Abstract

On April 20, 1999, Emergency Medical Service (EMS) providers in Littleton, Colorado responded to Columbine High School after reports of a mass casualty situation. Upon arrival, responders noted an active, violent, ongoing incident, with numerous casualties, an unknown number of heavily-armed assailants whose whereabouts were unknown, fleeing students and staff, and reports of explosions, odors of natural gas, and an activated fire alarm (Mell & Sztajnkrycer, 2004).