Hey everyone,
I’m a paramedic with a municipal EMS agency, and we’ve recently been putting a lot of focus on mass casualty incident and active shooter response readiness. We’ve been working closely with law enforcement in our area to run drills and tabletop exercises, and as a result, we’re taking a hard look at revamping both our gear setup and our operating procedures for these high-threat, multi-patient events.
We cover a mix of high-population locations including malls, schools, and frequent large-scale public events, so we’re aiming to tighten up everything from equipment to tactics to patient flow in the early phases of chaotic scenes.
Our agency is equipped with ballistic vests and trained to operate in warm zone environments alongside law enforcement during active shooter or other high-threat incidents.
Currently, we carry a small, dedicated MCI bag that includes:
• NPA’s
• Compact BVM
• Needle decompression kits
• Mylar blankets
• Webbing
• TQ’s
• Chest seals
• Israeli bandages
• Quick Clot
• Gauze and pressure dressings
We’re looking to improve this setup, both in terms of what’s carried and how it’s deployed. We’re also reassessing our staging, triage, extraction, and treatment models for active shooter and MCI situations.
I’m curious how other EMS agencies and tactical medics across the country are approaching this: • What gear do you carry specifically for MCI/active shooter incidents?
• Do you use specialized bags or kits?
• How do you handle triage, treatment, and extraction in these scenarios?
• Any lessons learned from real-world incidents or trainings that have shaped your approach?
We’re in the early stages of researching how other agencies set up their gear and what systems they have in place to support them during large-scale incidents. For example, one of our stations is centrally located within our district, and I’m planning to establish what is essentially a “doomsday bag.” This would be a large, well-stocked bag stored at the station, accessible to any responding resource—EMS, fire, police, or other municipal personnel.
The bag would contain a significant supply of trauma and bleeding control equipment, airway management tools, and other essential resources needed to manage mass casualty incidents. The goal is to ensure that any responder has immediate access to critical equipment when it’s most needed.
We’re trying to balance speed, simplicity, and effectiveness without overloading our people with gear they won’t actually use in the first critical minutes of an incident. Any input, advice, or photos of setups would be hugely appreciated. Thanks in advance!
