What ATP Flow Means
In the context of an Active Shooter/Mass Casualty Incident (AS/MCI), ATP Flow refers to the pipeline that moves victims from the crisis site to definitive care:
Access
Gain access to the victims. Law enforcement secures corridors, rooms, and casualty collection points. Fire/EMS or Rescue Task Force personnel are moved into the warm zone. The goal is to reach patients as quickly as possible.
Treat
Perform immediate lifesaving interventions — massive hemorrhage control, airway management, treatment of chest wounds, rapid triage.
Package / Transport
Package victims for movement. Move casualties to CCPs. Transfer patients to ambulances or higher levels of care. Begin evacuation to hospitals.
The Danger of "Parking Patients"
One of the biggest mistakes during a mass casualty incident is allowing patients to accumulate at a CCP while responders focus on treatment.
The objective is: Stabilize → Move → Save — not Stabilize → Wait → Save.
Throughput Saves Lives
Think of ATP Flow as a pipeline. When the pipeline is moving:
- —Victims are continuously evacuated
- —Ambulances continuously load and depart
- —CCPs remain open and functional
- —Treatment resources are available for new casualties
When the pipeline slows, CCPs become congested, ambulances become overwhelmed, and mortality increases.
Law Enforcement and Fire/EMS — Both Required
Law Enforcement
- —Creates access
- —Maintains secure corridors
- —Conducts casualty movement
- —Supports extraction operations
Fire / EMS
- —Performs lifesaving treatment
- —Conducts triage
- —Packages patients
- —Coordinates transport
Neither can accomplish ATP Flow alone.
The Modern Mission
The mission is no longer complete when the shooting stops. The mission is complete when victims are reached, treated, moved, transported, and reach definitive care.
The agencies that create the fastest ATP Flow consistently create the greatest opportunity for survival.