What is action? Action is commonplace, right action is not. As a discipline, it’s not any kind of action that will do, but directed action. Step by step, action by action, we’ll dismantle the obstacles in front of us” (Holiday, 2014). Robb Elementary forces YOU off the sidelines and onto the field, where YOU must act to stop the killing and stop the dying. This course, however, requires more of YOU. By examining the full isoelectric line of an active attack, we can find points of interruption before, during and after the event that will save lives. Be prepared to expand your thought processes and move way upstream, moving beyond just response and recovery to Left of Bang.

Recovery is critical for post-shooting after care because there WILL be stress symptoms that arise. We’ve combined stress science with the real life experience and advise of officers involved in Colorado mass shootings.

Course Overview:

• After Action Assessment - Learn about the effects of adrenaline and cortisol and which stress symptoms officers involved in mass shootings can experience.

• Manage Heart Rate Variability (HRV) - Understand how officer resiliency is connected to the HR by practicing several HRV regulating techniques.

• Recovery Planning - The goal is to not find yourself involved in a shooting without a game plan for after the action. Practice mobility exercises and learn about resources and techniques that will support your well-bring after a shooting.

This session will showcase a new ALERRT undergraduate course at Texas State University. The course provides undergraduate students with ALERRT Level 1 training presented using an experiential learning format over the 16-week semester. Following the description of the experiential learning course by Pete Blair and Cayce Williams, Hunter Martaindale will provide a detailed update of the 2000-2023 active attack data and provide an overview of a new data tool allowing users to filter the large data set and create usable graphics.

Captain Richard Meulenberg (Public Information/Media Relations) and Captain Mike Eckert (Incident Commander) debrief an active shooter event that occurred in Tulsa on June 1, 2022. The debrief will cover background on the suspect and what led to the shooting. The suspects actions on the day of the shooting. 2 of the initial 911 calls will be heard and body worn camera video of the first officers arriving on scene will be shown. Discussion will include training before and after the event and critical evaluation of the overall response including lessons learned.

Dr. Ciottone will discuss principles of Disaster Medicine in the context of mass casualty incidents involving intentional attacks. Such events often result in specific ballistic and blast-related wound patterns that put high demand on our healthcare personnel to care for the surge of critically injured victims. Dr Ciottone will define the unique mitigation, preparedness, and response measures required for intentional attacks, and discuss how healthcare systems and prehospital responders can best implement them.

This session will focus primarily on the facts surrounding the July 14th, 2023 ambush of Fargo Police while investigating a traffic crash. A timeline of the perpetrator’s activities for the 20 hours leading up to the ambush will be covered in detail. Body-worn cameras, squad car footage, and surveillance footage will detail the facts surrounding the ambush. The follow-up investigation and evidence that was discovered will be covered. The effort to determine motive and any other influences behind the attack will be discussed. Cooperation with multiple different entities and the learning points from this aspect will be reviewed.

Many active assailant events occur in large buildings; however, much fewer occur in high-rises. Attacks in large buildings and high-rises have unique challenges and considerations for public safety responders. In high-rise attacks, it is critical for responders to quickly determine if they are in an active shooter event or a criminal sniper event. In an active shooter event, the perpetrator is typically moving about, accessing and shooting more victims. In a criminal sniper event, the perpetrator is separated by distance and cover from their victims. In a criminal sniper event, the perpetrator is typically in a fixed and fortified position. Mitigating a criminal sniper or an active assailant in a high rise present many tactical challenges and considerations. This presentation will also focus on characteristics of large buildings, including tunnels, skybridges, maintenance access, SCIFs, large cold storage, and more. Each of these present numerous tactical challenges for responders. Many public safety responders fail to realize how many buildings in their area have their characteristics. This presentation will look at case studies from numerous incidents to provide lessons learned. This presentation will look at numerous tactics and response considerations for law enforcement. In addition, fire department and TEMS considerations for high rise and large building response will be discussed.

Three-part presentation of an officer responding the active shooter event. Before, during and after.

This session provides an overview of tactical leadership principles, intelligence, and decision-making on-scene in crisis events. As time, terrain, and threat variables grow, complexity degrades the efficiency of responding elements without appropriate control measures. Identifying key tasks for tactical elements/non-tactical enablers and converting raw information into credible intelligence allows element leaders to focus on forward momentum, i.e., directing operational resources to “What’s Important Now” within the crisis site/crisis area. The session will emphasize situational awareness through real-time reporting and current best practices such as Team Awareness Kit (TAK) integration.

Across the US several states have implemented statewide programs to deliver ALERRT training to first responders. Several of these programs will be represented by officials who are responsible for their state's ALERRT program. Implementation, funding, administration and overall management of the respective programs will be discussed. Additionally, each program will share the challenges, successes, and lessons learned.

Moderator for this discussion will be ALERRT's Regional Manager, Jeff Crow.

Panel members will include:

• Missouri - Dr. Bill Sandel and Cody Brewington

• Iowa - Matt Anderson and Jim Stover

• Virginia - Adam “Bull” Keene

• Massachusetts - Chief Jeff Farnsworth and Captain Richard Ridlon

Dr. Winckler will discuss the regional deployment of prehospital whole blood. He will discuss the region's entire plan on how to get Low Titer O+ Whole Blood to hospitals, ground EMS and HEMS. This will include a discussion of the science of whole blood, how a new blood service line was created, how the regional deployment plan was developed and the results of that effort.  The discussion will include results of patient care, including case studies and research. The discussion will also include lessons learned and regulations from state statutes, FDA and AABB. South Texas also has a plan to deliver blood to the scene in a mass casualty incident as well as a plan to have a civilian walking blood bank to deliver fresh whole blood directly to patients and hospitals.