Issues Including No Unified Command Delayed EMS Response to Uvalde Shooting

Law enforcement’s well-documented failure to confront the shooter who terrorized young students and teachers in Robb Elementary in Uvalde for 77 minutes wasn't the only snafu that day.

Emergency medical care was delayed due to a number of issues including the lack of unified command and roads clogged by police cruisers among others, according to a joint investigation by ProPublica, The Texas Tribune and The Washington Post.

"The disjointed medical response frustrated medics while delaying efforts to get ambulances, air transport and other emergency services to victims. Medical helicopters with critical supplies of blood tried to land at the school, but an unidentified fire department official told them to wait at an airport three miles away, according to the ProPublica. 

“We as a nation are not ready,” said Dr. Babak Sarani, the director of critical care at George Washington University Hospital. “The air assets and the ground assets do not talk to each other very well. The fire, the police do not talk to each other very well.”

Experts said that the Uvalde shooting response appeared to lack both an overall incident commander and someone clearly in charge of coordinating the emergency medical response.

Although helicopters were available, none were used to carry victims directly from the school. At least four patients who survived were flown by helicopter to a more fully equipped trauma center in San Antonio after first being driven by ambulance to a nearby hospital or airport.

Multiple cameras worn by officers and one on the dashboard of a police car showed just two ambulances positioned outside the school when the shooter was killed. That was not nearly enough for the 10 or more gunshot victims then still alive, though additional ambulances began arriving 10 minutes later, the newly released documents show.

Uvalde EMS radio traffic (12:58 p.m.) “10-4 we are [inaudible] at Grove Street and Grove Street is blocked off by law enforcement.”

One minute later, six students, including one who was seriously wounded, were taken to a hospital in a school bus with no trained medics on board, according to the Texas EMS records.

The bus driver handed the officers, at their request, a first aid kit that contained band aids. Frantic parents were trying to get onto the bus to see if their children were there.

Locked police cars parked throughout the area forced medics to frantically try various routes to the school, crisscrossing through residents’ yards. Thirty-three minutes after police killed the gunman, an ambulance struggled to access the school via South Grove Street, documents show.

In public statements made since May, law enforcement officials have defended their officers’ actions as reasonable under difficult circumstances. Federal, state and local agencies that responded to the shooting have not directly addressed the medical response, nor did they answer detailed questions from the news organizations that worked jointly on this investigation.

Jacklyn “Jackie” Cazares, 9, likely survived for more than an hour after being shot and was promptly placed in an ambulance after medics finally gained access to her classroom. She died on the way to the hospital, the reporters learned.

“We as a nation are not ready,” said Dr. Babak Sarani, the director of critical care at George Washington University Hospital. “The air assets and the ground assets do not talk to each other very well. The fire, the police do not talk to each other very well.”

Experts said that the Uvalde shooting response appeared to lack both an overall incident commander and someone clearly in charge of coordinating the emergency medical response.

The rural community’s emergency medical services are contracted out to private companies. On that day in May, Stephen Stephens, the director of Uvalde EMS, was in charge of organizing helicopters and ambulances responding to Robb Elementary, he later told investigators.

“My job was to manage assets,” he said, noting that Juan Martinez, his deputy, instructed medics arriving at the scene.

After police breached the classrooms where the shooter had been holed up, Stephens said he handed command over to the fire chief of neighboring Medina County. The Medina fire chief declined to comment to the news organizations.

It’s unclear what information Stephens had about how many victims first responders should expect to find. Multiple medics expressed confusion over who was in charge of the medical response and where to go, according to the report.

“There was no EMS command and control,” said Julio Perez, a medic for AirLIFE, who told investigators he was pleading to help. “Nobody could tell me anything.”

His account was backed up by Lewis, the manager for the air transport service, who said several of her medics were upset. “They feel like the resources weren’t used as they should have been.”