In June 2016, a lone gunman killed 49 people and wounded 53 at the Pulse nightclub in Orlando, Florida. Paramedics had to wait nearly three hours before it was determined the scene was safe enough to enter.
Doctors who studied autopsy reports determined 16 of the victims might have survived if they'd gotten basic medical care at the scene and been taken to a trauma center within an hour.
At the same time, the Department of Justice determined it would have been "reasonable" for paramedics to go into the nightclub after 20 minutes if law enforcement officers could provide cover.
Every time there is a mass shooting incident in the United States, Bruce Whitney said there are important lessons to be learned.
Whitney is an instructor with the Pima County-based Integrated Community Solutions to Active Violence Events, or ICSAVE.
The three-year-old nonprofit is staffed by 822 volunteers with law enforcement, military and health-care backgrounds. They travel throughout the state to offer free or low-cost training in first aid, CPR and active-shooter response to first-responders, schools, churches and others.
Last week, ICSAVE led an eight-hour class called Tactical Emergency Casualty Care to about 70 members of the Sahuarita, Tucson Police and Marana police departments, Raytheon security, U.S. Border Patrol and Arizona Department of Corrections at the Sahuarita Police Department.
Participants acted out scenarios where they dragged victims to relative safety and learned how to apply tourniquets, control bleeding and open airways just moments after the assailant had been cornered or incapacitated.
After every mass shooting incident, Whitney said agencies involved conduct "after-action" studies to look at what they did well and how they could have done better.
After the Columbine High School mass shooting in Colorado in 1999, law enforcement officers learned they couldn't wait for the SWAT team to assemble before taking on the shooters, Whitney said. After the Jan. 8, 2011, shooting in Tucson, where six people were killed and 18 others wounded, Whitney said authorities learned the individual first aid kits given to deputies had saved lives. As a result, law enforcement agencies are providing more advanced medical training to its officers, Whitney said.
Today, Whitney said law enforcement agencies don't wait for after-action studies to be published. People in law enforcement are calling their colleagues for advice in the days immediately following shootings. Some agencies are training individuals to access the information so they can give their commanders "real-time" intelligence, he said.
In the days ahead, officers will be reaching out to their colleagues in El Paso, Texas and Dayton, Ohio to see what lessons can be learned from the horrific shootings that took place there last weekend, he said.
Sahuarita Police training Sgt. Michael Falquez said he is constantly obtaining and reading reports so he can incorporate what other agencies have learned into the department's lesson plans.
"Unfortunately, these shootings seem to be happening more and more so law enforcement has to adapt to address the threats of the future," Falquez said.