The CSR Framework: The Chaos Phase – Immediate Threat Neutralization and Early Medical Entry
Introduction: The First Minutes Define the Outcome
When an active shooter incident unfolds, the chaos is immediate, overwhelming, and lethal. Victims fall within seconds. Panic sets in. Dispatch centers flood with calls. Law enforcement races to the scene while fire and EMS stage—waiting for the word that it's "safe to enter." But in those first five to ten minutes, the clock is already working against the wounded.
According to the FBI, 93% of active shooter incidents end within five minutes. That means by the time law enforcement establishes control, many victims will already be beyond saving—not because of the severity of their wounds, but because of the delay in medical intervention.
This is where the Chaos Phase of the Chaos–Stabilization–Recovery (CSR) Framework comes in. The CSR model replaces outdated, sequential response tactics with simultaneous threat engagement and medical preparation, ensuring that life-saving measures begin within the golden minutes, not after.
The CSR Framework: Phase-Based Operational Response
Before diving into the Chaos Phase, it’s important to understand where it fits within the broader CSR framework:
Chaos Phase – Begins at first gunfire. Focus is on neutralizing the threat and preparing for rapid medical entry.
Stabilization Phase – Shooter neutralized; MRTs deployed into hot/warm zones; triage, treatment, and casualty collection begins.
Recovery Phase – Threat cleared; EMS conducts full transport operations; Emergency Management initiates long-term response and reunification.
Each phase is designed to align tactical, medical, and command priorities, and the Chaos Phase is the most critical. It is during these first moments that Direct Threat Care must begin, and Medical Rescue Teams (MRTs) must be positioned for immediate deployment—not staged blocks away, waiting for permission.
The Chaos Phase: Defined
The Chaos Phase begins the moment the attack starts and continues until the shooter is neutralized or contained. It is characterized by:
Rapid tactical movement toward the threat
High casualty potential in confined spaces
Disorientation across agencies and victims
A critical window for hemorrhage control
Command disorganization—unless planned in advance
The mission during the Chaos Phase is twofold:
Immediate threat neutralization by law enforcement.
Rapid establishment of a Tactical Command Post (TCP) and early MRT staging for medical entry.
Traditional models wait until the scene is clear before EMS and Fire moves in. The CSR model says: bring care to the casualty as soon as it's tactically feasible.
The Role of Law Enforcement: Neutralize and Prepare
In the CSR Chaos Phase, law enforcement’s primary mission remains unchanged: neutralize the threat. However, the way they approach this objective now includes early coordination with MRTs and support for future medical access.
Key law enforcement responsibilities include:
Move to contact and stop the killing as quickly as possible.
Establish the Tactical Command Post (TCP) within proximity to the structure or venue.
Begin identifying safe corridors or suppressive fire zones that can support MRT movement.
Assign officers to support force protection for future casualty collection points (CCPs).
Establish initial Unified Command with fire and EMS at the TCP—not as an afterthought, but as a planned, parallel mission.
This dual focus ensures that medical doesn’t have to wait until the scene is 100% secure. Security and survivability are pursued at the same time.
The Role of Medical Rescue Teams (MRTs): Ready on Arrival
In legacy models, EMS and fire stage far from the threat, waiting for clearance. In the CSR model, MRTs are pre-designated teams trained to function within the warm zone, and under certain conditions, the hot zone itself.
MRTs are not traditional medics. They are tactically aware, medically trained, and equipped to deliver point-of-injury trauma care under Direct Threat Care protocols.
During the Chaos Phase, MRTs:
Stage at the TCP, not outside the perimeter.
Coordinate with law enforcement for situational updates.
Prepare for deployment the moment a viable corridor is established.
Receive specific assignments from Unified Command: casualty location, CCP support, or hallway triage.
Deploy with hemorrhage control kits, airway supplies, and comms gear.
This positioning allows them to enter within seconds of a suppression signal, not minutes after a scene declaration.
Direct Threat Care: Life-Saving in Real Time
The Chaos Phase is the domain of Direct Threat Care (DTC)—trauma care delivered while a potential threat remains. This differs from Deliberate or Indirect Threat Care, which occurs in more stable environments.
Under DTC protocols, MRTs are trained to:
Control massive hemorrhage using tourniquets, hemostatic agents, and pressure bandages.
Manage airways using basic and advanced tools (e.g., NPAs, BVMs, iGel devices).
Perform rapid casualty movement using drags, carries, or litters.
Triage under fire, identifying who can be moved, treated, or marked for later extraction.
These interventions are not long or complicated—they are measured in seconds. But in those seconds, lives are saved.
The Tactical Command Post (TCP): The Nerve Center
One of the defining elements of the CSR Chaos Phase is the early establishment of the Tactical Command Post. This is where:
Law enforcement leadership
Fire command
EMS supervisors
Emergency Management representatives
…converge in real-time operational unification.
From the TCP:
Tactical and medical elements receive updated threat intel.
MRTs get the green light for warm zone movement.
Casualty flow planning begins before the threat ends.
Unified Command is born—not as a theoretical ICS concept, but as a functional, live-action element.
The TCP is not an after-action location. It is the nerve center that brings all disciplines together while the event is still unfolding.
Eliminating the Legacy Lag
Too often in after-action reports, we see the same phrase:
“Medical entry was delayed due to scene safety concerns.”
Translated: we followed outdated doctrine and it cost lives.
The Chaos Phase in CSR eliminates this lag by:
Defining MRTs as early-entry units, not late responders.
Staging MRTs in proximity, not across the street.
Assigning law enforcement escort and support, not waiting for full clearance.
Equipping medics with the tools and mindset to act early, not after.
In the world of trauma, delay equals death. CSR erases that delay with a deliberate and trained integration of tactical and medical response.
Real-World Application: The Scenario
An active shooter opens fire in a school hallway. Officers arrive in 3 minutes. Within 2 minutes, they’ve neutralized the threat.
In the traditional model:
EMS is staged a quarter-mile away.
Medics wait 20 more minutes for scene clearance.
Multiple victims die from treatable hemorrhage.
In the CSR model:
MRTs are staged at the TCP from the start.
Law enforcement communicates secure corridors as they move.
MRTs deploy into hot and warm zones within 30–60 seconds of the takedown.
Victims receive tourniquets, airway management, and are moved to CCPs.
EMS and Fire begins transport as law enforcement continues clearing.
The difference? Lives saved because of speed, coordination, and integrated execution.
Conclusion: Chaos is Inevitable—Disorganization is Not
The Chaos Phase is by definition unpredictable. But how we prepare for it, how we respond to it, and how we embed medical into that chaos is fully within our control.
The CSR model gives us a new standard. It brings clarity to the confusion. It defines what law enforcement, MRTs, and command need to do within the first five to ten minutes, not after.
By adopting the CSR Chaos Phase approach, agencies shift from reactive silos to proactive integration. They empower MRTs to do what they’re trained for. They give victims a fighting chance.
In the fight for life, we don’t have time to wait. We need to move forward together, with purpose and precision. And it starts in the Chaos Phase.
