on one wall, and then you have a third group that has moved to a second wall but they're uninjured. You have now did a quick Triage of that room so you can call those folks using the medical terms of the "reds" which mean people that are injured that could not move. You can even classify them as a "red patient". Those people that are injured but can move are also known as a "walking wounded." Those would be your green patients. And then your uninjured folks that you would not assign them a color, they're just people that have been involved in the incident and they have no injuries. So you separated the people in your room into three different groups, and that's a quick way that you, as a law enforcement officer, can Triage a room and help you manage that room until your medical counterparts arrive. Bill Godfrey: Let me kind of summarize and see if I've got this right on what you're saying. You identify the room that you want to use, or the room that you're going to make entry to. You use some tactics, depending on their training or local policy, to do the room entry, I guess the numbers of the team affect that as well. They get in the room, they look to take control of the crowd, take control of the people that are in the room, get them up against a wall, the ones that can, screen off the ones that aren't injured so that you've got the uninjured that can't move that are on the ground. We call those the "reds", the injured that are up against the wall that move, those are the "greens", the uninjured are on another wall. Then, what Kevin was talking about, the points of domination, to post your people up where you could control the room, control access to the room, and basically have that be a safe ... maybe the wrong word, but a reasonably safe room to work in. Am I describing that right? Did I miss anything? Travis Cox: Yes, you described it perfectly. What this allows you do is you can then identify people that may need medical treatment right away, and as law enforcement officers, if we have security measures in place in that room, we could then begin doing some of those life-safety measures on those folks that are injured and cannot move. So this is our opportunity to start those life-safety measures until our medical counterparts arrive. Bill Godfrey: So if you've got a team of four or five officers, a couple of them can hold security and a couple of them can start getting into the medical care, try to do some life-saving stuff? Travis Cox: Absolutely. Absolutely. That's one of the things that we're there for. Obviously, we know there's a threat in the building. Once we address that threat, our next priority is to start addressing those injured patients or those injured victims inside this crisis site. Adam Pendley: And I think it's worth adding that it's really not that different than typical level one training that law enforcement has received all over the country. We know that if we address a threat in a room that as soon as that threat is neutralized, you go into a SIM, a Security, Immediate Action Plan, Medical. Well, a team that may be assigned just to go to a Casualty Collection Point and secure a Casualty Collection Point is also putting together a SIM. They get security of the room, they put an Immediate Action Plan together as far as how they're going to deal with additional injured, how they're going to sort the room, where they're going to evacuate patients from, what additional resources they need, and then they start addressing the medical. So a team that may not have addressed the threat, they may just be a follow-on team that's assigned to deal with Casualties in a particular area. They're going to put together a SIM for that room as well, Security Immediate Action in Medical. Travis Cox: Let me add one more thing to that, Adam. One of the critical things that those law enforcement officers are going to do when they do Triage that room in that manner, is it allows them to give the number of injuries and the type of number of injured folks that they have to the Tactical person, or that person that's on the outside that's setting up the management aspect of an active shooter response. By doing these things, we can let Tactical know, "Hey, we have this many injured. This is how critically are they injured," and it gives them information to know how many Rescue Task Forces we may need, how many medical personnel we're going to need, how many rescue units or ambulances we're going to need, based on what we're seeing inside the crisis site. Bill Godfrey: So that provides us an interesting transition point to talk about it. Once you kind of get all that stuff set, you call out to Tactical and you say, "Okay, we're ready for a Rescue Task Force." So at this point we've got a law enforcement team that's inside. They've secured the room, they've got a Casualty Collection Point, if they've got enough numbers to hold security and do medical, they've started that. We've called Tactical to say, "Here is what we've got, our location and numbers. We need a Rescue Task Force." So then the RTF goes Downrange. So, Tom and Robert, talk a little bit about that first RTF through the door that's going to dump into that Casualty Collection Point. What are their responsibilities? What do they need to do when they walk into this room full of injured? Take us through that and paint the picture. Tom Billington: Okay, well piggy-backing off what my law enforcement counterparts have said, right off the bat they've painted a picture for me as an RTF. Before I even get into the room, I know kind of what I'm going to be seeing. So if there's more than three patients, I know right off the bat I'm going to need another RTF, or maybe two to three more RTFs to help me. When I enter the room with my security contingent, it sounds like as Travis said, I'm going to have personnel that are green in one area that are standing, or walking wounded, and then I'll have the other patients that are more severely injured. Since we are the first RTF we cannot use tunnel vision. We have to get in there and start sorting and arranging which patients need to be treated, do some quick interventions while we can, some life-saving interventions, and then make sure we're setting up the room for the next RTFs to come in. The first RTF when you get in there, if possible, you want to stay in there and kind of control the room and work with the law enforcement counterparts. That way, one person familiar with how the room is working and what patients need to be Transported, etc. Robert, what do you think? Bill Godfrey: Yeah, Robert, what are some of the challenges that you see the RTF teams running into and the mindsets? What are the things that people that need to be prepared for? Robert Lee: The first thing is we've got to make sure that our folks don't get the tunnel vision like Tom said, and concentrate on one patient. We need to scan the room. Those critically injured that we call "reds", we need to assess them, start to treat them, and prioritize them according to the severity in which ones need to be Transported. Priority opposed to the other one, so that makes sure we get the patients that need the care the soonest to the hospital first. One of the things that a lot RTFs tend to do is they find a patient that's critical, and they start providing that care, and they don't focus on the big picture -the whole room and all the patients that we have. When the other RTFs come in, those patients that we've identified as priority, we can start providing that care right off the bat and get them ready for Transport. Bill Godfrey: So the coordination piece of it is huge for that first RTF coming through the door. Robert Lee: Yes. Yep. Bill Godfrey: When they ... I guess from what you're saying, one of the first things we want to see that RTF do is to re-Triage these patients. I mean, law enforcement presumably has done a dirty red/green split just to give us a sense of the bigger picture numbers. But we need to re-Triage them and is start enough, or does it need to be more than start Triage? What does that Assessment look like that needs to go on there from the Rescue Task Force? Travis Cox: Yeah, we need to concentrate on making sure we're doing a full Assessment of these patients once the manpower is in the room, and we've identified who we need to start with first. That full Assessment is important. Instead of just doing the Triage itself and maybe just a quick treatment, we need to do a full Assessment like we would anybody else. Bill Godfrey: Yeah, and I know, Tom, we've talked many, many times in a lot of the classes we've taught where the start Triage is used. I don't know about you, but I certainly seem to have run across a lot of active duty folks in the EMS community that kind of feel like ... I get the sense that they don't realize that they need to do more than start. They think the greens can sit and wait for an hour. Tom, talk to me a little bit about some of the challenges in dealing with the severity and the different color groups, prioritizing the x-field, to whose going to go first, the mix of severities, and the implications for that for our ambulance loading. Tom Billington: In this situation we're dealing with trauma, gunshots usually. Right off the bat we need to decide which gunshots need surgical intervention as soon as possible. We need to be able to decide which patients we want to treat and Transport first. The other issue making sure that although some patients may be listed as green, remember, that may change. The numbers will continually change. The main thing is just making sure you're communicating with Triage about what hospitals you can utilize, what care various patients are going to need, a chest would versus a head wound, depending on the facilities you have, and being able to coordinate those patients out accordingly. Bill Godfrey: One of the things that I hear are Tactical and Triage, and Transport group supervisors talk about frequently in the scenarios that we run, is their frustration that they don't feel like the RTFs necessarily are giving them the information they need. They're not very quick to relay it to them how many reds, yellows, and greens they have. How many black tags. Again, it is difficult with a moving target, because the numbers ... As you begin to move patients out to Transport, law enforcement may be bringing some additional patients in. You may have a green that goes to a yellow, or a yellow that goes to a red. It is going to be a moving thing. What is the best practice for RTFs? What should be expecting from the RTFs in terms of keeping Triage informed of the numbers? When do they do that, and how often do they need to redo that? Tom Billington: Well obviously when we get into the room we want to double check on the counts that law enforcement gave us, and then do a thorough Triage again, and make sure they're color coded correctly. That would be a good time to let Triage know what we have and what color type patients we have. Again, remembering that by the time they get to the ambulance, the ambulance may have to change those color tags with Transportation so Transportation will get a good number at the end. Again, just keeping the number as fluid as possible, keep getting the information going. Again, that's another reason why the first RTF in the room may want to be the primary room proctor, stay there, and be able to monitor the patients as they change and add numbers or change numbers accordingly. Bill Godfrey: Tagging on to what you're saying about that, Tom, one of the things that we talk about in class sometimes is the Field Triage Score, which of course was a Triage system validated in a military study. Basically, it has two measurement points. You check the Radial pulse. If it's present and it's normal, they get one point. If it's absent, it's weak, thready, tachycardic, they get zero. Then you check your Glasgow Motor Score, not the whole GCS scale, just the motor score. Basically, do they obey commands. If they obey commands, they get one point. If they don't obey commands or are unable, they get zero. You add it together, zero, one, two, red, yellow, green. It's a nice, simple system, again, validated in a military study. It gives us some sense that it's a good, quick, easy way to get a good Triage of the patients that we're moving. So we get these patients packaged up, let's assume that we've got more patients that one RTF is going to handle, and we've got two or three other RTFs that are coming into the room. What role, Tom, does the first RTF need to take on in relation to the other ones coming in, or is it just a free-for-all, they all come in and take their own patient? Tom Billington: As I discussed earlier, that first RTF is sort of the lead, and hopefully they will be staying there for the duration. When the next RTF comes in, that lead wants to look at the RTF leader and the medical leader, and say, "You two go over there. You have this. You have that. You have a red. You have this injury. You take care of that." When the next RTF comes in, same thing. So you're kind of coordinating the whole operation. Again, making sure that if it's a red, which red do you want treated first? Which one needs that surgical intervention? Again, being in charge of that room and being able to direct the medical resources when they come is imperative. Bill Godfrey: So we get them lined up, we know whose going to go first, we kind of lay them out in order in the room, then we've got to coordinate the evacuation over to the Ambulance Exchange Point. Of course, the challenge there is we want to get the ambulance as close as we possibly can, but that kind of creates some security issues for it, doesn't it? What are we ... So we're back over to the law enforcement side of this in having to kind of coordinate our movements and behavior. What does that look like when we say, "Hey, we want to use this exit door over here that goes right out to the parking lot as our Ambulance Exchange Point." Adam Pendley: Well I think it's important to keep in mind that there is a security element with the RTFs, and they remain there the whole time. Again, their first priority is to provide that security element for the folks that are doing the medical care, but they also have communication with Tactical, so if there is a particular door that based on its location looks like that it would lead out to a good Ambulance Exchange Point, the security element can communicate with Tactical, and make sure that that area is secure so you can use that space efficiently. But I also feel like it's important to remember that if the security element of the room is doing its job, and there are extra law enforcement resources available, so much of law enforcement across the country has received additional training on some direct threat care, and may be able to assist with the medical element as well. So, there's a lot of resources in that room, but everyone has to realize that it is an integrated, cooperative response to make sure that the room is sorted, that the room is Triaged, and that medical care is happening, and when the RTFs are ready, that secured ambulance exchange points are happening. It's kind of a continuum of care that starts from the point at which law enforcement initially makes entering into that room, sorts the room, communicates to Tactical and Triage the numbers that they have. RTFs are brought into the room to start the medical care, and then continuing with law enforcement, there's a good security element to move them out to an Ambulance Exchange Point that would also coordinate with Transport that's there with Triage and Tactical so ambulances can come Downrange and get people to the hospital as quickly as possible. Travis Cox: If I can add to what Adam said, which is very important, you know a lot of us in emergency services and law enforcement, we have that built-up immunity where we try not to get too involved, and there's people bleeding around us that sometimes we have to step over them. But when the killing has stopped, [inaudible 00:22:32] is so important in law enforcement can save so many lives and help with the medical as far as just putting that tourniquet on and just getting the position where the patient can breathe just until they get more intervention. So, a lot more lives can be saved working together. Adam, good point. Bill Godfrey: Yeah, so we get them packaged up, we figure out where we're going to do our Ambulance Exchange Point. Assuming that you're spread too thin on the inside, who's going to take care of getting security over the Ambulance Exchange Point? How does that play out? Tom Billington: Well, one of the things that needs to happen, is there needs to be good communication to whoever that medical leader on that Rescue Task Force is, speaking with the law enforcement element within that Task Force so that medical person needs to give a heads up to the law enforcement counterpart, "Hey, we'll be ready to move in two to three minutes." That's the que for law enforcement to start communicating with Tactical, whose managing everything moving in the warm zone to start setting up that security perimeter around where the Ambulance Exchange Point's going to be. Again, also that law enforcement security personnel on the inside needs to request the location from Tactical because the location that they want to use as the Ambulance Exchange Point may not be the most optimal spot based on the information that Tactical has. So, if the place where the rescue responders on the inside want to use as the Ambulance Exchange Point is a viable location, then they'll set up security there. If not, they may have to re-route them. They may have to go to a different location for reasons not known to them. Bill Godfrey: So, Kevin- Kevin Burd: Yeah. Bill Godfrey: Paint the picture on the Tactical side. Let's say we're dealing with a school, two, three story building, we're going to use an exit door on the rear side of the school. What does that Contact Team that gets sent to secure the Ambulance Exchange Point ... what do we want them to do? What do they need to be looking for? What's their job? What does that look like? Kevin Burd: Really, what we're looking for, again, just like the room management part, the room security part, is to provide almost like a security bubble, if you will, outside that door where we've determined this is going to be the Ambulance Exchange Point. We're looking for that 360 or 540 degree coverage, and want to ensure that we have unimpeded egress for the ambulances to get into that location. It almost has to be a ballet act, if you will. We are looking for communication coming from the RTF, or the medical team leader, that "Hey, we're ready to move patients in two or three minutes," the law enforcement counterparts are ensuring that, "Hey, we've got security at the Ambulance Exchange Point." We don't want to put the Casualties out in an area where they're waiting for an extended period of time for those ambulances to come. So, we want to ... like that ballet act, if you will. The RTFs are moving the patients down to that Ambulance Exchange Point, security is making sure that, "Hey, it's safe to come outside," the ambulance at the same time is coming up, and it's a coordinated effort between all the disciplines to get the patients on to that ambulance as quickly as possible, as safely and securely as possible, and off to more advanced medical care. Bill Godfrey: You know, it's interesting. I think your comment about it being a ballet is really an appropriate way to think of this. It's very much an integrated piece on how we all have to work together. Law enforcement has that initial role to kind of get control of the room, set up the security, do some initial Triage, even if it's just a gross Triage to split the room between the walking wounded injured and the ones who can't move, make it a warm zone so that we can get a Rescue Task Force in. They can come in and re-Triage, do some ... whatever emergent advanced stabilizing care they need to, and then coordinate a place that the ambulances are going to come pick them up. It is very much a ballet, but the winning part of that is we take time off the clock. It saves time, and that's our goal is not just to put the bad guy down quickly, but also to take time off that clock for the people that have been shot and bleeding, and get them into the back of an ambulance faster. So I love your analogy of the ballet, and I think like this, if you practice and train it, and beautifully orchestrate it, it is something that can really make a difference and save lives. Well guys, thank you. I think you really did a nice job of painting the picture for the process of a CCP, and kind of crossing over to the other [inaudible 00:27:15]. Thanks for taking the time this afternoon. Take care, and we will talk to y'all soon. Original Source: https://www.c3pathways.com/podcast/casualty-collection-points-and-ambulance-exchange-points

law security medical collection priority exchange sim transportation instructors transport tactical task force assuming ems ambulance ccp lieutenant paramedic triage casualties casualty fire chief active shooter radial assistant chief gcs robert lee aep transported tactically battalion chief rtf incident management downrange original source travis cox rtfs jacksonville sheriff's office c3 pathways bill godfrey

Stew and The Nunn, Episode 124 w/ Travis Cox

Play Episode Listen Later May 18, 2018 101:04

Stew and the Nunn will be talking about Current events and Veteran Social Media trends.

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Stew and The Nunn, Episode 124 w/ Travis Cox

Mindful U at Naropa University

Play Episode Listen Later May 17, 2018 101:04

Stew and the Nunn will be talking about Current events and Veteran Social Media trends.

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Travis Cox: Sustainability is Ecopsychology is Sustainability

Play Episode Listen Later Dec 5, 2017 28:48

Ecopsychology is a field whose goal is to bridge our cultures' long standing historical gulf between the psychological and the ecological to see the needs of the planet and the person as a continuum. Transpersonal ecopsychology is the evolving exploration expression and embodied practice of the inter-dependence of humans in the more than human world, which tends towards to the health balance and optimal well being of all. A change in our internal landscapes might change our relationships with the land in a way that includes extending social ethics to the land and an examination of our loyalties, affections, and convictions. Special Guest: Travis Cox, PhD.

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Stew and the Nunn w/ Travis Cox

Play Episode Listen Later Aug 9, 2017 61:47

The Nunn and Travis Cox a former USMC Recon Scout Sniper talk about transitioning from Military to Civilian life, jobs and programs that are helpful.

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Stew and the Nunn w/ Travis Cox

Play Episode Listen Later Aug 8, 2017 61:47

The Nunn and Travis Cox a former USMC Recon Scout Sniper talk about transitioning from Military to Civilian life, jobs and programs that are helpful.

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Stew & The Nunn w/ Travis Cox

Play Episode Listen Later Jul 19, 2017 73:31

The Nunn speaks with Travis Cox a former USMC Recon Sniper, OIF Veteran about all things Texas and Veteran Community.

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Stew & The Nunn w/ Travis Cox